SpaceOAR® Hydrogel

By: Carl Berkowitz, TCCC Volunteer

The prostate is a small organ located underneath the bladder and in front of the rectum in men that produces seminal fluid. It is also the site of one of the most common cancers among men. Approximately 160,000 men will be diagnosed with prostate cancer in the United States in a year, and 30,000 men will unfortunately succumb to their disease. The good news is that many cases of prostate cancer are curable if caught early.

One common treatment option is ‘external beam radiation therapy’ (EBRT), in which beams of radiation are focused on the prostate gland and surrounding areas from outside the body. While already effective and reasonably well tolerated, a relatively new technology has increased the safety of EBRT and can decrease long-term side effects.

Tri-Cities Cancer Center radiation oncologist Dr. Juno Choe says, “If I was going to have external beam radiation therapy for my prostate, I’d want to have the SpaceOAR gel placed prior to radiation”. He described SpaceOAR as a relatively new technology that physically separates the rectum and prostate gland during radiation therapy. This results in significantly lower radiation doses along the rectum, and this results in a decrease in associated side effects.

Images showing spacing between prostate and rectum with SpaceOAR gel. From

Results from a multi-clinic, randomized study of 222 men concluded the SpaceOAR technique was “…associated with low toxicity rates and a reduction in patients experiencing declines in bowel and urinary quality of life.” In fact, patients who received the SpaceOAR hydrogel product had declines in bowel, urinary, and sexual quality of life at a rate that were one-eighth of the amount in the control group. To which Dr. Choe notes that “Anybody getting external beam radiation should strongly consider the SpaceOAR hydrogel product as a supplement to their treatment.”

TCCC has all of the special equipment needed for this procedure. SpaceOAR can be inserted under local anesthesia, and it takes about 20 minutes to place. “We’ve found the gel insertion procedure to be relatively straightforward and painless” Dr. Choe says, and that the worse part of the procedure for his patients is a pinprick sensation that lasts for a couple of seconds as a numbing agent is injected. His patients then describe a short-lived sensation of pressure in the rectum as the gel is inserted which he explains “…results from a gentle pressure on the rectum. Our patients say this sensation of pressure usually dissipates almost immediately but may last a couple of days.”

Dr. Choe notes that “we’ve done a number of SpaceOAR insertions at the Center, and we have been pleased with both the relative ease of the insertion procedure and the separation achieved between the prostate gland and rectum. Patients have been very  happy with their radiation treatments with the use of the SpaceOAR hydrogel, and we have seen a very favorable side effect profile afterwards. ”

1 Int J Radiation Oncol Biol Phys, Vol. 92, No. 5, pp. 971 – 977, 2015

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