I’ve been getting some confusing, and contradictory info regarding what prep I’ll need when I start my EBRT next month, regarding enemas.
I grasp that I’ll need to do one before my CT Sim Monday. But then on the instruction sheet Emory/Winship sent me, it said I would have to have one every day before treatment. I know I should have a full bladder, and “empty my bowels,” but an enema a day sounds like a lot.
I’m obviously going to confirm these instructions when I go in on Monday for the CT Sim, but trying to figure out if this is something everyone does. I hadn’t seen before that when I researched radiation.
Thanks in advance for your help.
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Jpburns
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For me it was full bladder and empty bowels. I took Mirilax every evening, and worried I wouldn’t be able to “go” before heading to radiation. Always was able to thankfully.
Definitely get clarification from the Oncologist.
Good luck, the first trip is otherworldly overwhelming for me walking into that room, but the technicians where incredible bright lights during the month.
Follow their instructions! Do not take any laxatives and do not add fiber to your diet - it can cause gas and motion, which will force rescheduling of the CT and treatment.
It is important that the rectum is clear, so there is nothing pressing against your prostate. I know that many ROs instruct a low fiber diet and a Fleet enema before each treatment, and a comfortably full bladder. My RO told me to evacuate my bowels before the CT and treatments and to make no changes in diet, but follow your RO's directions.
My dear buddy said he ensured a brisk walk and evacuation every day pre EBRT and it became a new habit. He said it was more difficult to hold the full bladder but he managed during the 39 EBRT’s over 8 weeks without TOO much discomfort. He used DOVE soap in the shower and sorbolene post treatment. Great outcomes to you.
just finished my SBRT and VMAT I had to take a laxative daily ( lactulose) to empty my rectum. 33 days at 5 consecutive days days a week . Lost some weight about 5 kgs. Full bladder and empty rectum is the prep for this.
Enemas aren't required, but like others here are saying if you can have a bowel movement before each treatment it will be very advantageous. Otherwise you may be told to go try and have one after they start your treatment if the machine has trouble positioning itself. 🦊
i guess it’s an individual thing, as I have always (or nearly always) had a bowel movement first thing after breakfast I didn’t have an issue so no enemas were needed.
To be honest the only issue I had was when I tried their low fibre diet before my CT scan — so I decided to just went back to my normal diet for the daily radiotherapy sessions.
I also had no issues with the bladder as was always well hydrated and I often got in early as others sat in reception drinking to fill their bladders.
So I guess discuss and take into account your normal pattern - albeit maybe anxiety can sometimes alter things.
To be honest apart from the daily travel, fatigue and late on a bit of a slow urinary flow the whole process was so much easier than I had feared and often read about.
The real struggle for me has been the hormone therapy and of course worry and anxiety living with high risk prostate cancer and ongoing tests and monitoring.
In a way when having RT daily I felt I was actively doing something and surrounded by others in similar situation plus supporting staff on a daily basis. Once it’s over it’s I feels different and sometimos more difficult to mentally adjust to and learn to deal with.
I had 20 IMRT without spacer for prostate in 2021, and 30 IMRT for pelvic nodes in 2023. The daily prep needed to create the same conditions as the simulation CT. I did not change my diet, which for decades has included oatmeal and large salads, and Metamucil every night. It was rare not to have a BM in the morning before treatments, and only a few times was a Fleet liquid glycerin suppository needed. It is a mini-enema, a little bulb of liquid, sold in packs. I peed an hour before treatments and drank 1-1/2 cups. of water to refill the bladder part way. I had no discomfort or side effects from the radiations.
Your intake precision brought back memories. I had a bit of a drive to get to Stanford, so my hydration ritual began when I woke up. I drank a calibrated 24oz of water, did a core exercise regime which usually stimulated a movement. At departure, I voided, drove up rt17 for 30-45 minutes. At Stanford I would be too full to wait so I took took a no pressure void for 8seconds, then drank 8 gulps of water to ensure I was suitably uncomfortable at show time. I remember vividly the EBRT table movements, the silence as they evaluated my condition, the discomfort, and if I hit my volumes right, a gratifying loud click, the siren and red sign flashing, and the machine rotating all the while sounding like cards were being shuffled.Same as you, no SEs. Though I recently had an MRI, and the report came back that there was good anatomical evidence of the treatments. So it was effective I suspect.
Yes, I think we are justifiably concerned about the process. I played it conservatively at first and used daily enema because I couldn't always tell if bowel was empty or clear enough. After awhile you get better at controlling and timing of full bladder and empty bowel and if needed you can delay treatment for 30 minutes or so until it's adequate. Good luck.
I had 44 EBRT treatments 2.5 years ago and no enemas were ordered but full bladder for sure. Now I have fissure that will slightly bleed depending of "girth" of bowel movement. MO says that could have been caused by radiation. He didn't recommended any treatment.
A lot of people recommend coffee enemas for cancer, and I was using them every few days to treat Prostate Cancer. I believe it really straightened out my digestive system. Important to use blonde organic coffee so you know there are no strange additives. Available from a company called S.A. Wilson. google.com/url?sa=t&rct=j&q...
I had 44 treatments. I never needed to do an enema before a treatment. I went onto the low fiber diet that they recommended, it kept things flowing smoothly. I was able to set up a daily time of 11:00. I would have breakfast in the morning, have a nice poop and then head to the center. On the way, I drank a 16oz bottle of water, this made my bladder full by the time my turn came. I never had to make of shame (get on the table and then be sent back to waiting room to drink more water).
They will do a dry run before the real sessions start. My suggestion is to just do your normal routine and go in. They will tell you if there any issues with your bowel or bladder. That way you can adjust what you need to do when the real stuff happens.
Prior to each of my IMPT treatments, I was first checked by ultrasound to see if my bladder was at the minimum amount that was there for the planning session. If not, then you drink water and watch others go ahead of you. Then prior to the proton zap, small CT beams were used to see if anything is in the beam path. They will let you know if there is anything in your bowel including gas which you either pass or they will use a catheter to get it out before continuing. It was always a relief to make it to the table and pass the CT tests... I used a fleet enema 3 or 4 times over the 2 months of treatment when I felt I needed it. After treatment I built my gut back up with a host of refrigerated probiotics (yogurt, kefir, naturally fermented sauerkraut, etc.).
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