I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

Radiotherapy damage

User
Posted 28 Sep 2020 at 18:45

I’m on 2nd week of rt and wondering about any common long term effects. I understand that there is medication available to reduce rectal damage. It’s in the form of an injection?

Any preventative tips?

 

User
Posted 30 Sep 2020 at 21:07
Major long-term side-effects are not at all common; the overwhelming majority of men don't have any serious long-term bowel issues after RT.

I'm now 18 months after my RT (finished March 2019) and the only issue I really have now is somewhat increased frequency and much softer stools than previously. For the first few months after RT finished I frequently passed quite large amounts of mucus and had spells of proctitis (a burning sensation inside the rectum) but that gradually settled down and disappeared completely about a year after treatment ended.

Issues can develop years after treatment, but they aren't at all common. There's certainly no reason to expect to develop such problems.

Best of luck with the rest of your RT,

Chris

User
Posted 29 Dec 2020 at 17:48

I have radiation proctitis. A colonoscopy picked up raised veins where radiation had damaged my bowel. It manifests itself with a feeling of needing to go to the toilet, occasional bleeding, occasional mucus from back passage. I am over 3.5 years post salvage radiotherapy so it isn’t going anywhere. 
See link below 

Radiation proctitis

 

Edited by member 30 Dec 2020 at 10:15  | Reason: Typo

Ido4

User
Posted 31 Dec 2020 at 20:38

Originally Posted by: Online Community Member
What is 'radiation proctitis' and does it ever fix itself?

It's radiation damage to the rectum as a result of treating the prostate.

There are different types of damage, and they also fall into short-term, and late-onset.

The bowel ordinarily produces just enough mucus to lubricate stools exiting, which you don't normally notice. The excess mucus is the bowel wall's response to being irritated, which it assumes to be a toxin, bacteria, or virus, and the mucus is to try and wash it out (and diarrhea for the same reason). In this case, it's the radiation causing irritation, but the bowel behaves the same way, not having evolved a specific radiation response. This usually starts during the radiotherapy, and then diminishes slowly afterwards. My oncologist refers to it as "mucus farts", and another oncologist used the phrase, "an over abundance of rectum lube". For me, it was gone by about 10 months after radiotherapy, after which farting was safe again. This duration varies enormously from one person to another though. Actually, even after this I could tell there was still more rectum lube than before, because it makes taking a dump easier than it was before treatment! I mentioned this at a support meeting, and there were several agreements among other members, so I know that's not just me! I think at 16 months post treatment, rectum lube may be completely back to normal now.

You may also get some broken blood vessels, causing rectal bleeding during and just after radiotherapy, and due to soreness from diarrhea.

Then you may get some late-onset side effects, usually starting at least 6 months after treatment, but can be 5 or more years too.

Rectal bleeding is probably the most common. The radiation and healing cycles cause fibrosis of blood vessels, and they become fragile. Some time later, they break and bleed. Usually this is minor and goes away by itself, although you do need checking to make sure it's not bowel cancer. Sometimes it can be major, causing either incontinence, pain, unsafe bloody farts, or anemia, and then it needs treating. There are things that can help with this, but no sure fire way of fixing it. I have some minor painless rectal bleeding, which causes me no quality of life issues at the moment. After COVID, I'll look to get referred for it, but I had a clean bowel screening just before being diagnosed with prostate cancer, so I can probably rule that out. Otherwise, getting it checked out would be more urgent.

As a late side effect, I'm not sure what would cause mucus farts, but it's not difficult to imagine some permanent damage irritating the bowel wall, causing the over abundance of rectum lube.

Another late-onset impact from fibrosis of blood vessels can be erectile dysfunction. There are similar size blood vessels supplying the penis, and they can suffer from fibrosis and failure in the same time frame. (Unlike prostatectomy, ED is not normally caused by nerve damage in the case of radiotherapy, although that's not impossible in rare cases.)

User
Posted 15 Jan 2021 at 11:20

Cheers Peterco, yes hope its temporary same as you.

