how to maintain healthy weight during 6 weeks of radiation therapy?

[Orange95]

Can I please get some advice how not to loose too much weight during radiation? My husband had been told to be on laxative meds for whole duration of this treatment and he had been told to have at least 3+ b. movements a day. I am worried that he is gonna be too skinny, not overweight now.

[Elbers123]

The goal is to have an empty colon. I adjusted my diet and meal times to put my bowel movement close to procedure ( w in a few hours). Only twice did I need a liquid laxative. In general I am fairly regular. I had several weeks to practice. I also insisted on a steady schedule at the clinic. I lost about 6 pounds. Good luck!!

[Orange95 in reply to Elbers123]

Thank you, he is regular too, but not 3 + times a day.

[Atdabeach]

Laxatives make you lose weight only in the very short term. Once he's weighing with a relatively empty colon, his weight won't change much.

[Orange95 in reply to Atdabeach]

I hope so, thank you

[God_Loves_Me]

I have dietitians access from my oncology and she asked me to drink "Muscle Milk Genuine Protein Shake" and add some carbs in lunch and dinner. I have no diabetics so she did said that eating sugar help me to gain weight as well.

[Orange95 in reply to God_Loves_Me]

Thank you, he does not eat sugar at all.

[God_Loves_Me in reply to Orange95]

Yes Sugar is good source of high calories and also help you to get weight immediate

[Tall_Allen]

Laxatives increase bowel motility and are usually frowned upon with prostate radiation. I'm surprised his radiation oncologist asked him to do that; it is unusual, and 3X/day will dehydrate him. Are you sure that's what his radiation oncologist wants? It wasn't just a nurse who said that? You may want to double check with him.

[Orange95 in reply to Tall_Allen]

I will ask again

[Mike58]

I’m with T_A on this one. My oncologist advised aiming for an empty bowel and a full bladder for RT sessions, but going three times a day sounds extreme—it’s not typical, and using laxatives to force it could lead to hemorrhoids, which is definitely something to avoid.

I noticed your husband is on ADT, and honestly, losing weight while on ADT is tough. Most of us actually gain weight, especially around the belly. I’ve even tried a partial Keto and carnivore diet to help with weight loss, and after a week, I’ve dropped 3kg, which I’m pleased with, but I still have another 10kg to go!

So, if he’s already having a good bowel movement in the morning or before RT, I’d skip the laxatives. And don’t stress too much about weight loss during RT while he’s on ADT—he’ll likely follow the usual pattern and might even gain a little weight.

Wishing you both all the best!

[Jazzman2023 in reply to Mike58]

I agree......It was full bladder, empty rectum before going into radiation treatment....At my treatment center, guys who weren't in this condition prior to the treatment (through scans when on the table) were told to get off the table, go out and fill up or empty out, as required, then go back in (We called it the 'walk of shame')......And yes, the ADT can definitely cause weight gain, which can be partially offset by vigorous exersize. I went to the gym right after my treatments, to try and help with this..... Best of luck !!!

[London441]

Absolutely agree that the 3x/day edict is highly suspect. I would definitely double check that and let us know. Curious if it was a RO or just a staffer etc. There is no need for that, only a reasonably clean bowel. If it’s not clear enough they will tell you before the radiation is delivered , give you an enema that day if necessary etc.

[WisdomSeeking]

Hello,

diet should be low fiber and without gas. You may look at these guidelines: nutrition.va.gov/docs/Oncol...

Spicy food should be avoided. Fasting is not recommended because it creates gas. So he should eat normally, only avoid certain foods.

As others stated: the goal is to have a full bladder and empty rectum. My father tried to empty the rectum before every session. If he was unable to have a bowel movement, he took approx. 1 hour before the session a glycerin suppository. It was helpful. He didn't need a liquid laxative at all. He lost approx. 7 pounds after 4 weeks of radiation therapy but regained the weight in 1-2 months.

