How to treat rectal bleeding? Started after prostate cancer radiation

Posted by bill6161 @bill6161, Mar 11, 2023

I have prostate cancer which had metastasized to the pelvic cavity.
Started abirateron, then 26 external radiation treatments. For following five months I was doing great except for a lot of sweating and weakness. But stayed very active, ate well, and normal daily bowel movements. Then one month ago started rectal bleeding most days with stool. Dr says it is not unusual and should stop with time, but get a colonoscopy if bleed too much or really hurts. How to tell if bleeds too much ??? How to handle this??

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@vancouverislandhiker

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 .

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I had 5 high external beam radiation treatments for stage 2 Prostate Cancer which finished first week of August. Started bleeding rectally early in January. After a sigmoidoscopy revealed a small irritation problem with my anus My GP gave me sucralfate enemas to try for 6 weeks which did nothing and then tried sucralfate supositories which also did nothing. GP has asked for a G.I doctor-wait time to see around 2 months. Just wondering if you have met with the G.I. doctor yet and what he has suggested. I live in Kamloops, and have noticed that we don't have the same treatment options open to us here that are available at Mayo or other American medical facilities. Not sure if Vancouver would be a better option for me. I had to travel to the cancer clinic in Kelowna for my treatments and they have no system in place to help with radiation side effects-nurse told me to drink lots of water. Any info based on your experience would be greatly appreciated. Thanks for your time. David

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@vancouverislandhiker

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 .

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I live in Kamloops BC. I had 5 radiation treatments for Prostate cancer 9 months ago and started bleeding rectally 5 months ago. My GP had me try Sucralfate enemas and suppositories for 8 weeks which didn't help. I'm waiting for an appointment with a G.I. specialist. I'm wondering how you made out with your G.I. since we both live in British Columbia.

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@beluga

I live in Kamloops BC. I had 5 radiation treatments for Prostate cancer 9 months ago and started bleeding rectally 5 months ago. My GP had me try Sucralfate enemas and suppositories for 8 weeks which didn't help. I'm waiting for an appointment with a G.I. specialist. I'm wondering how you made out with your G.I. since we both live in British Columbia.

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Bulga , 5 treatments ? Was it EBRT or some other type of radiation? The usual dose is 30 sessions . Rectal bleeding can be a common side effect . Usually just when you have a bowel movement though . I saw a GI Doctor , he looked at my last Colonoscopy and said it looked healthy , and recommended we do a test to scope Oesophagus and stomach - just to be sure .....but he said it is common and the small blood vessels get irritated . Mine seems to be variable . about 1-5 times a week I will get some blood passing in bowel movements . Im not too worried after talking to GI Dr . What he did pick up on is , that I have a fatty liver . he recommended me loosed 10-12 lbs and some natural supplements such as milt thistle and such . he will scan my liver for this as well next month . Keep my in the loop of your progress .... James - Vanc Island .

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Thanks for getting back to me James. I had external beam radiation therapy in Kelowna. They are using a more intense once a week 5 week series radiation protocol now for cases like mine-I was diagnosed as stage two-3 lesions with Gleason 3+4. Did your G.I. suggest any treatment for the rectal bleeding, ie. Hydrocortisone Acetate Foam, or surgical remedies such as cauterization or APC? I am finding that there seems to be many more options for treatment in the USA than are available here in BC. Hope your treatments are positive.
David, in Kamloops

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If you have a diagnosis of radiation-induced proctitis, insurance may pay for hyperbaric oxygen therapy (HBOT)
> radiation proctitis: https://www.ncbi.nlm.nih.gov/books/NBK537343/

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@brianjarvis

If you have a diagnosis of radiation-induced proctitis, insurance may pay for hyperbaric oxygen therapy (HBOT)
> radiation proctitis: https://www.ncbi.nlm.nih.gov/books/NBK537343/

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My insurance paid for my recommended 40 treatments.

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@sarmajor

My insurance paid for my recommended 40 treatments.

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Had you tried other treatments before HBOT? If so, which ones and did any of them help?

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@vancouverislandhiker

Bulga , 5 treatments ? Was it EBRT or some other type of radiation? The usual dose is 30 sessions . Rectal bleeding can be a common side effect . Usually just when you have a bowel movement though . I saw a GI Doctor , he looked at my last Colonoscopy and said it looked healthy , and recommended we do a test to scope Oesophagus and stomach - just to be sure .....but he said it is common and the small blood vessels get irritated . Mine seems to be variable . about 1-5 times a week I will get some blood passing in bowel movements . Im not too worried after talking to GI Dr . What he did pick up on is , that I have a fatty liver . he recommended me loosed 10-12 lbs and some natural supplements such as milt thistle and such . he will scan my liver for this as well next month . Keep my in the loop of your progress .... James - Vanc Island .

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Hi James, hope you are well. I am waiting to see a GI. My GP had me try Sucralfate enemas and suppositories but neither worked. Wondering if your Dr's have given you any other treatments and if any of them worked.

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Hi , since my bleeding is intermittent my Dr has not prescribed anything for me . About 8 months ago I had a Colonoscopy . The GI Dr at the time said be 'believes' it to be radiation irritation in lower large bowel and should be fine in a year . If not fine, after 8 months , still getting blood in stool about 3 times a week . But the Dr said there was 'no issues' . I scheduled another Appointment with a GI Dr on Vancouver Island ( the other Dr was in Vancouver ) . The New Dr on Vanc Island was bad news . Never did anything . He doesn't return calls either from his office . Have to get another on . EBRT = external beam radiation . 🙂

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