Fiducial Markers and Rectal Spacers

These are two different things, having two different purposes.

Fiducial markers are tiny, usually gold, "seeds" planted into the prostate under ultrasound guidance. They are used to allow beam radiation machines to verify their targeting in near real-time during treatment. Placement of fiducials takes about 15 minutes, although the prep may take somewhat longer.

Rectal spacers are chemical-based spacers used to move the prostate away from the rectum and to add insulation to allow the prostate to receive its full intended radiation dose, while allowing the rectum to receive much less of a dose.

Fiducials have been in use for longer than spacers. In my reading, most RO practices still view the spacers as optional, while they usually see fiducials as necessities to plan and deliver the radiation dose required.

I can tell you more about fiducial placement, as I have these. I did not have a spacer implanted, as at the time of my treatment, most RO's were just learning about spacers, and many insurance plans would not cover them.

Thanks for the replies!

Has anyone here had the spacer?

Mine goes in Wednesday, in two days. (markers also of course)

Spacer or markers were never discussed as optional. Both were simply presented as part of radiation therapy.
To be honest it caught me off guard. I wanted to avoid surgery which is why I decided on radiation. I may have made a different decision if I knew radiation entailed surgery for these implants.

InTheShop said...
The markers are just placed with a needle - just like the biopsy - you'll hardly notice.

I better not notice as I will be under general anesthesia. LOL

No one here has had the spacer???????

As I said before, I did not have a spacer implanted.

That said, about a year or so ago, my PCa support group hosted a presentation by a prominent local PCa center, about the SpaceOAR spacer. No, it is not shaped like an oar. . . the name means "Space between Organs At Risk.

SpaceOAR is an injectable substance that goes in as a sort of a cross between a liquid and a gel. It is injected via hypodermic syringe. Shortly after injection, the substance gels, turning into a high-density, almost plastic-like substance that pushes the prostate and rectum apart, allowing the RO to plan a full dose to the prostate, with minimal dose to the rectum. The material gradually liquifies and is absorbed into the body over a period of months, eventually becoming fully absorbed and everything goes back to its normal position. One of the group members had the gel implant, and he verified that his completely disappeared fairly soon after the end of his treatment. That means that it probably lasts a few months, as he had conventional IMRT, not SBRT.

It sounded like a good idea. Had I been offered the option, I think I might have taken it. It wasn't available, and I did have some radiation proctitis, which had to be treated via laser.

My RO said no to both..