Your husband should also have a full bladder and empty rectum on CT simulation which is approx. 1-2 weeks before the RT. He should eat low fiber, low gas diet 3 days before the CT simulation.

For full bladder: it's good to have a bottle which have markings on it so you know how much you've drank, or you can create the markings on your own. For example my father drank 0.5 litre approx. 30 min. to 45 min. before the session. But everyone's bladder has different volume. My father is 70 and has urinary incontinence problems, younger men can drink more because they don't have such problems.

During RT it's recommended to drink a lot of water daily, so that body can regenerate.

You may look at a comic by a fellow cancer-figher @jpburns who was in a similar situation: healthunlocked.com/advanced...

Will it be a whole-pelvic-RT?

[Hami6]

Hi, like everyone else here, I'm surprised at the prescription of laxatives.In the UK, the protocol is empty rectum and full bladder. This is ensured by a protocol of micro-enema 60 minutes pre treatment, empty bowel and bladder 20 minutes later, drink 500ml 30 minutes pre treatment.

The daily enema is hard and I wonder if it's really required if you are regular in your bowel movements.

To this add a low fibre diet (reduces flatulence) and maintain hydration by drinking 2 to 3 litres daily.

In short, I'd question the advice given and if it's affirmed, consider a second opinion.

[IKNY]

I only had one BM per day, really had no appetite and had to work to keep weight on so that I wouldn’t have to be remapped which would have extended the process another 2 weeks.

I ate a large meal early in the morning )usually eggs and toast w/ coffee) as my radiation sessions were scheduled for 2-4pm.

For lunch I had bottle of ensure and for dinner usually a chicken protein and a salad.

Fridays after radiation I ate what I wanted.

When I started to get diarrhea after the 6th week (8 week sessions) I managed that by having one slice of Swiss cheese in the morning.

For a time I’d have a banana for lunch which caused lots of gas. Stopped that quickly.

I took no laxatives.

Skills gained

I can drink 20oz of water without stopping for a breath. :^)

Hope this helps, again my issue is appetite.

I still don’t have one since the surgery and am only what I can best describe as hungry in the morning.

No hunger pangs either.

Added

RADONC PA recommended to start Metamucil, which after 2 weeks kept on giving me bowel pain. He said it would keep things more firm.

I was also counciled by a GP PA to take a probiotic to regain gut enzymes after I had a course of doxycycline prior to radiation… that gave me tremendous gut problems and stopped after a couple of days.

I had been bitten by a deer tick the week before I was scheduled for treatment… thought I’d get in one more hike in the Adirondacks before my two month treatment in Boston.

[Rocketman1960]

For me when going through SRT having an empty bowel wasn't a problem, It was finding things that would stay in me long enough to be absorbed. I lived on pancakes with lots of Maple syrup and butter. I did loose more weight than I wanted but it all came back after treatment.

[T911]

In addition to a low gas diet I was directed to take Colace not with a laxative intent but for it to make bowel movements easier with less chance for any retained fecal matter in the rectum. It didn't modify my daily schedule and it did help me go as the low gas diet leans towards producing dense feces. That along with 10 ounces water 30 minutes before gantry time had me hit the marks for rectum and bladder condition every day but one. You get too know the feeling of the bladder being just right. Full but not too full.

[TheLarch]

My weight didn't change much during radiation. Empty colon and full bladder was the rule. They offered me laxatives but I just got myself used to going when I got up every day. I got up about 35 minutes before each radiation session around 3pm, emptied my colon and had a cup of coffee with milk. I drank some juice to wash down my meds and maybe a banana or a bagel if I felt like it. I only had a 5 minute drive to the hospital.

I didn't feel any side effects until about the 2-3rd week and moved to a more low fiber diet and took IMODIUM® (loperamide) for diarrhea for a couple weeks. I did gain a few pounds after radiation as I gained a little more energy and had more of an appetite.

I am a bit unusual in that the staff would tell me that I had a really full bladder as seen on the scanner and expected me to run to the bathroom after each session. But I wouldn't get the internal signal to my brain to relive my bladder for another 20-30 minutes.

