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zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/3/2009 10:42 AM (GMT -6)   
Hello I am a 55 year old had di vinci surgery in June of 2009. My psa numbers began to rise after surgery and now I am going to start hormone and radiation therapy.I am going to have gold markers implanted the 25th of december . I just need to see if some body can shed some light on those two procedures.I am a little bit afraid but I've been through so much so far I guess I can get through these two little obsticles with my wifes support.thanks to every one who can give me a little bit of insight.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23847
   Posted 12/3/2009 11:09 AM (GMT -6)   
Welcome, Zach to HW. Sorry you need to be among us, but glad you found us. Sorry that you have reoccurance so soon after your surgery. There are several of us, myself included, that are dealing with the same thing.

I just completed salvage radiation a week ago, 39 treatments. I did not include hormone treatment with it, at the advice of my radiation oncologist.

What would help, if you could make a signature of your stats and journey so far, it makes its easier for any of us to help understand where you are at so far. You can go to "Control Panel" at the top of this page. Fairly simple to follow.

Don't know anything about the gold markers, but sure you will get plenty of answers on the rest.

Good luck to you, and please keep us posted now that you found us.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


riverbend
Regular Member


Date Joined Mar 2009
Total Posts : 39
   Posted 12/3/2009 12:17 PM (GMT -6)   
For me the gold markers were like a "mini biopsy"... The procedure is actually similar, but quicker. I had the trans-rectal ultrasound once again to help guide the procedure. I got the local lidocaine topical anesthetic as I did in the biopsy. The placement of the markers felt very similar to the brief sting of a biopsy core going in - but there were only 2 (as compared to 14, for me at biopsy)... The only difference was that Loma Linda asked me to give myself an enema a couple hours before marker placement. I was all alone, and that was a bit tricky, but I managed. Ten minutes after the gold markers were in, I was back to normal...no pain, no soreness. Again, it was a mini-biopsy...pretty much a non-event.
Dx T1c in April, 2009 at 45 years old after recent PSA tests ranged from 2.93-3.25
2 of 14 cores positive at 5% and Gleason 3+3... 2 cores taken from a "protuberance" were "ASAP"
Proton radiation at LLMC May-June 2009


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 469
   Posted 12/3/2009 12:57 PM (GMT -6)   
Zach,

I am curious about the placement of the gold markers. Since your prostate was removed in June, just where do the markers go? Would like to know in case I have to do the same thing.

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 12/3/2009 1:26 PM (GMT -6)   
I am quite curious as well about the gold markers. I haven't heard about that for salvage radiation treatment. I am aware of the tatoos, but not the gold markers.

Regardless, sorry to hear you are in this position so soon after surgery. I am also not too surprised by the addition of hormone therapy, as that combination seems to have the best results for high risk cases.

Best of luck to you and yours. Not much of a Christmas present I am afraid though..
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


don826
Veteran Member


Date Joined May 2008
Total Posts : 752
   Posted 12/6/2009 8:42 AM (GMT -6)   
Hello Zach,
 
The gold markers or "fiducials" as they were called in my case are placed in the prostate bed adjacent to the location where the prostate used to be. In my case, since IMRT was primary treatment, the fiducials were placed in the prostate. There is a total of three in my case. The fiducials are used to locate the treatment area and direct the radiation beams during treatment. If you look at them on a CT scan they are very bright points of light so it will be hard to miss them. The actual procedure was done with a local anesthetic and they gave me something that made me forget everything else that went on. I was in the hospital for less than four hours and had no pain or problems after. Was told that there could be some blood in urine but never saw any. In short the procedure was uneventful. The best news is that you get to keep the seeds and they are made of gold. At todays prices might be worth the effort to retrieve them. turn
 
Best of luck to you.
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
 
 
 


zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/6/2009 11:46 AM (GMT -6)   
Don

Did they place them through your rectum,urethra or perineum? They have told me mine would be through my perineum and to me that just sounds so uncomfortable.But as always I will survive!
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-09


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 12/6/2009 12:06 PM (GMT -6)   
Thanks for joining us Zach I to wish you did not have to be here but since you are lets make the best of it. I am not familiar with the term gold markers so I will be watching this thread to get some education myself.
Please share in the discussions and make yourself at home here at HW

peace and love
Dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11

PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores
92%
80%
37%
28%


don826
Veteran Member


Date Joined May 2008
Total Posts : 752
   Posted 12/6/2009 12:08 PM (GMT -6)   
Hi Zach,
 
Through the perineum with a needle guided by ultrasound. I felt nothing and had no soreness afterwards. I think it sounds worse than it actually is.
 
