1. < Prostate Cancer

How to treat rectal bleeding? Started after prostate cancer radiation

Posted by bill6161 @bill6161, Mar 11, 2023

I have prostate cancer which had metastasized to the pelvic cavity.
Started abirateron, then 26 external radiation treatments. For following five months I was doing great except for a lot of sweating and weakness. But stayed very active, ate well, and normal daily bowel movements. Then one month ago started rectal bleeding most days with stool. Dr says it is not unusual and should stop with time, but get a colonoscopy if bleed too much or really hurts. How to tell if bleeds too much ??? How to handle this??

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flax | @flax | Apr 25 2:05pm
In reply to @gently "flax, the prep is the same. It is good to acertain that there isn't additional damage..." + (show)
@gently

flax,
the prep is the same. It is good to acertain that there isn't additional damage in the colon. Considering the angle of the beams with your cancer treatment your doctor might consider rectoscopy. My cancer was rectal.
It would be nice if they let you schedule both at the same time, so you'd only have one prep.
Was it easy for you to find a gastroenterologist for the Halo?
I'm delighted you were able to find a practitioner. Was it easy.

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I don't know what procedure my gastroenterologist will recommend. I'll find out with my appointment end of April. I'll post back when I know. I will also seek a second opinion from a near by Mayo Clinic if he doesn't recommend Halo.

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gently | @gently | Apr 25 2:55pm
In reply to @flax "It going on two years since the diagnosis of advanced prostate cancer at age 83. Radiation..." + (show)
@flax

It going on two years since the diagnosis of advanced prostate cancer at age 83. Radiation ended over a year ago and I have had my last Lupron shot 3 months ago.
Minor rectal bleeding has been going on for almost a year. I was told it may or may not end. Mine has gotten a little worse and will now consider having a procedure to cauterized areas that continue to intermittently bleed when having a bowel movement.

My question is: as anyone had this procedure and how successful is it.

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I called over thirty doctors mostly from pub med publications. I found a gastroenterologist at Scripps Green and a GI at Stanford was willing to attempt the procedure though he'd never done it before because Stanford had the equipment. The original author said he would except that they didn't have the equipment at Sutter.
I think I had to pay for the article because of a paywall. Your md should be able to pull it up if you send him the link. You might send it ahead of your visit through my chart or email. I suspect he won't know anything about it and thereby wouldn't be able to recommend it. I'm hoping you'll have luck. I'll appreciat your post.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Apr 26 2:27pm
In reply to @flax "It going on two years since the diagnosis of advanced prostate cancer at age 83. Radiation..." + (show)
@flax

It going on two years since the diagnosis of advanced prostate cancer at age 83. Radiation ended over a year ago and I have had my last Lupron shot 3 months ago.
Minor rectal bleeding has been going on for almost a year. I was told it may or may not end. Mine has gotten a little worse and will now consider having a procedure to cauterized areas that continue to intermittently bleed when having a bowel movement.

My question is: as anyone had this procedure and how successful is it.

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Hi @flax, As @heavyphil your question was asked in another topic, so I moved your post here:
- How to treat rectal bleeding? Started after prostate cancer radiation
https://connect.mayoclinic.org/discussion/how-to-treat-rectal-bleeding-which-started-six-months-after-prostate-r/

@bill6161 was asking similar questions and also scheduled to get a colonoscopy to rule out other possible causes.

You might also appreciate this related discussion:
- Looking for tips on managing Radiation-induced proctitis
https://connect.mayoclinic.org/discussion/radiation-induced-proctitis/

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mikewo | @mikewo | Apr 27 10:16pm
In reply to @mikewo "I had slight bleeding 140 post radiation. Most days it was a smear on my feces..." + (show)
@mikewo

I had slight bleeding 140 post radiation. Most days it was a smear on my feces on my second bowel movement of the day. I did have two days where the toilet turned pick from the blood but as someone who donated blood every two months for years as disconcerting as it was it was for me a drop in the bucket. I did have the SpaceOar gel inserted before the five proton radiation treatment. It stopped thirty days ago. I cut back on my blood thinners and that seems to have worked at stopping the bleeding. What the future holds who knows as you said your husband started two years after his radiation.

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One year anniversary of my last radiation treatment was 4/26/2024 and no bleeding now since my last posting. So far so good.

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beluga | @beluga | May 6 10:05pm

I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of the treatment I started to experience rectal bleeding. My family doctor had me take sucralfate enemas for 6 weeks with no improvement. Then we tried sucralfate supositories for 2 weeks with no improvement. Then 3 weeks without any treatment again with no improvement. Now waiting for an appointment with a gastrointestinal doctor. Any ideas anyone have with similar experiences for treatment or managing the bleeding would be greatly appreciated.

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5 replies
gently | @gently | May 7 6:38am
In reply to @beluga "I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of..." + (show)
@beluga

I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of the treatment I started to experience rectal bleeding. My family doctor had me take sucralfate enemas for 6 weeks with no improvement. Then we tried sucralfate supositories for 2 weeks with no improvement. Then 3 weeks without any treatment again with no improvement. Now waiting for an appointment with a gastrointestinal doctor. Any ideas anyone have with similar experiences for treatment or managing the bleeding would be greatly appreciated.