[Tommyj2]

never heard of 3 bm’s a day…..empty bowel yes……check again with the RO…..I’d LOVE to lose weight during upcoming proton therapy.

[Orange95 in reply to Tommyj2]

That is why I am asking here. I have it in writing how to get ready for treatment, it is print out of 2 pages from Manitoba Cancer Care.

[Tommyj2 in reply to Orange95]

Got it…..guess they are VERY serious about empty bowels.

[Orange95 in reply to Tommyj2]

I guess

[Oatmeal2]

Hi, like everyone else said, the goal should be one bowel movement per day. Laxatives and 3 times per day sounds incorrect. My husband had his 26 treatments at Memorial Sloan Kettering, one of the premier cancer centers, and the instructions were to take citrucel once a day with a lot of water, and to take 2 extra strength gas x tablets at night before going to sleep and 2 gas x about an hour-hour and a half before the treatment. They set up the appointments so you arrive about an hour before for the drinking prep and tell you when to start drinking. The nurse explained that when they tell you to start drinking try to go to the bathroom if you can, and then drink the required amount of fluid. I think 2 cups was the right amount for my spouse. Probably about 24 ounces of water but everyone is different. He will know if he is feeling like he has to pee and holding it in, his bladder is full.

[Tommyj2 in reply to Oatmeal2]

I got the same instructions fromMSK……Montefiore just stressed empty bowel however that was achieved. Along with a full bladder……

[j-o-h-n]

Now don't tell us the doctor(s) prescribed an orange a day for 95 days for your dear Husband?

(Sorry I couldn't resist)...

Good Luck, Good Health and Good Humor.

j-o-h-n

[Orange95 in reply to j-o-h-n]

Not this time.

[hfl20]

I was told to "not change my diet". Well... my diet prior to treatment was mostly vegan with lots of legumes, etc. Not only does the colon need to be empty of "stuff", but also gas. Having a young radiation tech stick a catheter up your butt to relieve gas while on the table just adds to the stress of a daily radiation treatment. The radiation treatment provided all the laxative I needed and I had the opposite problem of diarrhea that I then had to deal with. Using otc meds just made things worse and for my 2 months I was walking the tightline between constipation and diarrhea. My solution evolved to nothing but 2 cups of coffee in the morning and nothing but water (8 to 10 bottles) until late afternoon treatment. After treatment I would have something like a "Boost" for protein and vitamins and a simple meal of chicken noodle or vegetable soup with a few crackers. I lost about 25 pounds but the goal was nothing but having a full bladder and nothing (gas or other) in the beam path which was detected by a cone-beam CT scan prior to every treatment. I was abnormal - most of my buddies had no issue with gas, diarrhea or constipation. My suggestion is to forget the laxatives unless your hubby needs help with a good BM prior to every treatment. Regardless of the unpleasantness of treatment and/or loss of weight just take it day by day knowing that it will be over withing 8 weeks or so. After treatment, I regained all that weight and more on ADT even though I was fine with the weight loss.

[Orange95]

Thank you everyone. I am so glad I asked here, we were stressing out 3+ times. Thank you again.

[TaylorMill]

Was there any overriding concern that the RO had because of the specific nature of his treatment?

I will add to others' comments by adding that I received no direction resembling this for my 39 sessions of radiation either. No requested change in diet, laxative etc.

I didn't have any issue with my own bowel prep. The instruction was simply to ensure the lower bowel and rectal areas were "clean". I did on a couple occasions choose to use a Fleet enema in the lower bowel just like I did for previous prostate biopsy. But this was solely my choice as a couple times I didn't have confidence I was clean "enough".

All of my appts were around 9-9:30 in the morning. I would get up extra early on treatment days for a normal breakfast and to ensure plenty of time for a regular bowel movement.

[Orange95 in reply to TaylorMill]

Thank you, it is not specific to him. Just general printed info about prep for treatment given during an appointment with RO.