Space OAR

The SpaceOAR is to protect the surrounding tissues from radiation damage. In some cases where there is Extra Capsular Extension (ECE) extending into the abdominal wall, this may not be an option. So I think it is a good sign that your dr has opted for the use of spaceOAR with IMRT. And I would assume there are no mets in your case that would call for systemic treatment like zytiga - that again is a good sign that your PCa is localized. What is your gleason score and has your dr done the PSMA PET scan, mpMRI etc to further evaluate it before firming up the treatment

I am no expert on this - just picking up as much knowledge as I can to better understand my treatment options for a 4+3 gleason, 9 out of 14 presenting PCa. PSMA PET showed ECE. And there were signs of tracer uptake at the shoulder and 2 ribs - which I thought were from old injuries - but my Dr did not want to leave anything to chance so on top of Casodex + Lupron, he added Zytiga + Prednisone to my ADT regimen. next mpMRI is scheduled for April at which time he will assess (based on how well my PCa has responded) on whether to use Brachy + EBRT with spaceOAR

I wish you all the very best.

Cheers and happy New Year.

Tom

Sorry to hear about your T3b. Looks like our time-lines and to some extent the Diagnosis are similar except for the slight uptake in ribs and left shoulder. I had dislocated that shoulder from skiing around 2006. And I have had rib injuries from my soccer days. So I hope those are false positives for Mets. I would have expected it to show up in the lymph nodes first before managing to show up that far. But what do I know. Did my biopsy on 9/24 - was really upset that the results Sat on my Uro desk till 10/6, which led to cascading delays on subsequent scans, MRIs etc - I promptly changed to my current Uro who I am very happy with. He had scheduled me for RALP on 11/18 but advised against it upon the ECE findings. He and my Radiation Dr explained to me that with ECE a complete resection may not be possible and SRT after RP could lead to more complications with surrounding tissue damage due to lack of good target to direct the beams to. ADT was my best starting option. Started a 4 weeks Casodex Rx on 11/15. Then had my 1st Lupron (6 monthly x 4) injection on 11/26. Upon completion of Casodex on 12/12 they got me started on zytiga (abiretaron) 4 × 250 mg + 5 MG prednisone for 2 years

PSA on 12/1 lowered to 2.8 from 4.8

Major side effects for me are hot flashes. I get completely soaked in sweat in my sleep. sometimes constipation and occasional headaches.

I keep up with my regular exercises- hiking with weights in both hands, a full turn around in diet to vegetarian + fish for omega 3s, lots of lycophene rich foods - cooked tomatoes, papayas, pomegranates, purple cabbage kraut and nuts. Lots of turmeric with pepper and olive oil for better bioavailabilty of curcumin. Cut out fats and starch. I can feel the impact from this in lowered inflammation. My knuckles used to be inflamed and sore - now so much better. I take psyllium every morning to maintain regularity. While I have no clue what the disease is doing internally, I am feeling so much better. Had to make at least one pit stop on my 5 mile hike. Now I can do the full hike with no pit stops even after 4 cups of warm water. I wonder why I waited till this Dx to move to this healthy lifestyle change.

I thought of Lazarus and the rich man bible story. Rich man pleads for just a drop of water to quench his thirst from the hellish setting. God tells him that is not possible given the big divide. Then he pleads to God to at least send someone to warn his offspring and God says they have prophets and clergy to guide them and if they don't believe them, there is no chance they would believe in angels or someone coming from the dead to warn them.

My primary care had cautioned me that life style changes are known to help but I did not believe until this Dx. Actually even before the Dx the discomfort I felt in the groin area had propelled me to an anti-inflammatory diet. So overall I see a blessing In disguise through all this. To me it is a journey, one that I have fully embraced with no anguish or desperation of getting to a destination. However it unfolds, my role will be to put up the best possible fight.

I wish you the very best and full recovery from your treatment.

Best regards

Hi Agent,

Unfortunately you haven't received a comment from a survivor who has used space oar. I had IMRT in 2006 but the use of such "protection" wasn't popular or easily available at the time. In this forum there were reports about the benefits but also comments on nasty events, particularly due to unproper application/injection of the gel.

In such regard I would advise you to be certain that the doctors doing the procedure are highly experienced. I also would discuss with the radiotherapist about the details of the field of attack and isodose planning as it seems that RT with the use of space oar is programme for higher doses in those protected areas. Surely the outcome would not be favorable if the gel weren't able or properly set as intended.

In my case, RT caused proctitis and cystitis (scared tissues) in the colon leading to diverticulitis. It doesn't affect me much but if it was today I would try getting as much protection as possible.

Best wishes for a successful outcome.

VG

Glad to read about your most recent experiences. The IMRT session should be(come) equally routine after the first few.