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Stereotactic radiosurgery is a special form of radiation therapy— it is not surgery. Stereotactic radiosurgery allows precisely focused, high dose X-ray beams to be delivered to a small, localized area of the body.
The surgeon, radiation oncologist, and nurse will talk with you about the procedure. Before your procedure can be done, you will need to have certain tests. These tests may include blood work, urine testing, a CT scan (sometimes called a CAT scan), an MRI, or a PET scan. You may also require placement of tiny gold markers known as fiducials.
Your team will talk with you about the treatment. Be sure to ask any questions you have. You will then be asked to sign the consent form for your treatment.
A fiducial (fih-DOO-shul) is a small piece of gold sometimes referred to as a seed or marker. It is about the size of a grain of rice. The fiducial(s) marks the tumor. It can be seen on an x-ray and acts as a tracking device for the radiosurgery system to follow. The fiducial(s) will be placed in the appropriate area under ultrasound guidance by a urologist. This is an outpatient procedure and most patients return home within a few hours. You can have from 2 to 4 fiducials placed. You cannot feel them. They are not magnetic or radioactive and cannot be removed.
Fiducials will be placed 1 to 3 weeks before your radiosurgery treatment. You will need to stop any blood-thinning medicine such as Coumadin® and Plavix®, aspirin, and aspirin products at least 5 days before the fiducial placement. You will be told not to eat or drink anything after midnight the night before the fiducials are placed. You will need to have someone ready to drive you home after the procedure.
About 1 week after the placement of the fiducial markers, you will return to the radiation oncology department for a treatment-planning CT scan. At this appointment, a custom-molded “cradle” is made for you to lie on during treatment. The cradle will help you stay in the right position. At this appointment you may also have a catheter placed into your bladder to allow the radiation oncologist to see it better thus preventing any unnecessary radiation to that area.
The CT scan is done with you in the cradle. The CT images are sent to the planning computer. Once the CT scan is complete, the radiation oncologist and surgeon develop a custom plan according to information in the computer regarding your tumor. Planning your treatment may take 1 to 2 weeks.
After a plan has been made, you will be contacted by phone to schedule a date and time for treatments. You may receive 1 to 5 treatments over a 2-week period of time.
Once all your treatments have been completed, the radiation oncologist or nurse will speak with you and your family member and schedule your return follow up visit.
There have been minimal side effects associated with stereotactic radiosurgery treatment for pelvic tumors. The most common side effect is fatigue. Follow these tips to deal with side effects you may have.
Call immediately if you have any of the following symptoms:
To report these symptoms, or if you have any questions or concerns, please call the UPMC Hillman Cancer Center at UPMC Shadyside’s Radiosurgery Program Office at 412-623-2061.