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@beluga
beluga, several years ago, I experienced bleeding from radiation exposure. I was told by several oncologists and my trusted gastroenterologist that there was nothing that would help and I should just get used to it. They were wrong.
It took me several years to find out about this procedure and months to find a practitioner. I can recommed Dr. Buxbaum at USC. You may find a practitioner closer to you, but it will be a struggle. Lots of places use radiofrequency with little success. You need someone with the Halo 90.
Radiofrequency with the Halo 90 penetrates with a low controlled frequency that has been microscopically proven to allow the regrowth of normal epithelia in the rectum. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831406/#:~:text=RADIATION%20PROCTITIS%20AND%20ITS%20CLASSIFICATION,induced%20damage%20to%20the%20rectum.
The halo 90 is a wand with a tiny flat mesh (looks like a flyswatter) depth, frequency and duration are tightly controlled. Treated areas no longer bleed.
Copy this article and take it with you to the GI appointment. I don't expect he'll know about the procedure. Ask him for a rectoscopy to document the bleeding for insurance approval.
The procedure is done in hospital. A private office won't have this expensive equipment. The procedure itself only takes about 15 minutes, but you'll be there half a day. And they can only treat small areas at a time so you may have more than one session.
If you have any questions, I'm happy to answer.

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brianjarvis | @brianjarvis | May 7 9:04am
In reply to @beluga "I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of..." + (show)
@beluga

I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of the treatment I started to experience rectal bleeding. My family doctor had me take sucralfate enemas for 6 weeks with no improvement. Then we tried sucralfate supositories for 2 weeks with no improvement. Then 3 weeks without any treatment again with no improvement. Now waiting for an appointment with a gastrointestinal doctor. Any ideas anyone have with similar experiences for treatment or managing the bleeding would be greatly appreciated.

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If other remedies mentioned don’t work for you, and you have an official diagnosis of radiation-induced proctitis, look into hyperbaric oxygen therapy (HBOT): https://www.ncbi.nlm.nih.gov/books/NBK537343/

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gently | @gently | May 7 11:30am
In reply to @beluga "I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of..." + (show)
@beluga

I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of the treatment I started to experience rectal bleeding. My family doctor had me take sucralfate enemas for 6 weeks with no improvement. Then we tried sucralfate supositories for 2 weeks with no improvement. Then 3 weeks without any treatment again with no improvement. Now waiting for an appointment with a gastrointestinal doctor. Any ideas anyone have with similar experiences for treatment or managing the bleeding would be greatly appreciated.

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I tried HBOT and I think it works. The trouble is that it is two hours a session. Most with significant radiation proctopathy need 50 to 90 sessions. There is a lovely treatment center in Encinitas, Ca. It's on the second floor. Those ones in the basement are a bit depressing.

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samidh | @samidh | May 8 9:52am
In reply to @beluga "I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of..." + (show)
@beluga

I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of the treatment I started to experience rectal bleeding. My family doctor had me take sucralfate enemas for 6 weeks with no improvement. Then we tried sucralfate supositories for 2 weeks with no improvement. Then 3 weeks without any treatment again with no improvement. Now waiting for an appointment with a gastrointestinal doctor. Any ideas anyone have with similar experiences for treatment or managing the bleeding would be greatly appreciated.

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Hi Beluga,
Approximately a year post-completion of my 20 sessions of Tomotherapy, I experienced an alarming episode: a sudden onset of bloody discharge from the rectum, accompanied by copious amounts of mucus, even containing skin-like substances. I consulted my physician the following day, and I underwent an examination which confirmed radiation-induced proctitis. Treatment involved a self-administered enema (Hydrocortisone Acetate Foam 10% w/w), alleviating the symptoms within a few days, and halting the bleeding. Though the bleeding ceased around four months ago, residual mucous discharge persists post-defecation. Despite this, it doesn't significantly impact my well-being, and I continue to lead a content life.

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Moderator
Colleen Young, Connect Director | @colleenyoung | May 16 6:50pm
In reply to @beluga "I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of..." + (show)
@beluga

I received radiation treatment for prostate cancer 9 months ago. 5 months after the end of the treatment I started to experience rectal bleeding. My family doctor had me take sucralfate enemas for 6 weeks with no improvement. Then we tried sucralfate supositories for 2 weeks with no improvement. Then 3 weeks without any treatment again with no improvement. Now waiting for an appointment with a gastrointestinal doctor. Any ideas anyone have with similar experiences for treatment or managing the bleeding would be greatly appreciated.

Jump to this post

In addition to helpful replies you received, you might review these 2 discussions:

- How to treat rectal bleeding? Started after prostate cancer radiation
https://connect.mayoclinic.org/discussion/how-to-treat-rectal-bleeding-which-started-six-months-after-prostate-r/
- Looking for tips on managing Radiation-induced proctitis
https://connect.mayoclinic.org/discussion/radiation-induced-proctitis/

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