Colonoscopies after Salvage SBRT -- How Safe?

[Boonster]

My internist has recommended that I get a colonoscopy. But simply to make sure there is no indication of any rectal problems. I have no symptoms of any rectal disease.

I had salvage SBRT for prostate cancer nearly a year-and-a-half ago, in late August 2021, There is no indication that the SBRT damaged the rectum, although I did have some rectal bleeding in the month or two following the SBRT.

Can a colonoscopy damage the rectum -- especially if one has had salvage SBRT for prostate cancer?

It has been 12 years since my last colonoscopy. That colonoscopy as well as several earlier ones, did not find any polyp.

Thanks for any comment you might have.

Boon

[Hidden]

See a Gastroenterologist and discuss. I had a colonoscopy one year after IMRT. In fact I have had about 13 procedures during my lifetime. Got one coming up next month.

GD

[Boonster in reply to Hidden]

Thanks for sharing your experience. I have scheduled an appointment with a gastroenterologist -- at Georgetown University Hospital.

[Travelinman]

I had a colonoscopy one year after my IMRT. My radiation oncologist and my gastroenterologist felt that the timing would be fine. And everything turned out great. Of course, internal damage is always possible during a colonoscopy, and I had radiation to both the prostate bed and pelvic lymph nodes during my IMRT -- so my internal areas were especially sensitive. But, again, I was 100% fine afterwards. No guarantees of course, but this is a case where your doctors -- especially your oncologist -- should be able to guide you. Gastroenterologists are usually eager to get up in there.

[Boonster in reply to Travelinman]

Thanks very much for describing your experience. I'll check with my medical oncologist. She's at Johns Hopkins.

[JRPnSD]

I am not sure why your doctor is recommending a colonoscopy if there has been no indication of continued irritation during your 18 months since treatment. A preliminary exam and then a sigmoidoscopy should be the progression of the evaluation from my experience....unless you are just due for a colonoscopy.

[Boonster in reply to JRPnSD]

I have just started working with this internist. I think he's primarily interested in establishing a complete set of medical records, with immunizations -- and colonoscopies -- all up to date. My previous PCP has retired. Thanks for your comment.

[dadzone43]

Tell your gastroenterologist. If you can get poop through there, s/he can get a 'scope through there

[Boonster in reply to dadzone43]

Haha, good point!

[Hawk56]

I had a colonoscopy about a year after SRT, 39 IMRT, 70.2 GYa to the prostate bed. I discussed it with my Gastroenterologist, no issue he said, the procedure went fine, the prep of course is the hardest part!

[Boonster in reply to Hawk56]

Thanks. I hear the prep has become easier.

[reichel]

had a number of colonoscopies over the years. No polyps. Was up for one in 2022. Asked to use Cologard and it was was easy. I had RALP in 2020 and then had radiation and close to finishing Lupron Abiraterone and prednisone.

I was just sick of doctors and no mention was made of any issues. Of course I didn't ask.

[Boonster in reply to reichel]

Glad to read that you've had clean colonoscopies. Thanks for your comment.

[Don_1213]

I read a brief paper yesterday indicating that poop-in-a-bucket (Cologard) is an effective alternative to an invasive colonoscopy, especially if taken annually. The finding of disease is about equal.

I've been doing this for about 7 years now, annual Cologard and my GP seems happy. And I'm happy. And it's obviously much less risky.

[akaipop3ps]

Another Cologuard user here, have done it twice in three years. Not as good as colonoscopy but a good alternative.

[Boonster]

Thanks very much for the steer to Cologard. I'll check it out firnsure.

[Rev214]

I had a colonoscopy a year after my PBRT. Turned out they found, and removed a polyp for biopsy. Turns out a pre-cancerous Tubular Adenoma. Cologuard, as convenient as it is, would have not detected or removed what would eventually become cancerous.

Timing is everything in fighting cancer, the earlier the detection and treatment the better your chances.

Prayers for you to as you navigate these daunting choices on a path no one wants to walk

[Spyder54]

Boon, STOP ! Talk with your Radiologist who did the SBRT. Mine said wait 9 mos to 1 year. He said when they radiated my prostate there was some rectal and bladder involvement that he hit on the margins. He said NO INSTRUMENTATION. I did Colo Guard at home vs colonoscopy. Btw: my oncologist said Colo Guard will pick up Colon Cancer, but will NOT pick up prostate cancer that has entered the rectum. Hmmmmm? Mike

[Boonster]

Thanks for the advice. I did start with my radiation oncologist. I specifically asked him about the safety of getting a colonoscopy within 17-18 months of receiving SBRT. In reply he simply referred me without comment to a gastroenterologist at Georgetown. Go figure. I thought he would have a view on getting a colonoscopy.