Thanks 

Mrs MAS

Show Most Thanked Posts
User
Posted 28 Sep 2020 at 23:55
Not everyone has rectal damage as a result of RT - the oncologist will have written the radiotherapy plan in a way that minimises the risk of any radiation meeting the rectum. Some men have diarrhoea or mucus during the RT but it should ease within a couple of weeks of the treatment ending. Longer term problems tend not to show themselves until months or years later, usually in the form of radiation proctitis and yes, if that happens there are treatments like colorectal foam which is squirted in via the anus and can work for some men.

In terms of prevention, your onco and the radiology department have already done whatever is possible; there isn't really anything you can do except stick to the diet sheet if you were given one.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 29 Sep 2020 at 07:29

LKV

Just to add, make sure bladder is in the same state as your planning scan.  

Thanks Chris

User
Posted 29 Sep 2020 at 07:45

Originally Posted by: Online Community Member
I understand that there is medication available to reduce rectal damage. It’s in the form of an injection?

You may be thinking of SpaceOAR, a rectal spacer which is injected to separate the prostate from the rectum. You would need this done 2 or more weeks before your planning scan. It can't be done once treatment has started. It's currently not recommended for patients with PSA >= 20 either (theoretical risk of pushing micro-mets out of the radiation field so they survive), except as part of the ICEMAN trial at UCLH.

Edited by member 29 Sep 2020 at 07:47  | Reason: Not specified

User
Posted 30 Sep 2020 at 21:07
Major long-term side-effects are not at all common; the overwhelming majority of men don't have any serious long-term bowel issues after RT.

I'm now 18 months after my RT (finished March 2019) and the only issue I really have now is somewhat increased frequency and much softer stools than previously. For the first few months after RT finished I frequently passed quite large amounts of mucus and had spells of proctitis (a burning sensation inside the rectum) but that gradually settled down and disappeared completely about a year after treatment ended.

Issues can develop years after treatment, but they aren't at all common. There's certainly no reason to expect to develop such problems.

Best of luck with the rest of your RT,

Chris

User
Posted 23 Oct 2020 at 13:07

Two weeks later from RT doing Ok apart from frequent bladder urges getting more frequent. To the extent that I’m wearing a track in the carpet from bedroom to toilet at night!

Is this normal and how long does it persist?   Did I read somewhere that there’s medication that may help?

tks

User
Posted 23 Oct 2020 at 15:16

LKV

When you finished RT were you given contact details for the Late effects team. Not sure if all RT departments have them. 

Thanks Chris

User
Posted 23 Oct 2020 at 15:31
I had to get up for up to 8 times a night at one point during RT but this gradually reduced until a couple of months or so post RT I was back to my pre RT frequency of once a night which is still the same some 12 years on. I had mucus in diminishing way for several months post RT. I did have some soreness during RT and was prescribed Bepanthen ointment to dab on. Other hospitals suggest different ointments. Try to use plain soap not incorporating perfume when washing affected area..

I am convinced from what I have read and from my experience that it helps if you exercise and remain as fit as you reasonably can during RT and afterwards come to that.

Barry
User
Posted 29 Dec 2020 at 12:58

What is 'radiation proctitis' and does it ever fix itself? I finished radiotherapy twenty months ago, but my bowel problems seem to be getting worse - especially what I call 'watery farts', which can be very embarrassing as they can cause a slight leak of faeces.

 

User
Posted 29 Dec 2020 at 17:48

I have radiation proctitis. A colonoscopy picked up raised veins where radiation had damaged my bowel. It manifests itself with a feeling of needing to go to the toilet, occasional bleeding, occasional mucus from back passage. I am over 3.5 years post salvage radiotherapy so it isn’t going anywhere. 
See link below 

Radiation proctitis

 

Edited by member 30 Dec 2020 at 10:15  | Reason: Typo

Ido4

User
Posted 31 Dec 2020 at 20:38

Originally Posted by: Online Community Member
What is 'radiation proctitis' and does it ever fix itself?

It's radiation damage to the rectum as a result of treating the prostate.

There are different types of damage, and they also fall into short-term, and late-onset.

