Cologuard positive. Can I have a colonoscopy 8 months after radiation?

My wife had a virtual colonoscopy some years back. I think they used a CT scan. Of course, if something is seen you'll probably need a regular one to remove whatever they see (assuming they don't need to do surgery). I'm not a medical professional so I have no idea if it's use is indicated in your case, but you might ask your doctor to see if it's an option for you. Best wishes.

@johnny8924
When I was preparing for my 30 rounds of radiation at UFHPTI they required you to have a colonoscopy within 3 years of radiation start date.

Reason was that even with proton radiation the secondary damage to colon can occur and having a colonoscopy poses possibility of concern with a damaged colon and increase chance of bleeding.

You are doing the right thing by have your medical team discuss this and get back to you. They are the ones to guide you on this. It maybe worth the risk of having a colonoscopy with a positive Cologuard but that needs to come from your medical professional experts.

Does a positive Cologuard mean cancer seen or does it mean just blood found? I was told by my Mayo PCP that Mayo is the one who developed the Cologuard test.
Good luck!!

Cologuard's ads say you might experience false positives AND negatives.

Then what's the point of using it?

I am having a flexible sigmoidoscopy 11 months out , it is less intrusive and my RO has approved. Normally no colonoscopies for 1 year past radiation.

@kenhorse
Exactly what I'm thinking at this time!

I had a colonoscopy in Aug 2023, 3 mos after completing 37 IMRT salvage radiation treatments in May 2023.
No problems at all. I did advise the Gastroenterologist of my radiation treatment before the procedure and he reported no indication of any radiation treatment damage to my colon. I was particularly concerned because I had very bad radiation proctitis the second half of my radiation treatment, all symptoms resolved 2 - 3 weeks after radiation completed and it was reassuring to get a good report from the colonoscopy
Best wishes.

@michaelcharles
Thank you very much for your comments! Just curious, what motivated you to have a colonoscopy?

I have had regular, "call back" screening colonoscopies every 3 - 5 yrs seemingly forever because a polyp or 2 have been found at each exam and this was a 5 yr call back exam.
And I was glad to have this one because I was a bit concerned about bowel damage following the radiation proctitis and this was an opportunity to get it checked out.
Funny thing is that the Dr said because of my age, 75, I would not be receiving another 5 yr call back notice. But I intend to ask for one in 3 - 5 yrs because I have had benign polyps, and why would I want to risk colon cancer on top of my PCa? Similar to the "you don't need to check your PSA after age 65/70" or whatever that bad advice was for men.
Other than the prep, which sucks, the colonoscopy was a non-event.
Best wishes.

@johnny8924
If I read right you had IMRT. I believe that is internal type of radiation like pellets. Is that correct?

I had external beam radiation (proton). Thus no personal experience with IMRT. I am not sure if same radiation damage to colon is different with IRMT so can't comment on IMRT.

The colon is going to get some radiation damage from external radiation. It is why patients have the Space/Oar of balloon done to move colon away from prostate. The colon is right on top of prostate. So if R/O is treating your prostate and margins the radiation beam most likely will hit colon.

Per my R/Os what happens is the blood vessels in colon are damaged. The body will build new ones but are quite fragile and easily bleed with bowel movements. The new blood vessels over time become stronger and the bleeding will stop.

The amount of radiation the colon receives and cause damage to it also along with very sensitive. It is why colonoscopies requirement within 3 years is done at UFHPTI. So the need to have follow up colonoscopies within 3 years of ending radiation treatments is not there.

I had colonoscopy many years ago prior to my radiation treatments. I was due one at the 10 year mark. UFHPTI required I get one prior to radiation. At that colonoscopy they did find polyps and removed 3 of them. So the surgery to do this was not with a very highly irritated and damaged colon so you can see why the recommendations to have prior to radiation if you are due one within 3 years of radiation treatments (UFHPTI).

I will have to have another colonoscopy in 5 years not 10 years because of the polyps. I was told my PCP would set this up for me and would be on my patient information. I do not understand some post of those over 70 being told no colonoscopies after 70.

I was 76 when I had my last one and will be 81 when I was told will have my next one. The most common reason for doing colonoscopies is to remove pre cancerous polyps so they won't grow into cancer and to look for signs of bleeding brought to doctors attention that bleeding maybe present in body. (my Mayo doctors not me information).

I put off my colonoscopy for a few years because last time I had them they were done without sedating you, they just raw-dog you right there on a table and it SUUUUUUCCCCCCCKKKKKKKKEEEEEDDD!

Due to that experience, I kept putting it off and did a couple different variations of the stick test - Cologuard and some other one that didn't require such a large, um, "sample". Last year it came back positive so I got my colonoscopy and there were nothing but a couple polyps that they removed.

When talking to my gastroenterologist, he said both of those tests aren't particularly accurate but might indicate an irregularity. Its analogous to the PSA test - not a true signal of cancer but more of a "check engine light".