Markers in prostate before RT?

[Stellabell]

I just had the cat scan and marks put on my groin in order for them to map out a plan for radiation treatments. I have read where they generally implant markers in the prostate itself to help guide the beams. This procedure does not appear on my treatment plan. I assume it is because 17 of the 20 samples taken for the biopsy were positive, either 8 or 9, and they are just hitting the entire area? I will check with the radiologist Monday, but I am curious right now.

[Tall_Allen]

They treat the whole prostate plus a margin around it. The fiducial markers are part of the GPS they use so that they target it with greater precision.

[Stellabell in reply to Tall_Allen]

I didn't make myself clear. They do not plan on placing fiducial markers inside the prostate before the treatments start. Is this unusual? Cause for concern?

[Tall_Allen in reply to Stellabell]

Sorry I misunderstood. Would you please explain what is the treatment you are getting?

[Stellabell in reply to Tall_Allen]

IMRT I believe it is called. External beam radiation, 48 treatments total, 5 days a week. I had the cat scan, had the external marks placed on my groin and legs and am waiting for them to map out the exact plan. My question was about the fiducial markers that are placed inside the prostrate. Are they necessary to guide the treatments? Should I be concerned that they are not using them? Are they intended for a different type of radiation therapy?

[Tall_Allen in reply to Stellabell]

Thanks - the answer would have been different for salvage radiation. I think fiducials or radio transponders (Calypso) are absolutely necessary to prevent excess toxicity caused by organs moving around between treatments. I know that some ROs believe a rectal balloon can stabilize the prostate enough.

Also, 48 IMRT treatments is outmoded. The American Society of Radiation Oncologists (ASTRO) recently strongly endorsed doing it in 20 or 25 treatments:

pcnrv.blogspot.com/2018/10/...

(Radiation oncologists are paid by the number of treatments, so many may not want to do this)

BUT for a man with GS 9, the best kind of radiation is a combination of IMRT to the pelvic area with a brachytherapy boost to the prostate. It has MUCH better cure rates but late term urinary side effects may be worse.

pcnrv.blogspot.com/2017/03/...

Since you have probably already started hormone therapy, you have time to talk to other radiation oncologists who specializes in brachy boost therapy. Where do you live?

[Stellabell in reply to Tall_Allen]

Thanks, Allan. My previous posts will answer your questions.

[Tall_Allen in reply to Stellabell]

Got it!

[fldrifters1 in reply to Stellabell]

Hey Stella bill I had the exact same radiation procedure you're having mine ,,was 45 treatments 9 weeks 5 days a week and it all worked out just fine I did have the fiduciary markers put into the prostate the three gold specks and I would be asking them why you're not getting those with this pasito procedure... Yes it's just like another rectal biopsy only goes real quick and you're in and out of there so I would make sure about those fiduciary markers I think they're necessary and that's just my opinion but I would be checking with your radiologist if this is the route you're going the whole procedure like tall and said was maybe getting outdated but twerk for years for many many people and hopefully myself so good luck with it and please keep us posted.... David

[Aiden14 in reply to fldrifters1]

Thanks for the input

[tucker_man]

Did you end up getting the fiducial markers?

[Stellabell in reply to tucker_man]

No, I was told they were not necessary. A scan taken before each treatment is used to make sure the proper area is treated.

[Aiden14]

Thanks