Dr Reena Davda describes SpaceOAR® as “an excellent method to reduce the radiation dose delivered to the rectum in men undergoing prostate radiotherapy, as such reducing the risk of bowel side effects.”
While radiotherapy is effective in destroying cancerous cells, the delivery of high-energy X-rays, can pose a risk to adjacent healthy tissue. This includes the rectum which is just behind the prostate.
Even with the most precise form of radiotherapy planning and delivery, there remains a small risk of damage to the rectum which may cause symptoms such as rectal discomfort, urgency to pass bowel motions, or associated blood or mucus.
(Please note that due to SpaceOAR requiring expert planning, knowledge and use of our in-house advanced MRI imaging, SpaceOAR is only available as part of a course of radiotherapy at The London Clinic).
SpaceOAR® is a safe high-tech hydrogel that is injected into the space between the prostate and the rectum prior to radiotherapy planning scans and treatment.
The gel increases the space between the prostate gland and the rectum, moving the rectum further away from the high dose required to treat the prostate.
This reduces the risk of developing bowel side effects which in some cases if severe, may remain long term and require further interventions or treatments.
A patient's experience
One of Dr Davda’s patients, Paul Robinson, was diagnosed with an aggressive prostate cancer and treated using the new SpaceOAR® technique. He has generously agreed to share his story in a case study.
How were you diagnosed with prostate cancer?
I was going to the GP for a separate issue, but the doctor noticed from my records I’d previously had a test which showed my PSA to be slightly raised, so he sent me for a biopsy and a scan which showed that I had an aggressive prostate cancer.
They immediately put me on to hormone therapy tablets and explained my treatment options; radiotherapy; brachytherapy; or surgery.
I didn’t fancy anything at first, because of the complications involved and the risk of incontinence. However, Reena (Dr Davda) was recommended to me so I went to see her and when I expressed my fears she told me about SpaceOAR®. She gave me so much confidence I decided to go ahead and have the treatment.
What did the insertion of the SpaceOAR gel feel like?
It was effortless, I didn’t even know I’d had it done. I’d had a sedative and it was no problem at all, it just didn’t affect me. That evening I stayed in London (as I live in Newcastle) and went out with my son and daughter for a meal and a couple of drinks and had a lovely evening.
How was the radiotherapy?
I returned to The London Clinic and started the radiotherapy treatment, five days each week for eight weeks.
Having the treatment does involve timing it correctly so that your bladder has the right amount in it, sometimes it wasn’t ready, sometimes it was too much. But the staff there from the receptionist, to the radiographer, were just marvellous and explained everything very clearly.
I got a bit loose in my bowels once and I didn’t say anything at first but when I did speak to one of the nurses, (who told me off for not saying anything sooner) she gave me a couple of tablets just to settle that down.
What side effects did you experience during the radiotherapy?
Not many – I was a bit more urgent to urinate and after I’d had the radiotherapy with a full bladder it took a couple of hours for me to get the bladder back to normal. I knew where all the toilets were in London! But I didn’t have any pain or major discomfort.
Since having the treatment I’ve found I’m quite urgent to go when I need to urinate, it’s not so bad though. The other thing I’ve found is that my bowels are little bit more active in the morning.
How do you feel now?
I feel fine, I get quite a lot more wind and in the mornings and as I say, I’m quite urgent to go to the loo, but I’m not incontinent – which had been my fear. I’m not feeling tired, I work most days and I’m active all the time.
Do you think being active helps?
Yes because I don’t have time to think about anything – like whether it will come back.
What is your plan for follow-up tests?
My white cells were down but Reena checked on that with haematology and they said it’s nothing to worry about, they do go down because of the radiotherapy but they are back to normal again now.
The SpaceOAR® treatment was definitely the right option for me as it greatly reduced the risk of incontinence, whilst still enabling me to have the radiotherapy I needed to destroy the cancer.
I feel very positive about the future and think myself lucky I was able to go to the Clinic and be treated by Reena and all the staff who were so caring.
The London Clinic is proud to be the first UK hospital to introduce SpaceOAR®. We therefore have several years of experience of gel insertion, imaging and radiotherapy delivery using a combination of SpaceOAR with latest radiotherapy technology.
SpaceOAR is clinically proven to be safe, non-invasive and effective in reducing radiation to the rectum during radiotherapy.
Any views expressed in this article are those of the featured specialist(s) and should not be considered to be the views or official policy of The London Clinic.