Fiducial Marker Seeds for Prostate Cancer: What They Do and Why They're Used

 I am a 71 year old who has recently, (1 month ago), been diagnosed with  a single finding of early stage, small core adenocarcinamo (Gleason.6)

Other than the cancerous growth in or on my prostate I'm in good health, work out, lift weights, jog, play a lot of golf and have a very active sex life. MY former urologist who left St. Louis for Northwestern university ( one of the founding fathers of the PSA project at Washington U.) has suggested prostatectomy, however I am more interested in quality of life issues than longevity, ( A combination of both would be nice)

 I'm in the process of selecting a treatment option and the first radiation oncologist that I consulted with last week at St. Johns  Pratt Cancer Center ,   

recommended a form of radiation therapy called The Tomo Process, which uses 3D images from a combination of scannong technologies ( such as CT and MRI) and special software to establish the precise contours for each treatment volume(tumor) and any regions at risk.

 I mentioned that a well respected urology expert associated with  Prostate Commons , a respected medical website, had stated recently that "Fiducial Marker Seeds ( gold fiducial markers are the fixed standard of refrence for comparison or measurement every time the patient has their radiation treatment"

The R.O. stated that fiducial markers were indeed very helpful in allowing radiation to be directed precisely to the diseased areas of the prostate and that they had been used at St. Johns Pratt Cancer Center sucessfully until the Tomo process was initiated approx. four years ago.

However the Hi-Art (Tomo) treatment delivery machine combined with a CT scan just before each treatment  verifies the position of the tumor and insures that radiation is directed right where it should be. There is continious 360 degree treatment delivery  of modulated radiation therapy( IMRT) with a helical(spiral) delivery pattern. THe Photon radiation  is produced by a linear accelerator (or LINAC for short), which travels in circles around the patient and moves in unison with adevise called a multi leaf collimator, or MLC. Meanwhile the couch is also moving --guiding the patient slowly through the center of the ring.

In other words it allows minimum radiation exposure to healthy tissue without having to utilize the much more invasive process of inserting gold markers.

My question for Dr Greenstein is the information given to me from this particular radiation therapist reliable and what does he thing of Tomo therapy as a treatment option for earl stage prostate cancer.

 P.S. I have a consultation with a second radiation therapist at Barnes/ Washington University Cancer center next week. I believe that his bias has been in the direction of radiation seeding.

 Any advice that will aid me in reaching a decision on treatment options would be greatly appreciated.

  Martin