Barrier for RA and other questions

[Eadgbe]

I have been diagnosed with stage 2 PC. I am about to undergo radiation and the protocol is to insert some gold guides - I assume to help pinpoint the machine and a barrier between the prostate and rectum. I understandg these will be inserted transperenially [sic] but how will they be removed - or will they ever be removed? And what is the barrier made from - some sort of gel? Will it just dissipate? Does it impair movement or have other side effects?

After surviving a sepsis I received from the directed biopsy (trans rectal) my nether regions are speaking their own language again. My doc proscribed flomax, which seems to help a lot, but also finesteride. I've been reading about that and it seems like it has some severe side effects. I wonder is it worth taking or can I forego that? My ability to have a strong flow has improved with just the tamsulosin.

Any one with experience with the barrier?

[ODave]

The Gold is yours for life, they do not remove them. I had radiation but no SpaceOar gel in between. I was treated at UCSF

[John347]

I had SpaceOar gel inserted between my prostate and rectum last year prior to my 20 sessions of RT. Three tiny gold fiducials were inserted into the prostate at the same time under general anesthesia. Thanks to the gel I had zero side effects from the radiation. It certainly is money well spent.Here's a short video from Dr Scholz of PCRI...

youtu.be/V8Q8xeb6qKM(Not working as expected?)

[Tall_Allen]

The gold fiducials (about the size of rice grains) are your internal jewelry for life. They are now making Barrigel to show up on ultrasound so they can better see where its being placed. it dissolves over time.

[Eadgbe in reply to Tall_Allen]

Thanks again for your attentive comments.

[Photographerhere]

I has a spaceOR gel inserted. Not a fun procedure but it doesn’t take too long, and it dissolves after three months and supposedly protects the rectum from intense radiation. I had SBRT so only five but intense sessions. Bowels messed up for only two weeks post radiation.

[Don_1213]

Some radiation oncologists don't use markers or gel - they depend on the increased accuracy of the machine giving the radiation to avoid the organs at risk (OAR)... and some of them feel that disturbing the area of the tumor(s) isn't a good idea since there is some chances that will allow release of tumor cells seeding the area for later tumor growth.

My RO was of that opinion - and at the time he had at his disposal the latest Varian linear-accelerator with image targeting for each sweep of the machine. (IG/IMRT/ARC).

The reason for the large number of treatments is a bit counterintuitive - but it makes the consequences of any misalignment of the target and beam less significant. In treatments done in much larger doses - hypofractionation - any error in targeting is going to be more significant,

My oncologist didn't like the gold fiducials since he said they can make the technicians giving the treatment lazy - by just relying on the fiducials and not checking the actual tumor imaging. In my case I was fairly certain the technician was going to do a good job since he is and was a good personal friend. He made sure to be at the console even if another technician was administering the treatment.

I received 83Gy of radiation in 45 treatments, finished 4+ years ago and haven't really had any side effects attributable to the radiation treatment (and the radiation appears to have worked along with ADT to put my G10 PCa into remission.)

I would personally question finasteride if I was peeing OK without it. If you do take it - double your PSA readings to get a more accurate number. It basically halves the PSA readings - I experienced that, but since I knew this was the case it was no surprise when mine doubled almost instantly when I discontinued it.

As usual - don't consider this any sort of medical advice - it's merely a recitation of what I learned and experienced about radiation treatment of PCa.

Good luck with your treatment!