Blood in Stool 3 months after Proton treatment

@brianjarvis I’ve read where Barigel is superior but it’s not available here in Puerto Rico.. spaceoar or something similar is but he seems to say it’s more trouble than it’s worth.. however it’s my body so I will get whatever I can…

@islander2025 Barrigel is often preferred because its sculptable; SpaceOAR Vue offers better CT visualization because it’s enhanced with iodine.

There’s a newer rectal spacer product called BioProtect that is reported to produce a larger and more consistent space.

Use of a rectal spacer is just one of many treatment risk/benefit decisions that must be made.

I had 44 weekday radiation treatments during February-April. I've had diarrhea since and am taking extra fiber and probiotics daily. One day this week, I had bright red blood on the tissue following a bowel movement, but that was the fourth movement of the day. No evidence of blood today. I'm being monitored by a gastroenterologist. If it returns or persists, I'll contact him.

I had 39 sessions of VMAT (with SpaceOAR) 2.5 years ago. This past January I had two consecutive bowel movements with blood in the water. No other bleeding before, or since. I recently had a routine colonoscopy where the physician noted likely signs of radiation proctitis in the rectum, but no bleeding.

I have radiation proctitis. You may want to start a food diary to see if certain foods trigger the bleeding. With me, even small amounts of palm oil, and other myristic acid foods, as well as more than one cup of coffee can result in bleeding the next day!

I had 5 SBRT treatments and had some severe rectal bleeding 5 months later. My GP sent me to a Gastrointestinal Doctor after the usually prescribed enemas and suppositories didn't help. The specialist used APC-Argon Plasma Coagulation which worked well to clear up the problem.

Attached is a discussion on rectal bleeding and proton therapy. I can tell you that I was advised after my 28 session treatment that bleeding occurs in 30% of patients, then told 5% then told between 5-30% . Space oar will dramatically reduce that occurrence, I think it is still higher than other forms of radiation and that there is little margin for error. I believe error occurs with gel placement more often than some would suggest. I have had some bleeding shortly after treatment and one incident 11 months out along with digestive track issues. I do worry that bleeding would equate to proctitis ( chronic at some point ). Bleeding can occur with any form of radiation but it seems more prevalent in Proton. Just my opinion not a medical professional. I think based on my reading MRI guided SBRT seems to be a solid alternative.

@neilmartin Definitely not limited to Proton.

@neilmartin Very interesting. I’m sorry you have there issues. I would have thought due to the nature of protons, we would be less susceptible to any rectal issues. I did have the Barrigel spacer. I haven’t had any other specific issues with gastrointestinal issues or blood sinc e that one time. But I guess from what you are saying, time will tell. I had the 5 day course.

@beluga Was this Proton theapy? Sorry to hear that happened. It certainly goes against all my expectations of Proton and a spacer.