The Christ Hospital Health Network now offers improved treatment for men receiving radiation therapy for prostate cancer.
Brian Mannion, MD, discusses the benefits to the patient when Space OAR Hydrogel is used, what the procedure is like, who is a good candidate for it and when to refer to the specialists at The Christ Hospital Health Network.
Selected Podcast
SpaceOAR Hydrogel for Men who Undergo Radiation Treatment for Prostate Cancer.
Featured Speaker:
Learn more about Brian Mannion, MD
Brian Mannion, MD
Brian Mannion, MD was raised in Pennsylvania, attended the Massachusetts Institute of Technology (MIT), where he majored in chemical engineering. He then continued with parallel clinical and research training at the New York University School of Medicine, simultaneously receiving an MD and a PhD.Learn more about Brian Mannion, MD
Transcription:
SpaceOAR Hydrogel for Men who Undergo Radiation Treatment for Prostate Cancer.
Melanie Cole: The Christ Hospital Health Network now offers improved treatment for men receiving radiation therapy for prostate cancer. Our topic today is space or hydrogel for men who are undergoing radiation treatment for prostate cancer. My guest is Dr. Brian Mannion. He's a medical oncologist with the Christ Hospital Health Network. Welcome to the show. Explain a little bit about space or hydrogel for high dose radiation brachytherapy. Explain a little bit about what it is and how it came about.
Brian Mannion, MD: SpaceOAR, it’s a material. It’s an injectable gel and what it is, is it’s designed to protect the rectum from radiation. The prostate sits very close to the rectum and when we do radiation to the prostate gland, it’s very difficult to avoid some injury to the rectum. What the SpaceOAR does, as I said, it’s an injectable gel, and it’s inserted in between the rectum and the prostate creating a space of about half an inch, pushing the prostate away from the rectum, thereby allowing you to give radiation much more safely to the prostate.
Melanie: How did this come about? Who saw the need and thought this is something that we really need to come up with?
Dr. Mannion: There was a physician who noticed that in plastic surgeon that a similar compound is used to actually take away wrinkles in the skin. It would pump up the skin and he said this thing that creates space inside tissues, maybe I could use it in a different situation, namely to protect the rectum. He actually started working on it and perfected the system and start a company that now produces the product. It's been a very successful product. It's now been FDA approved over one or two years ago and it's really become a very popular system in our armamentarium, I think, that we have to make treatments not only more effective but safer.
Melanie: What is it made of? Is it safe? What happens to it once it’s done being needed?
Dr. Mannion: What it is, it’s something called polyethylene glycol, it’s something that’s a liquid, but then when you insert it, it thickens up. Think of it like jello and it stays there for about three months. The body does eventually degrade it and so it completely disappears. There have really been no safety issues with the product itself. There does not appear to cause any harm to the body in any way.
Melanie: Other patient selection criteria, is it ever contraindicated?
Dr. Mannion: Typically, if someone has had previous problems to the area where they might have had previous surgery there or their anatomy for some reason is different than usual, then they might not be a candidate, but the vast majority of men would be candidates for this.
Melanie: Can it help minimize the side effects of the radiation treatments? Speak about how it really works and tell us a little bit about what the procedure itself is like.
Dr. Mannion: The procedure itself, there's a needle that gets inserted and this is slowly injected through the needle. It’s done under visual guidance so they can see where it is at all times, and so it only takes either in the office or at the hospital about 30 minutes to put it in, so it’s really a fairly straightforward procedure and it’s done by a neurologist. The success rate of putting the gel in exactly where you want it is very high. It’s about 99%. There have been trials looking at how do people do if they get radiation treatment without the SpaceOAR or with the SpaceOAR. It turns out that there is about 70% reduction in rectal complications and about a 70% drop in the amount of radiation damage that occurs to the rectum as a result of pushing the prostate away from the rectum. The outcome for these patients, they typically have much less incidence of other bowel dysfunction or even urinal dysfunction as a way of protecting these organs from the radiation.
Melanie: Sure, because many of those side effects are what men most fear about prostate cancer, the side effects of treatment, so this is really helping to reduce some of those. What about erectile dysfunction, incontinence and those kinds of things?
