Innovative Procedure Minimizes Potential Prostate Cancer Radiation Side Effects

January 15, 2021
Rose McNulty

Florida Cancer Specialists has integrated SpaceOAR Hydrogel into its armamentarium as a pre-treatment for radiation therapy in prostate cancer patients.

Florida Cancer Specialists (FCS), the largest independent medical oncology and hematology practice in the United States, now offers an innovative procedure called SpaceOAR Hydrogel for patients set to undergo radiation therapy for prostate cancer.

Radiation therapy is an effective treatment option for many cancer patients, but one limiting side effect is the potential for radiation to cause unintended damage to surrounding healthy tissues. In prostate cancer, there is a risk of damage to the rectum when patients undergo radiation therapy, but the innovative pretreatment spacer can help mitigate that risk.

To create space between the prostate and the rectum, the hydrogel is implanted in an outpatient procedure before the start of a radiation therapy regimen. It provides an additional half inch of separation between the rectum and prostate to protect the former from exposure to radiation, which can lead to bowel issues.

“In the past, we used to treat patients with 8 to 9 weeks of radiation, but that's very inconvenient, and the newer data show that these patients can be treated in shorter periods of time,” Luis Carrascosa, MD, a radiation oncologist at the the FCS Ocala Cancer Center, told The American Journal of Managed Care® in an interview. “But naturally, when you are treating them for a shorter period of time, you're giving more dose every day, so there is more risk to the rectum if you don't take the appropriate measures.”

Artificially creating the space necessary to protect the rectum from radiation has allowed a drastic reduction in treatment length in some cases, cutting the timeline from 9 weeks to just 4 weeks. This means patients can receive appropriate treatment for their cancer on a more convenient schedule and saving on costs.

Inserting the gel is an invasive procedure, but one that adds minimal time to the pretreatment timeline. And while the most common side effects are pain, bleeding, or infection, they occur very rarely, Carrascosa said. The procedure is done under ultrasound guidance, so the practitioner can visualize what they are doing.

Hydrogel’s integration into the prostate cancer treatments offered at FCS comes at a time when shorter treatments are becoming the standard of care for prostate cancer, Carrascosa said. It is the first and only FDA-cleared spacer for reducing the radiation dose delivered to the rectum.

“For now, for early-stage prostate cancer, the preferred approach is to do these short treatment schedules. So no longer should patients only be given the option of 9 weeks of radiation,” he said. “There are still going to be advanced cases or high-risk cases that may be 9 weeks, but for early-stage cases, the preferred approach nowadays is a shortened scale of radiation.”