Dr. Nadim Nasr

The only patients that I do hesitate in placing them, and I place my own spacers and fiducials. It's not our urologists that do them. The only patients that I hesitate in are the patients where we suspect some extension outside the prostate on the MRIs that they had before the biopsies. Those are the ones that I do hesitate in putting in spacers.

So there is some data in the radiation oncology literature that suggests that placing a spacer when there is extraprostatic extension could potentially push some of those malignant cells away from the prostate and away from the high-dose region, especially if you're using very conformal techniques like SBRT.

So there is some data in the radiation oncology literature that suggests that placing a spacer when there is extraprostatic extension could potentially push some of those malignant cells away from the prostate and away from the high-dose region, especially if you're using very conformal techniques like SBRT.

So there is some data in the radiation oncology literature that suggests that placing a spacer when there is extraprostatic extension could potentially push some of those malignant cells away from the prostate and away from the high-dose region, especially if you're using very conformal techniques like SBRT.

Now, where that is going to end up, and we don't really know, we're going to have to see what the future of the data holds, but Those are the cases where I might hesitate a bit in putting in spacer initially and might consider putting it down the road if my initial dosimetry shows that I'm compromising coverage to spare the rectum.

Now, where that is going to end up, and we don't really know, we're going to have to see what the future of the data holds, but Those are the cases where I might hesitate a bit in putting in spacer initially and might consider putting it down the road if my initial dosimetry shows that I'm compromising coverage to spare the rectum.

Now, where that is going to end up, and we don't really know, we're going to have to see what the future of the data holds, but Those are the cases where I might hesitate a bit in putting in spacer initially and might consider putting it down the road if my initial dosimetry shows that I'm compromising coverage to spare the rectum.

My experience parallels Eric's in terms of seven or eight years ago, we started using Spacer and You know, we're really doing, I mean, I probably end up doing somewhere between 50 to 100 cases a year. I did try the Baragel. I felt that the entire process of switching the tubes and the needles was a little clunky.

My experience parallels Eric's in terms of seven or eight years ago, we started using Spacer and You know, we're really doing, I mean, I probably end up doing somewhere between 50 to 100 cases a year. I did try the Baragel. I felt that the entire process of switching the tubes and the needles was a little clunky.

My experience parallels Eric's in terms of seven or eight years ago, we started using Spacer and You know, we're really doing, I mean, I probably end up doing somewhere between 50 to 100 cases a year. I did try the Baragel. I felt that the entire process of switching the tubes and the needles was a little clunky.

And I never really liked the end result of how the gel separated versus doing the hydrodissection and knowing that, well, you've got a nice space and you can go. The only time that I feel, at least in my experience, that there may have been a slight advantage

And I never really liked the end result of how the gel separated versus doing the hydrodissection and knowing that, well, you've got a nice space and you can go. The only time that I feel, at least in my experience, that there may have been a slight advantage

And I never really liked the end result of how the gel separated versus doing the hydrodissection and knowing that, well, you've got a nice space and you can go. The only time that I feel, at least in my experience, that there may have been a slight advantage

is in patients who we are retreating with radiation, where there's a lot of scar tissue in that perirectal space, and it will simply just not hydrodissect with the saline. I have used Baragel in those cases where I knew where the positive nodule was in the prostate to try to get some separation behind it.

is in patients who we are retreating with radiation, where there's a lot of scar tissue in that perirectal space, and it will simply just not hydrodissect with the saline. I have used Baragel in those cases where I knew where the positive nodule was in the prostate to try to get some separation behind it.

is in patients who we are retreating with radiation, where there's a lot of scar tissue in that perirectal space, and it will simply just not hydrodissect with the saline. I have used Baragel in those cases where I knew where the positive nodule was in the prostate to try to get some separation behind it.

But that's really, I mean, I would say, you know, less than three cases that I've done in that. The vast majority that we're doing is Spacor.

But that's really, I mean, I would say, you know, less than three cases that I've done in that. The vast majority that we're doing is Spacor.

But that's really, I mean, I would say, you know, less than three cases that I've done in that. The vast majority that we're doing is Spacor.

There's no prostate, so...