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About Your Placement of Fiducial Markers or Beacon Transponders (Calypso)

This information will help you prepare for the placement of your fiducial markers or beacon transponders (Calypso®) at Memorial Sloan Kettering Cancer Center (MSK).

The prostate is a walnut-shaped gland that is located below your bladder and sits directly in front of your rectum. It surrounds your urethra, which drains urine from your bladder. The gland also adds fluid to your semen.

Markers will be inserted into your prostate so that your doctors can have a better view of your prostate during radiation therapy. There are 2 types of markers: fiducial markers or beacon transponders (Calypso®). Your radiation oncologist will determine which marker is best for you.

You have been scheduled to have markers placed on:

___________________________ (date) with Dr. _______________________.

Your procedure will take place at the following MSK location:

Sidney Kimmel Center for Prostate and Urologic Cancers
353 East 68th Street (between First and Second Avenues)
Concourse Level
New York, NY 10065
 

Before Your Procedure

Tell your doctor if you:

  • Take medication to thin your blood (anticoagulants) such as:
    • Aspirin
    • Clopidogrel (Plavix®)
    • Dalteparin (Fragmin®)
    • Heparin
    • Warfarin (Coumadin®)
  • Take steroids such as prednisone
  • Take any other medications such as herbs, vitamins, dietary supplements, or natural or home remedies
  • Have taken any antibiotics in the past 3 months
  • Have any heart condition
  • Have implanted devices such as knee or hip replacements
  • Are allergic to the antibiotic ciprofloxacin (Cipro®) or any other medications
  • Are allergic to latex
  • Had a urinary tract infection (UTI) in the last month
  • Had an infection or were ever hospitalized after a prostate biopsy
  • Have a history of Achilles tendon injuries or tendonitis
  • Have difficulty hearing
  • Work in a hospital or nursing home

10 days before your procedure

  • Stop taking
    • Aspirin
    • Products that contain aspirin
    • Vitamin E

2 days before your procedure

  • Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as:
    • Ibuprofen (Advil® or Motrin®)
    • Naproxen (Aleve®)

The Day of Your Procedure

  • You can eat your regular breakfast the morning of the procedure.
  • Do a Fleet® enema the morning of your procedure. You can purchase it at your local pharmacy without a prescription. Follow the instructions on the box.
You will need to take an antibiotic to prevent infection from the procedure. Your doctor or nurse will tell you which antibiotic you will take. Check the box next to the antibiotic that you will take below:
 
  • Ciprofloxacin 500 mg (2 tablets)
                - Your doctor will give you a prescription for this medication.
                - Take the first tablet 2 hours before your procedure.
                - Take the second tablet 12 hours later.
 

 

  • Gentamicin (injection)

               - Your nurse will give you the injection 1 hour before your procedure.

  • Ceftriaxone (injection)

                - Your nurse will give you the injection 1 hour before your procedure.

  • Imipenem (injection)

               - Your nurse will give you the injection 1 hour before your procedure.

Notes

 

During Your Procedure

Your surgeon will use a local anesthetic to numb the area around your prostate. It will be similar to what you get at a dentist’s office. A probe will be placed into your rectum. Three markers will then be placed within your prostate through a needle.
 
This procedure will take 30 to 45 minutes. Before you are discharged, your nurse will tell you how to care for yourself at home.
 

After Your Procedure

Temporary effects on your stool, urine, and semen

  • You may see blood in your stool. You may also have a small amount of bleeding coming from your rectum. These can occur right after your procedure and continue for a few days when you move your bowels.
  • Blood may be in your urine for 7 to 14 days after your procedure. The bleeding may come and go. Drink at least 6 to 8 glasses of liquids daily for 5 to 7 days to minimize the amount of blood in your urine. Limit your intake of liquids after 8:00 pm to avoid trips to the bathroom during the night.
  • Your semen may appear “rusty” for up to 12 weeks after your procedure. This is because small amounts of blood may be in it.

Activity

  • Do not engage in any sexual activity for 3 days after your procedure.
  • For the next 5 days after your procedure, do not do any sports, work out in a gym, ride a bicycle, or lift any objects heavier than 10 pounds.

 

Call Your Doctor or Nurse if You Develop:

  • Bright red blood or large clots in your urine
  • Heavy or continued bleeding out of your rectum
  • An inability to urinate
  • A temperature of 101° F (38.3°C) or higher
  • Shaking chills
  • Dizziness
The information in this resource is selective and does not cover all possible side effects; others may occur. Please report any problems to your doctor or nurse.