Gold markers- are they outdated wit new radiation machined

I am diagnosed with locally advanced prostate disease( refuse to dignify it wit a name) Gleason 8. Just got3 rd Lupron shot. Dr wants to start radiation. This is my dilema : one dr has newer machine that doesn’t need markers. Another dr I met yesterday uses gold markers. I really like this dr best
Wat to do. ?
Choose new machinery or dr I like better?

Jack

Additional welcome to the club that chose us and not the other way around.

I just finished 44 treatments and I had the gold markers implanted. It was not a big deal. Are you sure that you are comparing the same treatments. I heard that proton treatment does not require the gold markers, while photon treatment does. So far the studies do not indicate a measurable difference between the two forms of radiation.

I agree with the prior posts. It's the team that matters.
I had those fancy markers implanted prior to SBRT, but if one can do without the procedure to implant these markers, that would be a plus. After all, the procedure, although low-risk, requires minor surgery and anaesthesia.

The newer machine is a siemans SOMATOM definition as.
Other one is Varian true beam intensity modulated machine.
Never been on a support group yet. Thanks to all. God bless 🕊

No gold markers for me, just small tattoo like dots, exterior skin, not sure why but was happy about one less "probe"

I did not have markers and did just fine. I asked my RO about them and he said it was just marketing and that nothing proved they had any advantage. Plus they hurt to have inserted.

The gold fiducials assist when they do final alignment. IMHO they make it easier and more repeatable.

I had HDR and IMRT. They inserted the gold fiducials during the HDR portion. They will place the tatoos on you when they do the simulation for your IMRT treatment plan, those fiducials wll be nice beacons.

I was treated on Varien True Beam. They place you on the table, align to the tatoos. Then a Cone Beam CT is done, now they look at your anatomy from the CT and do the final alignment, if you have the markers, they look at the markers and anatomy on the CT.

Maybe they dont need the markers, but the way I looked at it, accuracy is critical, and another tool to assist is a good thing. I was glad I had the markers, if I had opted for pure IMRT, they would of gone with the Cone Beam CT and aligned off anatomy only, this told me the fiducials were worthwhile.

good luck to you, it is tough deciding what to do and where to treat.

but, but, gold markers are the gold standard ...