Post Radiation Therapy - Blood in Urine
Following removal of my prostate, I had 40 sessions of radiation therapy to the pelvic area. The radiation therapy was concluded in 2018. This past week I have noticed 3 instances of blood in my urine. I was concerned enough to contact my urologist, and he reassured me that he believes it is a result of radiation from 2018 and nothing serious.
I did some research and found a site that may describe my condition. It is called radiation cystitis, and the site stated that 1% to 2% of men who receive radiation to the pelvic region will experience bleeding 5 to 20 years later, due to injury to the bladder during radiation.
My question to any of you fellows out there who may be in that 1-2% with me: "How long did the blood in the urine continue; did it stop on its own at some point? And did you require any medical treatment to get it to stop? I would appreciate any responses.
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Hello. I am a RN and I am answering for my husband. He was diagnosed with Prostate CA in 2009 and received Proton therapy. Everything went peachy until 2017 when he had profuse bladder bleeding as a consequence of the radiation. He was diagnosed with Radiation cystitis. He remained in the hospital for several days having bladder ablation and a TURP. Since he kept bleeding the urologists ordered Hyperbaric Oxygen. He got 80 treatments and bleeding stopped….Until now in 2024 when bleeding episodes have started again. The urologists in Mayo Clinic said that the symptoms come and go. There are many options offered to stop it and surgery was brought in the conversation to remove bladder. My husband is 82 yrs, diagnosed with Amyloidosis that has affected his heart resulting in Right Side Heart Failure. Surgery is a risk at that age. No Oncologists in Proton therapy institute told any patient that Proton therapy could cause Radiation cystitis and even rectal bleeding. Znd probably they are not telling them either today. When my husband had that bleeding crisis in 2017 I called Proton Therapy institute and spoke with one of their oncologists, Dr Mendelhall, and she told me that they were starting to see many patients with prostate cancer who had finished treatment years ago with the same bleeding issue. She was the one who recommended Hyperbaric Oxygen treatment for my husband. That is the treatment they are recommending for Radiation Cystitis crisis. Hope this helps.
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3 ReactionsI had 32 Proton treatments in 2016. The RO would ask me if I was having any blood in urine or stool. Just 3 months ago passed the stringy red clot in my Primaries office and sent to lab with no real read other than blood in urine. It has happened twice since then. I probably do not help things in that I ride, row, Peloton machines, I lift , and Ruck. So far I pass the blood and stringy mess and my next urine is clean...All kidney test are normal and I am regularly scanned because of stage 4 mCRPC.. I have no pain so I just move on.....
My experience has been very similar to that posted by hector13. I had robotic surgery to remove a malignant prostate in 2007 (age 62) but my PSA started to rise again in 2018. I had 39 radiation sessions in 2018 focused on the area where prostate was removed which reduced PSA from 0.13 to 0.01 to 0.03 range where it remained the last time it was checked in early 2025. In May 2024, six years after radiation I started periodically seeing blood and small clots in urine. Sometimes it would be months between episodes. On one episode (while on Eliquis) a large blood clot plugged my urethra requiring an emergency room visit and a foley catheter to clear the blockage. My urologist did a cystoscope to check the bladder and found no issues. He said that it was probably from some damage to my urethra and offered no resolution. Now about 18 months after it started, I still have periodic relatively small amounts of blood in the urine and sometimes will pass clots. The latest was a relatively large clot that passed today after months of all clear. I'm wondering whether excessive straining or exercise might be a trigger.
I had proton radiation for prostate cancer 15 years ago. Now I am bleeding about every 3 weeks a couple of times in one day when I pee.
I had a scope about 2 years ago and the urologist said it was wall damage in the bladder from the radiation treatment .
Since blood is more frequent now than it was a couple of years ago, and there is an occasional small chunk of blot material, what should be my next step? Just keep on trucking or get another scope?
@robotic07 Probable cause is the radiation but the Elequis certainly is a contributing factor.
Phil
@dmedlen I had non invasive bladder cancer a few years ago; it was cleared up 🤞with BCG bladder flushes; so now I go yearly for scopes.
After my SRT I was concerned about secondary cancer (which, BTW, is rare) so I continue to go for scopes; my urologist saw no damage at the last visit (due in 2 weeks).
But if your Uro DID see damage I think you should definitely follow up on it as damage and chronic inflammation can give rise to cellular changes down the road.
Phil
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1 ReactionLots of good information here…. Thanks to all of you. Well I had 44 radiation treatments that ended May 2025. This past week in April of 2026 out of the blue there was a load of blood in my urine along with blood clots. Scared the hell out of me. Saw my urologist real quick and he believes it’s from the radiation. Doing a cystoscopy in 5 weeks just to be sure the bladder cancer has not returned. I did that battle for 4 years 2008-2012. I’ve had over 30 cystoscopies to date. But missed the last two years fighting the prostate cancer. This coming week I’m seeing my Oncologist so we’ll see what he thinks. I was a Gleason 7 with seminal vesicle invasion. Taking that damn ORGOVYX for about 16 months now…. Hope to get off it soon. Best of luck to all of you and God Bless. Ken