Birmingham St. Vincent's Hospital is the first in the state to offer the SpaceOAR® System, a new, less invasive treatment for prostate cancer that offers a higher cure rate and fewer side effects than traditional therapies.
According to the American Cancer Society, prostate cancer is the second-most common cancer in American men and is the second leading cause of cancer-related death in the United States. One of the most common treatment options for the disease is radiation therapy which uses high-energy particles to kill cancer cells. Treatments include external beam radiation therapy, proton beam therapy, and brachytherapy.
In up to 85 percent of cases, the tumors form in the lower part of the prostate next to the rectal wall. If the rectum is in the radiation line-of-fire, it can sustain significant damage, resulting in bowel complications, bleeding and pain. These side effects can be temporary or last for years.
To help avoid radiation damage, the space between the prostate and rectum can be increased with an absorbable gel spacer. Approved by the FDA in 2015, SpaceOAR (OAR stands for "organ at risk") is a soft gel-like material that temporarily pushes the rectum away from the high-dose radiation area. It is the only prostate cancer spacing device to receive FDA clearance.
"We insert the hydrogel liquid through a small needle into the space between the prostate and the rectal wall while the patient is under local or general anesthesia. We use ultrasound imaging to place the hydrogel in the proper location," says Susan Salter, MD, a radiation oncologist at St. Vincent's Birmingham. "The liquid becomes a gel and forms a cushion to protect the rectal area from the radiation. By separating the prostate from the rectum, Space OAR System reduces the radiation dose to the rectum and may eliminate or reduce complications from the procedure."
The 30-minute procedure is typically performed in a hospital, surgery center of doctor's office and is inserted during the same procedure where small gold markers are placed in the prostate to track its movement during radiation treatment.
Susan Salter, MD (right) with prostate cancer patient Richard Hydinger
After injection, SpaceOAR hydrogel remains as a soft gel separating the prostate from the rectum for about three months while the patient undergoes radiation therapy. Once the patient's radiation therapy is complete, the hydrogel gradually liquifies and is naturally absorbed by the body.
SpaceOAR is the only rectum-sparing hydrogel available in the U.S. and abroad and can be used with all radiation modalities. Similar hydrogels are approved in Europe and the U.S. for use on some of the most sensitive tissues in the body. In clinical trials, SpaceOAR System patients reduced their rectal radiation by 73 percent which reduced rectal pain and resulted in a 71 percent reduction in long-term rectal complications.
Salter says the goal of radiation therapy is to maximize radiation to the tumor while avoiding or minimizing radiation to surrounding normal tissue. "We don't have long-term results yet, but our patients have tolerated the procedure well and have not experienced discomfort," she says. "Clinical trials in the United States have found the SpaceOAR System to be safe with no device-related adverse events."
The St. Vincent's staff is enthusiastic to offer this new technology. "It speaks to the focus of our Birmingham St. Vincent's cancer center on the latest technology for our patients," says Lauren Thomason of St. Vincent's Marketing. "This is huge for prostate patients in Alabama who may not have had the option in the past."