High risk prostate fractionation

[Barcelona PSG]

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Im right there with you and notice I didn't say the long term complications or severe things are less. Need more time to know that and I bet even with Barigel, they are not entirely trivial which is why I am still selective in who gets any spacer.

What I can say for sure though is that they are night and day less bothersome shortly after they are put in. Most people say that can't feel them or barely feel them after about 24 hours. That was categorically not my experience with spaceOAR. That honestly felt like a solution that was worse than the initial problem most of the time IMO. Even when well placed and no rectal infiltration, a lot of people were still very bothered by them. Based on that alone, Im through with SpaceOAR.

This is a Bioprotect balloon spacer. I dont like spacers in general, but I do for select cases like inflammatory bowel disease, irritable bowel syndrome and for reirradiation. The balloon-based spacer is very easy to place and provides good symmetry, and the best part is the reproducibility for each case. I have done about 30 of these cases so far and had one patient with a large 130cc prostate needing Flomax, but no other complications.
It doesn't bother people either.

PS: I dont have any conflicts of interest with the Bioprotect company.

 

[theradiator]

Another big thanks to our 'leaders'. Check out this video from 46:00 to 48:00 for a nice discussion of rectal spacers where the British and Canadians are literally laughing at us due to our indiscriminate and perceived financially motivated use of SpaceOAR.

 

[Gfunk6]

Another big thanks to our 'leaders'. Check out this video from 46:00 to 48:00 for a nice discussion of rectal spacers where the British and Canadians are literally laughing at us due to our indiscriminate and perceived financially motivated use of SpaceOAR.

"He told me to **** off."

Real high quality discussion there.

"

 

[ramsesthenice]

View attachment 409157View attachment 409156
This is a Bioprotect balloon spacer. I dont like spacers in general, but I do for select cases like inflammatory bowel disease, irritable bowel syndrome and for reirradiation. The balloon-based spacer is very easy to place and provides good symmetry, and the best part is the reproducibility for each case. I have done about 30 of these cases so far and had one patient with a large 130cc prostate needing Flomax, but no other complications.
It doesn't bother people either.

PS: I dont have any conflicts of interest with the Bioprotect company.

You are not the first (or second) person with this feedback. Just looking at images like yours, I would have expected people to feel it but apparently most people do not.

FYI, I have no COI with any of these companies either. And despite my friendly comments about Barigel above, some of their high volume paid consultants play up some really f****** crazy stuff. Like injecting into the prostate to get separation between GTV and urethra for periurethral tumors when doing a focal boost.

I will promote ideas I think are good, but not specific products. Across the board. It caused some friction at my prior job when I refused to give talks for Elekta about the Unity. Im fine to talk about adaptive MRI-guided radiation as a topic. But I won't act as a paid spokes person for a company or product that I didn't develop. I don't judge people who do, but I've seen too many people go all in and get clouded judgement IMO. Before you know it, every prostate patient (even cervix!) should have a spacer or every curative case should go on the MRL.

 

[TheWallnerus]

Another big thanks to our 'leaders'. Check out this video from 46:00 to 48:00 for a nice discussion of rectal spacers where the British and Canadians are literally laughing at us due to our indiscriminate and perceived financially motivated use of SpaceOAR.

It’s “outlawed” in some EU countries.

 

[evilbooyaa]

View attachment 409157View attachment 409156
This is a Bioprotect balloon spacer. I dont like spacers in general, but I do for select cases like inflammatory bowel disease, irritable bowel syndrome and for reirradiation. The balloon-based spacer is very easy to place and provides good symmetry, and the best part is the reproducibility for each case. I have done about 30 of these cases so far and had one patient with a large 130cc prostate needing Flomax, but no other complications.
It doesn't bother people either.

PS: I dont have any conflicts of interest with the Bioprotect company.

Bioprotect is a cool idea but have you seen the caliber of the ****ing thing that is expected to go into the perineum? It requires a scalpel to make a skin nick so you can really shove it in there.

Handing Rad Oncs a needle is one thing - we've been sticking needles into cancer-y things since the beginning of Rad Oncs.

Handing Rad Oncs a scalpel is quite another, IMO.

Just due to the Barrigel. I wish Barrigel would make a VUE equivalent. Might not be feasible but would be the relative end-all-be-all of spacers.