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Physician's Perspectives

Cross-Specialty Collaboration for Patients with Prostate Cancer

Ryan Hankins, M.D.
Urologist, Georgetown University Hospital

Sean Collins, M.D.
Radiation Oncologist, Georgetown University Hospital

The information provided in this editorial is based on the experience of Dr. Hankins and Dr. Collins. It does not represent the opinion or recommendation of Boston Scientific.

Editorial commentary

A study shows that a uro-oncology multidisciplinary team approach for prostate cancer patients may lead to more accurate and complete preoperative staging and neoadjuvant/adjuvant treatment (as opposed to a non-multidisciplinary team approach), as well as positive impacts for patient management.1 But the data is not yet conclusive. A multidisciplinary, patient care team may include a urologist, oncologist, radiation oncologist, and pathologist.

Over the past 10 years, Dr. Ryan Hankins, a urologist, and Dr. Sean Collins, a radiation oncologist, have been committed to working as a team when it comes to treating patients. Both are physicians at Georgetown University Hospital in Washington, D.C., where they have created a comfortable and productive relationship through collaboration and knowledge sharing.

Regardless of which doctor initially meets with the patient, they discuss the case and determine together if the patient is a candidate for a perirectal spacer. “Communication between the radiation oncologist and urologist is paramount because we both need to agree that the patient is a candidate. Since Dr. Collins is the treating physician, he generally makes the decision and I confirm it,” Dr. Hankins says.

The importance of urologist to radiation oncologist communication

Drs. Hankins and Collins communicate regularly — often daily — on patient cases. When making decisions on who should receive a perirectal spacer such as SpaceOAR™ Hydrogel, they look at various aspects of the patient’s medical history and medical condition. “We are always in communication,” Dr. Hankins says about their partnership.

With Dr. Hankins’ clinical experience managing complications associated with radiotherapy and understanding the potential role of a perirectal spacer such as SpaceOAR Hydrogel can play in preserving the patient’s quality of life, they are able to offer tailored care to patients with prostate cancer who enter their practice.2,3

Procedural collaboration

The two physicians work hand-in-hand, reviewing potential treatment options and determining from the start the best approach for each patient. If both doctors and the patient agree on radiation therapy, their focus shifts to addressing potential side effects.

“Perirectal spacing is important in trying to minimize side effects associated with radiation therapy,” Dr. Hankins says. “Both Dr. Collins and I speak to our patients about this. I mention to every patient who I send to radiation oncology that they should consider having a perirectal spacer such as SpaceOAR Hydrogel placed because it may help decrease radiation exposure to the rectum.” As a result, the chances of experiencing side effects related to bowel, urinary, and sexual function may be minimized.2,3

When performing the SpaceOAR Hydrogel procedure, Dr. Hankins usually uses local anesthesia so patients may be able to resume their daily activities on the same day.* “They usually say they felt nothing during the placement procedure,” Collins says.

Dr. Collins also discusses his aging patient population. “I’ve noticed that men are living longer, into their 90s, so we actually need to control the cancer for a longer period of time,” he says.

Designed with the patient in mind

When Dr. Collins first considered using SpaceOAR Hydrogel several years ago, he recognized that Boston Scientific, the device manufacturer, was focused on product training. “They weren’t about selling the product,” he recalls. “They were only going to let us use this product after completing training to become a certified applier.”

“And they actually listen,” Dr. Collins says about Boston Scientific, explaining that the company acted on feedback to add design features that are intended to enable visualization on CT. Boston Scientific developed SpaceOAR Vue™ Hydrogel, its next-generation hydrogel spacer that is designed to offer visibility via CT scan when compared to non-iodinated spacers.4

He continues, “the fact that we have a company that listens to us, cares about us, and also cares about the patient is very exciting.”

Dr. Hankins confirms this noting that, “They really have led the way by designing a product intended to help preserve quality of life for patients undergoing radiation therapy.”

Another important aspect highlighted during training is how to identify signs that indicate the procedure should be aborted. Through key steps of hydrodissection and aspiration, Drs. Collins and Hankins can confirm the placement of SpaceOAR Hydrogel.