Dr. Mannion: It does seem to help in protecting from some of those things as well. In interviews with patients and how many of them have a significant decrease in urinary or sexual function, which is another potential side effect or radiation, there is a dramatic drop in the number of patients that have those problems, so it seems to have no negative impact on how effective the radiation is, but a very dramatic effect on the side effect profile of the radiation.
Melanie: How fascinating. Tell us a little bit about your prostate second opinion clinic or the prostate collaborative.
Dr. Mannion: At our hospital, what we feel is that patient experience is at the forefront of what we try to do best. We have found that before we had this program, patients would have to go to a surgeon to get surgical opinions and they would have to go to a radiation doctor to get a radiation opinion and so on because they're often many different potential approaches for patients with cancer. We decided to eliminate all that and just have the patient come to one center, and at the one center, they could see all of the specialists who would all sit down together with the patient and talk about the pros and the cons and the risks and the benefits of every approach all at one sitting. We have patients that come in and they will meet with all of these specialists in one room at the same time, and based on that, we come up with one single recommendation for the patient. I think it eliminates a lot of controversy in the patient's mind about what is best and not best. Patients really enjoy it. They think it's an incredible experience, they leave with a much more clear-cut answer rather than just a long list of possibilities for them, and it's been very successful for us.
Melanie: What would you like other physicians to know about referring to your second opinion clinic?
Dr. Mannion: We just want to make sure that they understand it’s very simple, it’s really a single phone call, and the other thing is that we have no interest in trying to take the patient away from the normal caregivers, but after a patient comes in for one of these consultations, we will send the patient back to the original team that has first seen the patient and give our recommendation. We just want to do what's best for the patient and so I think from the physician standpoint, we want to be sure that they are still the patient’s doctor. We’re not their doctor.
Melanie: That’s a very good point to make. Wrap it up for us. Tell us a little bit about more space or hydrogel and what you would like other physicians to know about it?
Dr. Mannion: I think physicians need to understand that we're always making progress and this is a new product that is very safe to administer and it makes radiation treatment, which has already been a very effective treatment, not only effective but also much safer with zero side effects and that patients should have a lot less fear of what are going to be the long-term effects of radiation now that we have that product at our disposal to use.
Melanie: Great information. Thank you so much for joining us today and for sharing your expertise, it’s a fascinating topic. Thank you so much again. You're listening to Expert Insights, Physician Views and News with the Christ Hospital Health Network. Information on this topic can be found at christhospital.com/prostate. More information on Dr. Mannion and all of the Christ Hospital physicians is available at tchpconnect.org. That’s tchpconnect.org. This is Melanie Cole. Thanks so much for listening.
SpaceOAR Hydrogel for Men who Undergo Radiation Treatment for Prostate Cancer.
Melanie Cole: The Christ Hospital Health Network now offers improved treatment for men receiving radiation therapy for prostate cancer. Our topic today is space or hydrogel for men who are undergoing radiation treatment for prostate cancer. My guest is Dr. Brian Mannion. He's a medical oncologist with the Christ Hospital Health Network. Welcome to the show. Explain a little bit about space or hydrogel for high dose radiation brachytherapy. Explain a little bit about what it is and how it came about.
Brian Mannion, MD: SpaceOAR, it’s a material. It’s an injectable gel and what it is, is it’s designed to protect the rectum from radiation. The prostate sits very close to the rectum and when we do radiation to the prostate gland, it’s very difficult to avoid some injury to the rectum. What the SpaceOAR does, as I said, it’s an injectable gel, and it’s inserted in between the rectum and the prostate creating a space of about half an inch, pushing the prostate away from the rectum, thereby allowing you to give radiation much more safely to the prostate.
Melanie: How did this come about? Who saw the need and thought this is something that we really need to come up with?
Dr. Mannion: There was a physician who noticed that in plastic surgeon that a similar compound is used to actually take away wrinkles in the skin. It would pump up the skin and he said this thing that creates space inside tissues, maybe I could use it in a different situation, namely to protect the rectum. He actually started working on it and perfected the system and start a company that now produces the product. It's been a very successful product. It's now been FDA approved over one or two years ago and it's really become a very popular system in our armamentarium, I think, that we have to make treatments not only more effective but safer.
Melanie: What is it made of? Is it safe? What happens to it once it’s done being needed?
