Fiducial Markers and Hydrogel Spacers for Prostate Radiotherapy

Radiotherapy is an established treatment for prostate cancer. Over the years, radiotherapy treatment has continued to evolve and improve. Radiotherapy treatment outcomes for prostate cancer have become incredibly good, along with reduction in associated toxicity.

If you have a diagnosis of prostate cancer, your Bristol Urology Associates surgeon will work closely with your Oncology team. We have evolved joint methods of working to improve patient outcomes. To effectively treat the prostate tumour with radiotherapy, Radiologists need an accurate view (via x-ray) of the prostate gland during radiation therapy.

To help improve this view, urologists may insert gold markers, called fiducials, into the

prostate. This is done by placing hollow gold needles through the rectum and moving a fiducial through each needle. This allows state-of-the-art targeting of the prostate with radiotherapy which is then ‘image guided’.

If desired, we can also, under the same anaesthetic and through the same transperineal route, insert hydrogel spacers between the rectum and prostate. These spacers will create extra distance between rectum and prostate by placement of the hydrogel, which reduces rectal toxicity during radiotherapy. The hydrogel used by BUA surgeons is a cleverly selected one (Space OAR), which gets reabsorbed over three months also by which time radiotherapy is complete. NICE has approved this procedure which is becoming increasingly popular among Oncologists as well as patients.