What is SpaceOAR® Hydrogel?
SpaceOAR® Hydrogel is an FDA-cleared medical device. It temporarily separates the prostate from the rectum during radiation therapy for prostate cancer. The name “SpaceOAR” has a meaning: “OAR” stands for “Organ at Risk,” referring to the rectum, which can be exposed to radiation during treatment.
The hydrogel is made primarily of water and polyethylene glycol (PEG), a gel commonly used in other medical products. When the two liquid components are combined, they form a soft, gel-like substance that acts as a spacer. This spacing gel pushes the healthy tissue of the rectal wall away from the prostate by an average of 0.5 inches, creating an essential protective buffer zone.
The hydrogel remains entirely in place during your radiation treatment course for about three months. The body gradually absorbs it over approximately six months, so it doesn’t require a removal procedure.
Who is SpaceOAR® Hydrogel for?
Have you or a loved one been diagnosed with prostate cancer? Is radiation therapy part of your or their treatment plan? If so, you or your loved one probably has concerns about the potential side effects of that radiation. This is natural. Radiation therapy is highly effective for treating prostate cancer, but because the rectum sits right next to the prostate, it can sometimes be affected by radiation exposure.
SpaceOAR® Hydrogel is specifically designed for men with prostate cancer who have chosen the treatment option of radiation therapy (radiotherapy). It’s particularly beneficial for patients receiving external beam radiation therapy, intensity-modulated radiation therapy (IMRT), or stereotactic body radiation therapy (SBRT).
While not every prostate cancer patient will require SpaceOAR® Hydrogel, it can be beneficial for men whose conditions might make radiation treatment more challenging. More than 50,000 patients worldwide have been treated with SpaceOAR® Hydrogel, available at many cancer centers across the United States.
If you’re considering radiation therapy for prostate cancer, discussing SpaceOAR® Hydrogel with our urologist and radiation oncologist can help determine if it’s appropriate for your specific situation.
How is SpaceOAR® Hydrogel inserted?
The SpaceOAR® Hydrogel procedure is minimally invasive. It is typically performed as an outpatient in a hospital, surgery center, doctor’s office, or outpatient clinic. It takes an average of about 30 minutes to complete.
Here’s what to expect:
- You’ll receive anesthesia – either local anesthesia to numb the area, general anesthesia, or monitored anesthesia care (MAC).
- Using ultrasound guidance for precision, your doctor will insert a needle through the skin between the rectum and prostate (transperineally).
- The two liquid components of SpaceOAR® Hydrogel are injected through this needle and combined to form the soft gel spacer.
- The gel immediately creates space between your prostate and rectum.
After the procedure, there’s typically a one-week waiting period before starting radiation treatment. This waiting period allows your anatomy to settle. Physicians rate the procedure as “easy” or “very easy” 98.7% of the time, and the placement is 99% successful.
What are the benefits of SpaceOAR® Hydrogel?
Clinical studies have demonstrated several significant benefits of using SpaceOAR® Hydrogel during prostate cancer radiation therapy.
Reduced radiation dose to the rectum
By pushing the rectum away from the prostate, SpaceOAR® Hydrogel significantly reduces the radiation that reaches the rectum. This may help minimize the side effects of treatment.
Fewer bowel complications
At three years after treatment, patients with SpaceOAR® Hydrogel experienced 75% less rectal toxicity (grade 1) compared to those without the spacer. This means fewer issues with bowel function, including less rectal pain, bleeding, and urgency.
Better preservation of sexual function
Men who had SpaceOAR® Hydrogel and had sufficient erectile function before treatment were 67% more likely to maintain their sexual function at three years post-treatment compared to those without the spacer.
Fewer urinary complications
The use of SpaceOAR® Hydrogel reduced the likelihood of serious changes in urinary quality of life by 60%. This means fewer problems with urinary urgency, frequency, and leakage.
Improved quality of life
Overall, during follow-up, our SpaceOAR® Hydrogel patients reported better quality of life scores for bowel, urinary, and sexual function than those who didn’t.
Additional treatment benefits
SpaceOAR® Hydrogel also helps stabilize the prostate during treatment sessions. This decreases prostate motion caused by bladder filling and rectal gas. The reduced movement can help improve the precision of radiation delivery.
What are the side effects of SpaceOAR® Hydrogel?
Like any medical procedure, SpaceOAR® Hydrogel carries some risks. However, clinical trials have shown it to be generally well-tolerated. Potential complications may include:
- Pain or discomfort during or after the procedure
- Site inflammation
- Infection (though rare)
- Temporary urinary issues (urgency, urinary retention)
- Constipation or rectal muscle spasm
- Bleeding (rare)
More serious but extremely rare complications could include damage to surrounding tissues, allergic reactions, or blood vessel blockage. Notably, in clinical studies, no device-related adverse events, rectal perforations, severe bleeding, or infections were reported.
Before proceeding with SpaceOAR® Hydrogel, our urologist will thoroughly discuss these potential risks and help you determine if the benefits outweigh the risks for your situation.
Is SpaceOAR® Hydrogel right for you?
If you’re facing prostate cancer radiation therapy, SpaceOAR® Hydrogel might be an essential addition to your treatment plan. This temporary spacer has been clinically shown to reduce radiation side effects and help preserve the quality of life during and after treatment.
