radiation proctitis follow up

[Jmr11820]

Saw my GI doc about my persistent bleeding and clots, now accompanied by mucus, urgency, and irregular bm’s. He has scheduled another colonoscopy next week to rule out any other source of my issues. At the same time he will do Radio Frequency Ablation assuming no other source of symptoms is found. Questions are1) anyone have RFA for radiation side effects and 2) what is the latency period for radiation to become a cancerous lesion. I can’t find much consensus. I had a colonoscopy after in June 2021. RT ended July 2020.

[maley2711]

Overall studies of modern PCa radiation haven't found a significant increase in secondary cancers ...we do know that what you are experiencing can happen to small but still worrisome number of men who undergo PCA radiation...it appears you are one of the unlucky. What type of RT did you have? was there a good protocol for bowel prep, and were you able to comply successfuly? I'm guessin you have had thought of blaming the RO and his technicians? Of course, we never know for sure the cause of such SEs......some men are probably just more sensitive possibly?

[Justfor_ in reply to maley2711]

10-15% second cancer incidence after 10 years of irradiation, isn't "significant" as of you? Ok, if one is in his 80s when irradiated, but for the younger ones?

[chefjlu in reply to Justfor_]

Always be careful with % stats. There are many factors involved as well as time factors of collection. It is true that once you develop 1 cancer you have a higher risk of developing another cancer. Reason for checkups with your PCP as well as other pertinent doctors. Also radiation treatment has improved greatly over the years and continues to improve. Radiation dose, pinpointed beam, etc. have vastly altered exposure level during treatment. Treatment with radiation risks are greatly outweighed by the resulting outcomes. It is important to make changes in your lifestyle to improve outcomes as well as reduce risks. Diet, exercise, and positive mindset all work in your favor. Even with genetic connection "you can be predetermined, but it does not mean predestined".

[Justfor_ in reply to chefjlu]

% stats do have a wide margin of error, but this is by far less compared to subjective quantitative assesments regarding "insignificance". I wonder whether the people suffering from radiation damages were told beforehand that the incidence of it is somewhere between 3-8% would had ruled it as "insignificant" and had accepted the risk.

[chefjlu in reply to Justfor_]

While I almost became a doctor, passing over with about 1/2 year left to complete. I take the time to learn everything I can about any treatment and also ask questions before beginning. I understand the fear of radiation treatment and realize that some doctors may not explain enough. So in this time in history information is readily available and second opinions are overwhelmingly acceptable (still some that don't like it, I'd advise finding another doctor). It is always important to be a strong advocate for your health. Everything in life has risks and quality of life is important, weighing it for yourself is always the best approach as you should know your own situation the best.

[Justfor_ in reply to chefjlu]

Totally agree. Some years ago in this forum a wife from Ireland was asking advice regarding her husband's sRT. I raised the odds of a second cancer and they asked their Irish RO. He told them 15% at 10 years. They accepted the risk and went on with it. People are entitled to advocate for themselves after digesting as much available info on their cases as possible.

[j-o-h-n in reply to chefjlu]

6 Months to go..... and you decided to cook the meals instead of cooking the paYtients. You deserve an award..... So we're sending you a doctor's white coat stained with stove drippings.......... Welcome aboard.......

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 07/04/2023 7:55 PM DTS

[AlvinSD in reply to Justfor_]

10-15% seems very high. A recent study by Stanford found it was only 0.5% higher

“In a study of about 145,000 men with prostate cancer, the team found that the rate of developing a later cancer is 0.5% higher for those who received radiation treatment than for those who did not. Among men who received radiation, 3% developed another cancer, while among those who were treated without radiation, 2.5% developed another cancer.”

med.stanford.edu/news/all-n...

[Justfor_ in reply to AlvinSD]

You probably only read the begining of the paper, the "catchy" part of it. You also failed to notice that in it, no time frame was mentioned . Since the Hiroshima bombing it has become public knowledge that radiation is a slow killer. Killing rate accelerates with time. From the paper you mentioned:

"In a span of five years post-radiation, only 1 in 333 patients developed second primary cancer, according to the study. Fifteen to 20 years after treatment, that number rose to 40. Morris noted that it’s important to consider the patient’s age when deciding if radiation is the best treatment".

On another note, do you know the elementary rule of financial market analysts?

"Regarding future stock prices you can make price predictions or the time frame it will take to print a specific price, but NEVER both of them at the same time".

[Jmr11820 in reply to maley2711]

Oh yeah, did all the water protocol. did not do enemas, but my appointment was at 1 pm and was instructed to try and empty my bowels each day before my appointment.

[maley2711 in reply to Jmr11820]

were you mostly able to comply with the empty bowel request? I'm interested, as I have some sort of chronic bowel movement problem, even with soft stools.....and lots of trapped gas that can cause real pain....not sure what to do re radiation treatment.

[Jmr11820 in reply to maley2711]

yes. fully compliant.

[maley2711 in reply to Jmr11820]

did you do anything beyond the ordinary in order to comply withthe empty bowel request? As it stands now, I could not be fully compliant...very irregular!!!!

[Jmr11820 in reply to maley2711]

my appointments were at 1 pm every day, so that made it fairly convenient in terms of having an empty bowel. It was a little tough keeping my bladder full each time, but I managed.

[JPnSD]

My radiation Proctitis didn't appear until almost 2 years post Salvage RT. Colonoscopy with Argon Laser cauterizing of the locations of the spots. Drs. were blazé about the need for space bar, etc.

[Jmr11820 in reply to JPnSD]

did you have symptoms other than bleeding?

[JPnSD in reply to Jmr11820]

No...just some sporadic bleeding over the few months prior. Not heavy...but noticeable when wiping.

[AlvinSD in reply to JPnSD]

I got 28 sessions of EBRT at USCD. I asked about SpaceOar but my RO said that because of the location of my tumor he didn’t think it was a good idea as it could push some of the cancerous cells out of the way of the radiation field. It’s been six months and so far I’m OK.

I have a suspicion Kaiser discourages the use of SpaceOar as a cost saving measure. I know of two other people in SD where Kaiser was saying it was unnecessary and the patient really had to push back to get it. I was also told by a KP Urologist “you don’t need it…it’s only for people with diverticulitis or other bowel issues” which is totally inaccurate. Additionally, they make you go to Los Angeles to get it placed which is absurd.

Part of me is glad I didn’t get it because I’ve heard from two guys who recently had it placed and they said it was extremely painful and all KP did was give them local lidocaine…no sedation whatsoever.

[Spyder54]

your Bio does not say when you had your Radiation.

My Doc at MSK said NO INSTRUMENTATION for at least a year. Said tissue is fragile after Radiation.

There must be a scan that could show where the bleeding is coming from ?? Maybe some type of food intake like oatmeal could bind up the fissure where bleeding has originated? Hopefully someone here has experience stopping bleeding. I have heard from this forum that it may come and go from time to time but will usually stop soon thereafter. Mike

[Jmr11820 in reply to Spyder54]

had RT July 2020, RP was 10/2019. Colonoscopy was done 6/21.