Fiducial Marker and Rectal Spacer Placement therapy at MSK

[Ptripp2]

hi all,

I haven’t been on here in a bit. I’ve been trying to catastrophize less by limiting my exposure to PC stuff.

Anyway…My dad met with a radiologist over a week ago and they are in support of him getting this type of radiation therapy, “Fiducial Marker and Rectal Spacer Placement”. It sounded like brachytherapy from what I was. Apparently, my dad is a borderline candidate for this, having 6 markers In the prostate instead of 5, which is ideal for the procedure. If he doesn’t get this form of treatment soon he loses the option, so he is scheduled 8/5.

I’m worried because the doctor mentioned permanent side effects with his bowel and urinary system as a possibility. I know doctors tend to throw that kind of thing out a lot even when it’s rare and wanted to hear how you all felt if anyone here had this? Any feedback at all. My dad also is scared and asked if we could find out how others tolerated this.

I can get more info if more is needed. Thank you so much in advance for anything shared.

[Tall_Allen]

It’s not brachytherapy. They are just procedures to help make his radiation less risky. Of course any procedure has small risks of their own.

[Spyder54]

I had MSK Precise. With Dr Sean McBride. This is their image guided Stereo Tactic Ablative Radiation (SABR/SBRT). I had only 3 fiducials (the most painful part of process), and 10 tattoo’ on chest and pelvic region. They line up the tattoo’s (little dots, like freckles) with 10 laser lights on ceiling, and mold a warm cast around, which later is hard and tightens yo to table for NO movement. Then, at a 2nd appt they do the actual Radiation. In my case, 5 treatments to the prostate, and 3 to the T5 in spine. Done over 10 days. Painless. Their machine is a custom combo of Radiation beam, CT, MRI, and ultrasound which gives them precise angles vs the Fiducials, and Tattoos, vs the PCa. I have had no blood in urine, and no blood in stool, although that can be a temporary risk. MSKCC did good by me. Rang completion bell 6 months ago on Jan 20, 2022. PSA has been dropping last 3 tests, after waiting 3 mos. Best of luck, Mike

[Ptripp2 in reply to Spyder54]

Thank you for sharing your experience. It’s helpful to know what it’s going to be like. It sounds like your situation was best case scenario. My dads a trooper and ready for side effects, but the thought of permanent side effects is scary, however a risk he’s planning on taking.

Also I did not know PSA would lower from it!

[Spyder54 in reply to Ptripp2]

Yes, wait 3 mos on PSA, or false positive. Dying PCa cells give off large amounts of PSA. Wait 3 months.

[Emmett50]

Hi. This sounds like the SpaceOar (not sure of name) that my husband had placed prior to radiation. His insurance covered it. I know there’s different opinions on this board about how useful it is. My husband found the procedure to be very tolerable. It was a done at a teaching hospital so he had an audience. That didn’t bother him as he’s a ham, Anyway, he’s several years post radiation and hasn’t had any of the potential issues that can happen with 39 sessions. He had two incidents of bowel incontinence but that was it. I don’t know what part the rectal spacer played but he’s glad he had that procedure.

[Ptripp2 in reply to Emmett50]

Thank you, I read more into it and It and there will be a space oar, so it is the same thing. Also, 39 treatments, wow, I hope those weren’t all at once! So glad he didn’t regret it and it worked out

[Spyder54 in reply to Emmett50]

Yes, Dr McBride at MSKCC said I was NOT a good candidate for Space Oar. Said location of PCa vs Rectum made it a difficult and poor choice. So it is not for everyone. Also, he made it clear that 5 treatments at higher dose of Gy’s, vs 39 sessions of lower dose is controversial. Some evidence points to higher, but fewer treatments may be just as effective. He said with me living in FL and flying up to NYC, 5 is easier and less costly than 39, obviously more convenient. Stressed that Prostate is a tough gland and hard to kill. Said death of Prostate will happen over 18-24 months. Said he see’s Mens PSA sometimes drop further after 18 mos which convinced him that Radiation Therapy is still killing cells after 18 mos.

Also, common sense tells you that Hospital makes less money on 5 higher doses vs 39 lower doses.

Hope that helps, Mike

[AlvinSD in reply to Spyder54]

My RO said the same thing about my cancer and SpaceOar. He said it could (theoretically) move some cells out of the path of the radiation. With a GS9, he thought the risk to me from that outweighs the benefit of SpaceOar.

[VCinTx]

“Fiducial Marker and Rectal Spacer Placement” was embarrassing for me because my RO was female. I was a tiny bit sore for a couple of days but this procedure will be a guide for your Radiologist and the Space Oar will keep your rectum safe from the radiation.

[Ptripp2 in reply to VCinTx]

I would imagine the whole thing to be uncomfortable. My impression is day 1 is the most painful.

[VCinTx in reply to Ptripp2]

I saw this as "one day" in my battle with Prostate Cancer. I won't let a little pain and embarrassment stop me in my treatment.