Local Anestheia vs Total Sedation for Marker and Spacer Gel insertion

[mijona]

72 yo Gleason 7 Localized Prostate Cancer - Just starting the process. Was interested to know if anyone has had the Markers and Spacer Gel inserted just with local anesthesia, outpatient procedure and recommended ? Thanks for your help.

[ToolBeltZia]

I had a general. More comfortable for me....and makes it easier for the Dr to be precise. See if they do SpaceOAR or Barrigel. I had Barrigel, as it does not polymerize like SpaceOAR does, it does not have a (very) limited working time like SpaceOAR.

[mijona in reply to ToolBeltZia]

Great. Thanks for the info.

Also I see that you went with the High Dose RT as opposed to the Low Dose RT. What made you choose one over the other ?

[ToolBeltZia in reply to mijona]

Studies have shown that PC may be more sensitive to fewer higher dose treatments rather than more lower dose treatments. At worse SBRT (ulta-hypofractionation) has been show to be "non-inferior" to normal or hypo-fractionation. The GI and GU side effects do not show much difference, and the rate of bio-chemical recurrence and metastatic recurrence is the same as more traditional fractionation and as surgery. SBRT was also able to apply a focal boost to the dominant lesion as traditional RT can. Studies show this boost to the tumor increases the "cure" rate. All these points along with getting it done in 5 sessions over two weeks rather than 30-50 sessions over 6-10 weeks led me to go with SBRT. I ran my treatment plan past a friend who is a gastroenterologist and his son, an oncologist, and they both agreed it was "state of the art".

If you have any additional questions please do not hesitate to ask.

[MarkS]

Hi, I'm due to get the Barrigel spacer inserted at the beginning of Feb. That will be under local which is a lot easier, one hour in and out. It is apparently no more uncomfortable than a biopsy and that was easy enough. You can drive straightaway and you don't get the long term effects on the brain of a general.

[Photographerhere]

i had spaceOAR inserted with local anesthesia. Once they got going it was less than 4 minutes, wasn’t fun for sure It not awfully painful. It was more embarrassing than painful. Five nurses and a doc with your knees up to your chest

[mijona]

Your comments and experiences greatly appreciated. Was told any movement during the procedure could cause complications, so wondering if local anesthesia was enough to keep still.

[ToolBeltZia in reply to mijona]

This is the main concern. Watch a video showing how it is done, the tolerance between your prostate and rectum is about two needle widths..... probably don't want to twitch at the wrong time. General was the way to go.

[turkeyjoe1]

I got knocked out completely, best thing I ever did.

[GregHay]

I had spaceOAR and markers in one session with a local. I found it more painful than the biopsy but tolerable.

[mijona]

Great info/comments. Thanks for the replies.

[Atdabeach]

I had fiducial markers placed with local anesthesia. Uncomfortable for sure -- a couple of injections to numb the skin (no big deal), then a deep needle to numb the prostate (this was the worst part, but I'd say no more painful than a biopsy). Once fully numb, I didn't even feel the marker placements.

[mijona]

Hi Atdabeach. Great. Thanks.