One week of IMRT for recurrent PCa - issue with empty rectum

Posted by melvinw @melvinw, Oct 1 4:58pm

I started IMRT last week for a local recurrence (small nodule in prostatic fossa detected by DRE, PET PSMA and MRI scans; PSA is 0.11). Five treatment sessions so far and no side effects. The big challenge, which was really downplayed in the pre-RT instructions, is not having a full rectum (gas and solids). I’ve got the bladder filling down, and that is all good if the clinic stays on schedule (yesterday they were running 40 minutes behind). Today, the radiation therapist told me that my rectum had too much gas and that down the line, that would lead to diarrhea. I have a BM every morning like clockwork and then don’t eat before the treatment. She said to try for a BM again an hour before my appointment. I told her that I tried that last week, and the result was that my rectum was then too full of solids (no BM), and I didn’t receive a treatment that day. She then said I might need to alter my diet. I’m a para-vegan (no dairy, and no meat other than skinless chicken breast). I consume a whole grains/food diet and do not eat sugar nor ultra-processed foods. My diet is pretty much in accordance with all the dietary recommendations, and then some.

So, I’m a bit frustrated with situation. First, it would have been helpful to be informed of this issue before starting treatment so that I could have attempted some adjustments. Second, the dietician is recommending one thing and the radiation therapist something else. There is a lack of coordination on top of the lack of advanced information. I recall pressing a nurse about the BM issue and all she said was to have a daily BM before each session and I would be fine. Well, I have done that and apparently, the situation is not fine.

I have a consult with my RO tomorrow and will discuss this issue and get her take on it. In the meantime, I’d appreciate any feedback/shared experiences/solutions that worked. I’ll do my best to get this dialed in but there only seems to be so much I can do at this point. I might start be cutting beans out of my diet, or greatly reducing them.

Many thanks for sharing your thoughts and experiences.

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mjp0512 | @mjp0512 | Oct 15 12:22pm

In reply to @jimbsmith "@mjp0512 empty bowel is my only stress also" + (show)

@jimbsmith

Took a couple weeks but I've got it figured out. Strong coffee and oatmeal breakfast, Chicken and rice for late lunch/early dinner, Greek yogurt evening. Vegetables and fiber on hold until radiation completed. Works for me.

melvinw | @melvinw | Oct 15 1:29pm

In reply to @mjp0512 "@jimbsmith Took a couple weeks but I've got it figured out. Strong coffee and oatmeal breakfast,..." + (show)

@mjp0512 Same breakfast here, and yogurt in the evening too. I’m okay with vegetables, as long as they aren’t raw. No bean/legumes. Minimal whole grains, brown rice etc. Chicken and tofu based meals for lunch and dinner. Cup of ginger tea in the afternoon. Also drink 8 oz of tomato juice daily for the lycopene and other good stuff. Working pretty well so far.

mjp0512 | @mjp0512 | Oct 20 5:31am

Yea...it's Monday again. Another week of daily zapping and then one more day! Can't wait till this is over but the end is in sight. One hour there, one hour back with 5 minutes on the rack is getting old. Oh, and side effects?...Haven't had an issue with hemorrhoids since I stopped drinking 30 years ago but they're back with a vengeance. HEY CANCER...

melvinw | @melvinw | Oct 20 7:56am

In reply to @mjp0512 "Yea...it's Monday again. Another week of daily zapping and then one more day! Can't wait till..." + (show)

@mjp0512 Monday indeed. Glad to hear that you can see the barn!. I’ll hit the halfway point tomorrow (19/38). One day at a time. But today I’m halfway through a cup of coffee with one full BM checked off. Good start!

Hope the hemorrhoids settle down after you’re done with treatment. So far, the only side effect for me is some fatigue at the end of the week, but I recoup on weekends.

mjp0512 | @mjp0512 | Oct 21 6:12am

In reply to @melvinw "@mjp0512 Monday indeed. Glad to hear that you can see the barn!. I’ll hit the halfway..." + (show)

@melvinw Pretty darn sad that the accomplishment of the day is a morning BM 😒🤣🤣

melvinw | @melvinw | Oct 21 8:18am

Even sadder if that BM isn’t accomplished!

perrychristopher | @perrychristopher | Oct 22 5:24pm

Hi, l am on treatment 17 of 39. I had issues with gas bubbles on my original marking day so tech told me to take a GasEx pill. I take the 24 hour pill at night each day before my 7:50 am appointment. No issues since.

melvinw | @melvinw | Oct 22 6:32pm

In reply to @perrychristopher "Hi, l am on treatment 17 of 39. I had issues with gas bubbles on my..." + (show)

@perrychristopher Yup, Gas X has worked well for me when I needed it. The thing that catches me is that I gulp down ~30 oz of water 45 minutes before my appointment, then sometimes that gets things moving. Just as I’m about the head out the door, I detour to the bathroom for a quick release. But, other than that early gassy day, I haven’t missed a treatment.

Hang in there!

mjp0512 | @mjp0512 | 6 days ago

In reply to @perrychristopher "Hi, l am on treatment 17 of 39. I had issues with gas bubbles on my..." + (show)

@perrychristopher Today is my last Thursday and yep, Gas X works. Been using it 2 hours before treatment since Day 1. Haven't missed one yet. We got this, guys. Radiation does end.