To determine if SpaceOAR® Hydrogel is appropriate, we urge you to speak with Tower Urology’s healthcare team about your diagnosis, treatment plan, and insurance coverage. Many Medicare plans and private insurers now cover SpaceOAR® Hydrogel when medically necessary.
Remember, every prostate cancer journey is unique, and adding SpaceOAR® Hydrogel to your radiation therapy treatment could help protect your quality of life both during and after treatment.
Why is Tower Urology the best choice for using SpaceOAR® Hydrogel to Protect your body during prostate cancer radiation therapy?
Tower Urology’s board-certified urological team has been a leader in effectively treating cancer needs for over two decades. Our specialists are trained in all aspects of cancer diagnosis and treatment.
Tower Urology is a proud affiliate of Cedars-Sinai Medical Center, ranked #1 in California and #2 nationwide by U.S. News & World Report. This partnership reflects our dedication to delivering the highest standard of urologic care alongside the best urologists in Los Angeles. Our years of experience and access to Cedars-Sinai’s world-class facilities ensure that our exceptional and innovative urological care positions Tower Urology as a leader in Southern California.
We invite you to establish a care plan with Tower Urology.
Tower Urology’s health care professionals are conveniently located for patients throughout Southern California and the Los Angeles area, including Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, and Downtown Los Angeles.
Our services include treatment for testicular cancer, prostate cancer, bladder cancer, kidney cancer, and cancer fertility management.
SpaceOar® Hydrogel FAQs
Approximately three months before it dissolves.
SpaceOAR Hydrogel is specifically designed and FDA-approved only for use in prostate cancer radiation therapy.
The SpaceOAR Hydrogel insertion is a minimally invasive outpatient procedure that typically takes about 30 minutes to complete. However, the procedure has three phases: before insertion, during insertion, and after insertion. Here’s what you can expect during each phase:
Before the procedure
You’ll need to prepare by:
- Taking prescribed antibiotics starting the day before your procedure and continuing for three days.
- You may need to perform an enema on the morning of the procedure if you don’t have a bowel movement.
- Temporarily stop blood-thinning medications (with approval from your prescribing doctor).
- Taking prescribed medications for anxiety and pain about one hour before the procedure/
- Have someone drive you home from the appointment due to the medications.
During the procedure
- You’ll lie on your back with your feet in stirrups, similar to the position for a prostate biopsy.
- The procedure can be performed under local anesthesia that numbs the injection area or general anesthesia that puts you to sleep,
- Then, a transrectal ultrasound (TRUS) probe will be inserted into your rectum to provide visual guidance throughout the procedure. Our doctor will then carefully insert a needle through your perineum (the area between the scrotum and anus). Your doctor will inject the gel through the needle as a liquid, using a smooth, continuous technique.
After the procedure
Most patients report minimal discomfort during and after the procedure. You may experience:
- Some temporary discomfort at the injection site.
- Mild pain and numbness behind the scrotum.
- Some urgency to urinate and reduced strength of urine stream.
- These symptoms typically improve over the first few days, and most patients can resume normal activities shortly after the gel is implanted.
Most of our patients return to normal activities after the procedure, but there are a few guidelines we will ask you to follow for two to seven days. These include:
- Avoid strenuous activity or heavy lifting.
- Avoid jogging, bicycle riding, cutting grass, and raking leaves.
- Avoid sex for one week after the procedure.
- And avoid rough contact in the perineal area (where the injection was administered).
Yes! Medicare covers SpaceOAR Hydrogel procedure when it is deemed medically necessary.
Sources
What is SpaceOAR Hydrogel?
https://www.spaceoar.co.uk/home.html
SpaceOAR® Hydrogel for Prostate Cancer Treatment
https://www.marywashingtonhealthcare.com/our-services/cancer-care/advanced-cancer-treatments/spaceoar-treatment-for-prostate-cancer/
U.S. Pivotal Trial – SpaceOAR Hydrogel
https://www.bostonscientific.com/en-US/medical-specialties/urology/prostate-health/prostate-cancer/spaceoar-hydrogel/clinical-results/pivotal-trial.html
How Much Does SpaceOAR Cost | Insurance Coverage Status
https://www.spaceoar.com/about-spaceoar-hydrogel/patient-insurance-coverage/
SpaceOAR Hydrogel Reduces Side Effects of Prostate Cancer
https://www.foxchase.org/healthcare-professionals/physician-enewsletters/updates-urologic-oncology/summer-2019/spaceoar-hydrogel-reduces-side-effects-prostate-cancer-radiation-therapy
How SpaceOAR Hydrogel works
https://www.bostonscientific.com/en-US/medical-specialties/urology/prostate-health/prostate-cancer/spaceoar-hydrogel/product-and-procedure.html
SpaceOAR™ Hydrogel Clinical Trial | FDA Cleared
https://www.spaceoar.com/about-spaceoar-hydrogel/clinically-shown-results/
Hydrogel Spacer Prospective Multicenter Randomized Controlled Pivotal Trial: Dosimetric and Clinical Effects of Perirectal Spacer Application in Men Undergoing Prostate Image Guided Intensity Modulated Radiation Therapy
https://pubmed.ncbi.nlm.nih.gov/26054865/
