Blood in Stool 3 months after Proton treatment

No it was not. As far as I know, there is currently no Proton therapy available in Canada. Our health care system is much different than yours. Our government health care covers all of the costs for prostate cancer treatment and it's possible side effects so both the radiation and APC treatments were free.

@robertov I think there are some subtle issues here. First, a well done gel spacer is protective. I believe that with IMRT it makes the treatment safer. I think with Proton it makes it much safer , meaning, if the spacer has a lower quality placement there may be more risk with proton. I agree with most that the proton beam is more accurate, there is in my mind a challenge though. If it is positioned via CT , you have a highly accurate beam with a targeting system that is no better than IMRT say 4-5 mm. In your case you likely had control like Cyberknife fiducial implant feedback that would shut Proton streams off if it sensed an out of position prostate. That is not the case with 28 or 44 session proton to my knowledge. There is a 2 axis alignment prior to each treatment then no active feedback for position. My personal issues are not so bad , they have improved over time but it has caused me to explore this. I think proton has the potential to be extraordinarily accurate and is in fact gaining ground in many areas. It seems prostate treatment has a different set of variables than some other cancers. In the end it may be the premier treatment but I think it has a few iterations to go.

I'm surprise this would happen with with 5 sessions of Proton therapy which is much more targeted then most radiation therapies lasting 30-40 treatments. If blood is bright red it's most likely from hemorrhoids.

@robertov
I will post to you what my R/O at UFHPTI, R/O at Mayo Jacksonville, and PCP at Mayo Jacksonville advised me about this. I also read about this in the information packet given to me at UFHPTI.

This comes directly from my R/Os. When you get radiation to prostate many things are done to lower radiation damage to healthy organs, tissues. However some radiation damage most likely to occur. The colon gets hit and damage does occur.

What happens is after your finish treatments the body starts to make new blood vessels that were damage. These vessels are very fragile. Normal bowel movements, constipation, etc. can damage these vessels. Thus you will see minor spot like bleeding. As the blood vessels mature they become stronger and will eventually not bleed.

This mirrored exactly what happened to me and really thank R/Os giving me a heads up could experience it. I do know when meeting each week with my R/O during treatments would directly asked about any bleeding. Those type questions continued to after treatments ended at 3 months, than 6 months, then yearly as they are now.

Talk to your R/Os about this and the degree of your bleeding. Just wanted to pass on my direct experience with this.

This was not Proton therapy.

@beluga
Hello @beluga: Not sure who you were replying to or someone else. Here is information given to me about photon and proton radiation treatments. This comes from my R/Os at UHPTI and Mayo Jacksonville. The same secondary damage to organs and tissues happens with both photon and proton radiation treatments. Proton is considered possible lower secondary damage and secondary cancers due to highly controlled beam.

Proton radiation does not proceed past programmed spot where photon does. The R/Os I mentioned say the success rate of both are same but it is the fact that proton can be stopped prior to exiting the body where photon cannot.

Many have Space/Oar (I did) and or balloon to move colon away from prostate to lesson secondary damage to colon. However since most, like me, margins need to be treated so the chance of a certain amount of radiation can affect surrounding organs, and tissues.

It is why UFHPTI gives an information packed and spends hours with you going over not only the treatments but side affects and what is common and what causes it.

@jc76 credit to UHPTI, these discussions and expectations going into treatment help tremendously. Getting an “oh by the way” discussion post treatment erodes trust and creates perhaps more concern than required. You begin to wonder what else don’t I know. My situation is resolving it would have been easier knowing up front the nuances of this particular treatment.

Agree Neil. Iind if i didn’t directly ask about something, I recid no information that I didn’t uncover myself. The time that is spent with you is minimal. Having to ask quesitons over email isn’t very satisfying. I’ve turned to ChatGPT for more information. Over the last couple of days, others brought up issues that I had no idea about. Among them rectal prostitus (isn’t that why I chose Proton?), long term proctitis, diahhria. I have my first visit post treatment. My psa is undectible. I’ll see if she tells me it is all ADT (which it likely is) or I need to bring that up.

@jc76 My understanding jc. Also from reading your comments here. However, no one spent hours with me on anything. Which disappointed me as I expected time with my care team. Unless I specifically asked a question, no one said anything. Once Proton was decided, it was a conveyor belt of treatment activities and no followup. On the 28th I have my first post-treatment appt with their PA. We’ll see what she has to say.

@jc76 As always jc, very much appreciated. Having had SBRT Proton, I didn’t have the many. Treatments and opportunities to meet my R/O. In fact, I had to specifically ask him to meet with me at session 3. Since then it is questions through the portal. My 3 month visit is next week. I’m down to undectable but I believe it must be the 9 months of orgovyx, not the proton treatment. I’ll see what the PA says. Thanks!