Good luck,
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
 
 
 


zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/6/2009 12:20 PM (GMT -6)   
Don,
I am learning very quickly almost everything sounds worse than it really is.I think its all the time they give you to think about it is the culprit!
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-09
organ confined
extracapsular seminal vesicle involvement
lymph node involvement


don826
Veteran Member


Date Joined May 2008
Total Posts : 752
   Posted 12/6/2009 1:21 PM (GMT -6)   
Hi Zach,
 
Yes, I think that sometimes the doctors give out little information and we take the small amount gven and build a worst case scenario in our minds. A philosopher once noted that "the things that he most worried about in life were the things that never happened'.
 
By the way, I see that you have lymph node involvement. Are they planning to do full pelvic radiation in addition to the prostate bed? My first 25 sessions were a combination of pelvic and prostate specific.
 
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
 
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23847
   Posted 12/6/2009 1:35 PM (GMT -6)   
The "gold markers" was new education for me as well. I had 7 tattoos prior to my salvage radiation. Look like tiny moles. You will be lucky, you will have a gold mine under your ass!

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/6/2009 2:29 PM (GMT -6)   
Don
I'm not sure about the area they are going to zap yet I know they are going to do my prostate bed but not sure if they are going to do my pelvic area as well. I will keep you posted

Zach
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-09
organ confined
extracapsular seminal vesicle involvement
lymph node involvement


Hankb00
New Member


Date Joined Jul 2014
Total Posts : 2
   Posted 7/13/2014 9:57 AM (GMT -6)   
Hello,
My name is Hank and, sadly, I have now joined the world of recurrent prostate cancer. I am scheduled for salvage radiation in a few weeks and I was exploring gold fiducials (and everything else!) as a way to better target the prostate bed when I came across this forum. The hospital where I will be treated (I'm not sure of the rules about naming specific institutions or doctors) does not use fiducials in salvage radiation, but I noticed that several posts mention having used fiducials. So, if you received radiation after cancer reoccurrence can you let me know if fiducials were used and if you believe it was helpful? Thank you.

dennis h
Regular Member


Date Joined Apr 2014
Total Posts : 60
   Posted 7/13/2014 11:34 AM (GMT -6)   
I am in the process of undergoing CK treatment for PCa I chose this over surgery and part of the treatment is placing fiducial markers in the prostate in my case or elsewhere for those who have had surgery. There are 2 ways transrectal like a biopsy and perineum. Some centers like the perineum because it avoids the possibility of infection by going though the rectum. The perineum approach is usually done with some sedation transrectally a local. I had the bad luck of going to St Luke's in Houston who uses a trans buttocks approach and as far as I can tell they are the only ones doing it this way and of course they screwed it up but also of course it was because of my weird anatomy not their incompetence. Needless to say I am looking to go to another CK site. If ANYONE suggests implanting markers in any way other than transperineum or trans rectal RUN AWAY!!! The other lesson I would pass along is if you feel uncomfortable with any of the advice you are getting leave post haste and find another doctor. I felt uncomfortable from the start with St Luke's but convinced myself I was imagining things and ultimately convinced myself to go through with using them. BIG MISTAKE
60 yr white one positive core Gleason 3+4= 7 PSA 16 (2 negative biopsies over the last 4 years w rising PSA). Bone and CT neg

PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 3533
   Posted 7/13/2014 12:24 PM (GMT -6)   
Hankb00,

I started a mew thread for you so people can answer your question without needing to read through a lot of five-year-old comments.

www.healingwell.com/community/default.aspx?f=35&m=3130916

Welcome to the forum!
61
Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012:
1)neg (some inflammation),
2)neg,
3)positive 1 of 14 GS6(3+3) 3-4%, 2nd opinion GS7(3+4)
4)neg.
Mild Pre-op ED
DaVinci RRP 6/14/12. left nerve spared
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
Start 24 mo ADT3 7/26/12
Adjuvant IMRT 66.6 Gy 10/17/12 - 12/13/12
Leaky but better, Trimix, VED
Forum Moderator - Not a Medical Professional
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