Prostate Cancer Recurrence-Fiducial Marker Placement ?

[Prodius]

PSA starting to edge up after 4 years at zero after a radical prostatectomy . Looking over the paper work given to me at Moffitt Cancer Center, it details the placement of a Fiducial Marker where the prostate use to be. Given that the Moffitt is two hours from where I live, I decided to get a second opinion at a local hospital near where I live. The local hospital told me, no need for a fiducial Marker since the prostate is no longer there. First time doing radiation. What is normal in terms of the fiducial marker and salvage radiation with no prostate? Should I trust the local hospital?

[Tall_Allen]

The local hospital is right. Fiducials are placed IN the prostate prior to primary prostate radiation. The prostate BED, which is what is irradiated with SALVAGE RT, is made of loose tissue. Fiducials can't hold on, at least not very well. While a few institutions (e.g., UCSF) try to place them anyway, most don't. The prostate bed tissue moves independently of the pelvis. Image guidance has to be done visually.

[bitittle in reply to Tall_Allen]

UCSF placed 3 markers in my prostate bed prior to SRT. I went along with recommendation.