Dr. Mannion: What it is, it’s something called polyethylene glycol, it’s something that’s a liquid, but then when you insert it, it thickens up. Think of it like jello and it stays there for about three months. The body does eventually degrade it and so it completely disappears. There have really been no safety issues with the product itself. There does not appear to cause any harm to the body in any way.
Melanie: Other patient selection criteria, is it ever contraindicated?
Dr. Mannion: Typically, if someone has had previous problems to the area where they might have had previous surgery there or their anatomy for some reason is different than usual, then they might not be a candidate, but the vast majority of men would be candidates for this.
Melanie: Can it help minimize the side effects of the radiation treatments? Speak about how it really works and tell us a little bit about what the procedure itself is like.
Dr. Mannion: The procedure itself, there's a needle that gets inserted and this is slowly injected through the needle. It’s done under visual guidance so they can see where it is at all times, and so it only takes either in the office or at the hospital about 30 minutes to put it in, so it’s really a fairly straightforward procedure and it’s done by a neurologist. The success rate of putting the gel in exactly where you want it is very high. It’s about 99%. There have been trials looking at how do people do if they get radiation treatment without the SpaceOAR or with the SpaceOAR. It turns out that there is about 70% reduction in rectal complications and about a 70% drop in the amount of radiation damage that occurs to the rectum as a result of pushing the prostate away from the rectum. The outcome for these patients, they typically have much less incidence of other bowel dysfunction or even urinal dysfunction as a way of protecting these organs from the radiation.
Melanie: Sure, because many of those side effects are what men most fear about prostate cancer, the side effects of treatment, so this is really helping to reduce some of those. What about erectile dysfunction, incontinence and those kinds of things?
Dr. Mannion: It does seem to help in protecting from some of those things as well. In interviews with patients and how many of them have a significant decrease in urinary or sexual function, which is another potential side effect or radiation, there is a dramatic drop in the number of patients that have those problems, so it seems to have no negative impact on how effective the radiation is, but a very dramatic effect on the side effect profile of the radiation.
Melanie: How fascinating. Tell us a little bit about your prostate second opinion clinic or the prostate collaborative.
Dr. Mannion: At our hospital, what we feel is that patient experience is at the forefront of what we try to do best. We have found that before we had this program, patients would have to go to a surgeon to get surgical opinions and they would have to go to a radiation doctor to get a radiation opinion and so on because they're often many different potential approaches for patients with cancer. We decided to eliminate all that and just have the patient come to one center, and at the one center, they could see all of the specialists who would all sit down together with the patient and talk about the pros and the cons and the risks and the benefits of every approach all at one sitting. We have patients that come in and they will meet with all of these specialists in one room at the same time, and based on that, we come up with one single recommendation for the patient. I think it eliminates a lot of controversy in the patient's mind about what is best and not best. Patients really enjoy it. They think it's an incredible experience, they leave with a much more clear-cut answer rather than just a long list of possibilities for them, and it's been very successful for us.
Melanie: What would you like other physicians to know about referring to your second opinion clinic?
Dr. Mannion: We just want to make sure that they understand it’s very simple, it’s really a single phone call, and the other thing is that we have no interest in trying to take the patient away from the normal caregivers, but after a patient comes in for one of these consultations, we will send the patient back to the original team that has first seen the patient and give our recommendation. We just want to do what's best for the patient and so I think from the physician standpoint, we want to be sure that they are still the patient’s doctor. We’re not their doctor.
Melanie: That’s a very good point to make. Wrap it up for us. Tell us a little bit about more space or hydrogel and what you would like other physicians to know about it?
Dr. Mannion: I think physicians need to understand that we're always making progress and this is a new product that is very safe to administer and it makes radiation treatment, which has already been a very effective treatment, not only effective but also much safer with zero side effects and that patients should have a lot less fear of what are going to be the long-term effects of radiation now that we have that product at our disposal to use.
Melanie: Great information. Thank you so much for joining us today and for sharing your expertise, it’s a fascinating topic. Thank you so much again. You're listening to Expert Insights, Physician Views and News with the Christ Hospital Health Network. Information on this topic can be found at christhospital.com/prostate. More information on Dr. Mannion and all of the Christ Hospital physicians is available at tchpconnect.org. That’s tchpconnect.org. This is Melanie Cole. Thanks so much for listening.