Wonder gel protects prostate patients from collateral damage
A GEL that prevents damage from radiotherapy could help thousands of men treated for prostate cancer by separating the prostate gland from the rectum.
By PAT HAGAN
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A new gel can help reduce the damage caused by radiotherapy
If radiotherapy treatment is needed to zap cancerous cells in the prostate there is a high chance of "collateral" damage to healthy tissue in the surrounding area.
Yet a high-tech gel already being used by specialists at The London Clinic could eventually benefit thousands more men who undergo the treatment every year in the UK.
Radiotherapy is the most common form of treatment for prostate cancer, firing high-energy X-rays into the damaged area to destroy any cancerous cells.
Although it is painless, it does mean attending hospital five days a week for several weeks to have a daily blast of treatment that takes between 10 and 20 minutes.
However it can be extremely difficult to precisely pinpoint the right target zone. As a result, a significant number of men end up with radiation damage to the rectal wall which can cause diarrhoea, rectal bleeding and painful tissue "tears" called fistulas. The condition is so common it even has its own name, radiation proctitis.
Many patients experience rectal bleeding within six weeks or so of starting radiotherapy but it can develop up to nine months after treatment has ended.
Many patients experience rectal bleeding within six weeks or so of starting radiotherapy
The revolutionary new substance, called SpaceOAR gel, gets round the problem with a brilliantly simple solution.
It is injected into the area in liquid form once the patient has had either a general or local anaesthetic or has been sedated.
It contains water and two liquids which, when combined, quickly turn into a soft gel that sets and remains in place.
This same material is already deployed in other areas of medicine, including surgical sealants used in the brain and spine.
SECONDS after being injected, the liquid solidifies and expands to push the rectum several inches away from the prostate.
Doctors can then target the prostate, safe in the knowledge that they will not damage the rectal wall.
US firm Augmenix Inc, which makes the gel, says it is possible that doctors could increase the amount of radiotherapy because the risk of collateral damage is reduced and that high-dose radiotherapy could improve a patient's chances of making a full recovery.
Once the treatment is finished the gel stays in place for about six months, which is long enough to cover repeat courses of radiotherapy.
After that it gradually breaks down and gets harmlessly absorbed by the body, with little or no discomfort to the patient.
Every year in the UK nearly 40,000 cases of prostate cancer are diagnosed and it kills 10,000 men, equivalent to more than one an hour. The risks increase with age, men over 50 are more likely to develop a tumour and there is a strong genetic element to it.
"Some men develop ulcers or bleeding from radiation proctitis and it can be very troublesome. We are getting better at focusing radiotherapy beams more precisely but as the rectum is millimetres away it often gets caught up in it.
"Yet if you can just move it away from the prostate by even a couple of centimetres it can really help. That means you can give a higher dose and target it more precisely.
"This gel is still largely experimental but it's a fairly obvious solution to a common problem and is highly likely to be very effective. It is potentially quite a big breakthrough."
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