Creating a winning team

Like any team, communication, collaboration, and partnership are essential. Prostate cancer patients may benefit when their care team works together to develop a course of treatment with a team mentality.1 Collins concludes, “We want to work together to give our patients the best possible outcomes for their prostate cancer.”

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*The information provided is based on the experiences and opinions of Dr. Collins and Dr. Hankins. It does not represent the opinion or recommendation of Boston Scientific. Some patients may experience certain side effects with the placement of SpaceOAR Hydrogel, including but not limited to pain associated with SpaceOAR Hydrogel injection, pain or discomfort associated with SpaceOAR Hydrogel, or allergic reaction.


  1. Heidenreich A. Multidisciplinary team meetings for prostate cancer treatment: we can do much better in daily life. Oncol Res Treat. 2019;42:363–365.
  2. Hamstra DA, Mariados N, Sylvester J, et al. Sexual quality of life following prostate intensity modulated radiation therapy (IMRT) with a rectal/prostate spacer: Secondary analysis of a phase 3 trial. Pract Radiat Oncol. 2018;8:e7–e15.
  3. Hamstra DA, Mariados N, Sylvester J, et al. Continued benefit to rectal separation for prostate radiation therapy: final results of a phase III trial. Int J Radiat Oncol Biol Phys. 2017;97:976–985.
  4. Data on file with Boston Scientific.

Ryan Hankins, M.D. and Sean Collins, M.D. are Boston Scientific consultants who were compensated for their contribution to this editorial. Statements made represent the opinion and experience of Dr. Hankins and Dr. Collins. Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary. 

Caution: U.S. Federal law restricts this device to sale by or on the order of a physician. 

CAUTION: The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at Products shown for INFORMATION purposes only and may not be approved or for sale in certain countries. This material not intended for use in France. 

IMPORTANT INFORMATION: These materials are intended to describe common clinical considerations and procedural steps for the use of referenced technologies but may not be appropriate for every patient or case. Decisions surrounding patient care depend on the physician’s professional judgment in consideration of all available information for the individual case. 

Boston Scientific (BSC) does not promote or encourage the use of its devices outside their approved labeling. Case studies are not necessarily representative of clinical outcomes in all cases as individual results may vary. 

Results from different clinical investigations are not directly comparable. Information provided for educational purposes only. 

For information purposes only. The content of this article/publication is under the sole responsibility of its author/publisher and does not represent the opinion of Boston Scientific. 

SpaceOAR and SpaceOAR Vue Hydrogels are intended to temporarily position the anterior rectal wall away from the prostate during radiotherapy for prostate cancer and in creating this space it is the intent of SpaceOAR and SpaceOAR Vue Hydrogels to reduce the radiation dose delivered to the anterior rectum. 

SpaceOAR and SpaceOAR Vue Hydrogels contain polyethylene glycol (PEG). SpaceOAR Vue Hydrogel contains iodine. 

Prior to using these devices, please review the Instructions for Use for a complete listing of indications, contraindications, warnings, precautions and potential adverse events. 

As with any medical treatment, there are some risks involved with the use of SpaceOAR and SpaceOAR Vue Hydrogels. Potential complications associated with SpaceOAR and SpaceOAR Vue Hydrogels include, but are not limited to: pain associated with SpaceOAR and SpaceOAR Vue Hydrogels injection, pain or discomfort associated with SpaceOAR and SpaceOAR Vue Hydrogels, local inflammatory reactions, infection (including abscess), urinary retention, urgency, constipation (acute, chronic, or secondary to outlet perforation), rectal tenesmus/muscle spasm, mucosal damage, ulcers, fistula, perforation (including prostate, bladder, urethra, rectum), necrosis, allergic reaction (localized or more severe reaction, such as anaphylaxis), embolism (venous or arterial embolism is possible and may present outside of the pelvis, potentially impacting vital organs or extremities), syncope and bleeding. The occurrence of one or more of these complications may require treatment or surgical intervention. URO-989811-AB. 

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