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Radiotherapy - and rectal bleeding

Posted 09 Jan 2020 at 20:16

Am starting Radiotherapy on Monday.  37 sessions Monday to Friday.  This will be External beam radiotherapy to the prostate and pelvic lymph nodes.  Radical radiotherapy.   

The oncologist has warned me that since SpaceOR can not be used, as they need to address the perirectal nodes, then the chances of both stort-term and long-term rectal bleeding is high.

Not a great thought!

Has anyone had those types of side effects after radiotherapy?


Posted 09 Jan 2020 at 23:54

I had pelvic lymph nodes treated too, 23 sessions. Had some blood from increased wiping/soreness initially, my own fault for eating a whole broccoli 2 weeks in, which was a major disaster - barely able to leave the toilet for next 2 days. From 4 weeks in, I occasionally passed blood with No. 2's. This continued with very occasional blood up to 10 weeks after EBRT, and no more since (now 22 weeks after EBRT). This isn't an issue if it's expected and you know why it's happening. Passing blood is only an issue when it's not expected, or if it's excessive in duration or quantity.

You may need to move to a low fibre diet after the first week or so - be prepared to do this if you start to get the shits, but doing it before it's needed risks you getting constipated. Most people get excess mucus production during RT, resulting in what my onco eloquently refers to as mucus farts. That still comes and goes for me, although less than during and immediately after the RT.

Passing blood can happen again 1 to 5 years afterwards (4.5 years is apparently common). This is when small rectal blood vessels hit by the EBRT eventually break. It's harmless and requires no treatment, but you will probably require an colonoscopy just to confirm it is that, and not bowel cancer.

There is a small chance of long term bowl damage and a very small chance of some degree of anal incontinence, although even before SpaceOAR (which is not yet widely used), this risk was much reduced by the high precision targeting of modern linear accelerators.

Good luck. The conversations between patients in the RT waiting rooms going through the same things sharing intimate issues are a lifetime experience I'll never forget.

Edited by member 10 Jan 2020 at 00:55  | Reason: Not specified

Posted 10 Jan 2020 at 00:02

One other thing, you should be doing your pelvic floor exercises regularly now. You may find later in your treatment and for a few weeks afterwards, that very significantly helps you stay continent (certainly the case for me). I did them while driving to/from the RT sessions, and other times too when I thought of it.

Posted 10 Jan 2020 at 00:04

I had “wide beam” EBRT, too, finished 10 months ago. I had no bleeding, but did start passing quite a lot of green-tinged mucus (which is the lining of the rectal wall). This peaked a few weeks after the end of RT and gradually tailed off, although it still happens very occasionally. The other side-effect I had was proctitis - a burning sensation inside the back passage. This came and went in spells, typically lasting 2-3 days each time, but I’ve not experienced it for several months now. It wasn’t painful as such, just rather uncomfortable.

All in all, not too bad an experience at all.

Best of luck with your treatment,


Edited by member 10 Jan 2020 at 00:06  | Reason: Not specified

Posted 10 Jan 2020 at 08:24


            I'm on HT, had chemo and start my 37 x EBRT next Thurs and I am having local nodes eradiated + 1 x mesorectal node that showed up on the pet scan. I've been worried about side effects to my backside too so will be following this thread to see how you get on.


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