Hey, I remember this same question on another topic and two other men had the same issue; cautery worked out well for both. Don't remember the topic -sorry!

This procedure is completely successful and painless. I was told by a number of oncologist that I should just get used to it because nothing would be effective.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893353/#:~:text=Radiofrequency%20ablation%20(RFA)%20has%20been,1%20or%202%20RFA%20sessions.
You have to acertain that they are using the Halo 90 ablation wand and not settle in when they say radiofrequency. This wand was specially developed for esophageal ablation. In the use for proctopathy ( radiation proctitis has a different etiology than proctitis) it is shown to restore the normal epithelium because of a carefully controlled depth of frequency.
I had a difficult time finding a practitioner. But found the best at USC, dr. Buxbaum. My experience was six years ago, so maybe it is more commonly known now.
Radiation proctitis doesn't begin immediately after radiation but is progressive even years after treatment.
It's an outpatient procedure done in hospital. I would check in a 6am and usually have the procedure by noon. They usually administer light anesthesia, but I never had it because the rectum doesn't have any pain nerves. You get a little sensation with the application of the wand, but you can watch the whole procedure. I never experienced any pain afterward. I say never because I had it done several times. The treated areas never rebleed, but new areas will bleed and they limit the number of applications.
Hyperbaric oxygen treatment also works, but it takes a long time. Its two hours a day in a chamber and it can take up to 90 sessions to achieve results.

flax,
the prep is the same. It is good to acertain that there isn't additional damage in the colon. Considering the angle of the beams with your cancer treatment your doctor might consider rectoscopy. My cancer was rectal.
It would be nice if they let you schedule both at the same time, so you'd only have one prep.
Was it easy for you to find a gastroenterologist for the Halo?
I'm delighted you were able to find a practitioner. Was it easy.

Flax, I had 22 sessions of external beam radiation about a year ago. This was in supplement to my prostatectomy which was three years ago. A slight increase in my postoperative PSA from 0.0602 0.14 is what triggered the radiation treatment. It was rising slightly. Since in my PSA has been 0.14, 0.11, and now 0.072. It's definitely heading in the right direction but it was slow. With my 22 sessions of external beam radiation there was absolutely no chemicals or ADT. 3+4 Gleason . The rectal bleeding started about four months after my radiation and continues until this day. I have a G.I. doctors appointment upcoming, so I can report back. My appointment is mid May, so if you want to get a hold of me during that time frame I can certainly tell you what the G.I. doctor told me. My urologist suggested that there is likely some irritation from the radiation and sometimes bleeding can come from polyps. He recommended that I see a G.I. doctor and that I requested the colonoscopy as well as the search down my oesophagus into my stomach looking for polyps and other abnormalities. However he suggested that the situation is not uncommon and is usually a result of irritation to the large intestine, irritation to the polyps in the large intestine and polyps in the stomach. He said the definitive answer must be obtained. God Bless Sir . James on Vancouver Island .

Ask about hyperbaric oxygen therapy (HBOT) for radiation proctitis: https://www.ncbi.nlm.nih.gov/books/NBK537343/

I called over thirty doctors mostly from pub med publications. I found a gastroenterologist at Scripps Green and a GI at Stanford was willing to attempt the procedure though he'd never done it before because Stanford had the equipment. The original author said he would except that they didn't have the equipment at Sutter.
I think I had to pay for the article because of a paywall. Your md should be able to pull it up if you send him the link. You might send it ahead of your visit through my chart or email. I suspect he won't know anything about it and thereby wouldn't be able to recommend it. I'm hoping you'll have luck. I'll appreciat your post.

Hi @flax, As @heavyphil your question was asked in another topic, so I moved your post here:
- How to treat rectal bleeding? Started after prostate cancer radiation
https://connect.mayoclinic.org/discussion/how-to-treat-rectal-bleeding-which-started-six-months-after-prostate-r/

@bill6161 was asking similar questions and also scheduled to get a colonoscopy to rule out other possible causes.

You might also appreciate this related discussion:
- Looking for tips on managing Radiation-induced proctitis
https://connect.mayoclinic.org/discussion/radiation-induced-proctitis/