The bowel ordinarily produces just enough mucus to lubricate stools exiting, which you don't normally notice. The excess mucus is the bowel wall's response to being irritated, which it assumes to be a toxin, bacteria, or virus, and the mucus is to try and wash it out (and diarrhea for the same reason). In this case, it's the radiation causing irritation, but the bowel behaves the same way, not having evolved a specific radiation response. This usually starts during the radiotherapy, and then diminishes slowly afterwards. My oncologist refers to it as "mucus farts", and another oncologist used the phrase, "an over abundance of rectum lube". For me, it was gone by about 10 months after radiotherapy, after which farting was safe again. This duration varies enormously from one person to another though. Actually, even after this I could tell there was still more rectum lube than before, because it makes taking a dump easier than it was before treatment! I mentioned this at a support meeting, and there were several agreements among other members, so I know that's not just me! I think at 16 months post treatment, rectum lube may be completely back to normal now.

You may also get some broken blood vessels, causing rectal bleeding during and just after radiotherapy, and due to soreness from diarrhea.

Then you may get some late-onset side effects, usually starting at least 6 months after treatment, but can be 5 or more years too.

Rectal bleeding is probably the most common. The radiation and healing cycles cause fibrosis of blood vessels, and they become fragile. Some time later, they break and bleed. Usually this is minor and goes away by itself, although you do need checking to make sure it's not bowel cancer. Sometimes it can be major, causing either incontinence, pain, unsafe bloody farts, or anemia, and then it needs treating. There are things that can help with this, but no sure fire way of fixing it. I have some minor painless rectal bleeding, which causes me no quality of life issues at the moment. After COVID, I'll look to get referred for it, but I had a clean bowel screening just before being diagnosed with prostate cancer, so I can probably rule that out. Otherwise, getting it checked out would be more urgent.

As a late side effect, I'm not sure what would cause mucus farts, but it's not difficult to imagine some permanent damage irritating the bowel wall, causing the over abundance of rectum lube.

Another late-onset impact from fibrosis of blood vessels can be erectile dysfunction. There are similar size blood vessels supplying the penis, and they can suffer from fibrosis and failure in the same time frame. (Unlike prostatectomy, ED is not normally caused by nerve damage in the case of radiotherapy, although that's not impossible in rare cases.)

User
Posted 13 Jan 2021 at 19:12

Hi Sanz1820, 

I have seen your post at an opportune time.

My husband finished radiotherapy in May 2020 with minimal bowel issues during and just after treatment.

At the beginning of December 2020 he started getting bowel issues including the watery farts you mention, urgency to get to the loo (he goes 2 or 3 times a day since radiotherapy, was once a day before) and now not making it to the loo in time, sometimes having an accident only knowing about if there's a smell or sticky feeling. This is upsetting him.

He's been advised to try fibogel which are having no effect as yet. 

Andy62, I have read your post above and it seems this is a late effect. Hoping there are other options to try and alleviate. Does anyone have any experience or ideas? 

Edited by member 13 Jan 2021 at 19:14  | Reason: Spelling

Mrs MAS

User
Posted 13 Jan 2021 at 19:23

HI Mrs MAS,

There are various treatment options for rectal bleeding. I don't know their applicability for the other symptoms.

The bleeding is a failure to heal, and hyperbaric oxygen therapy is something that is sometimes tried, and it sometimes works. Steriods are sometimes tried and sometimes work too. Argon gas laser can be used to cauterize leaky blood vessels, and I've no idea but that doesn't sound so applicable to excess mucus.

There are probably more treatments I don't know about.

User
Posted 13 Jan 2021 at 19:43

Thanks  for that info,Andy.

Yes bleeding is not an issue for Mr MAS, just this new urgency/having accidents with bowel leakage and sometimes not having felt it come out.

Over Christmas he had his routine bowel screen which came back fine. 

Confident this is a late effect of radiation and just hoping there's more to try after the fibogel. Developing intolerance to lactose was also mentioned so that could be the second thing to try.

Regards

Mrs MAS

User
Posted 14 Jan 2021 at 19:28
It sounds like I suffered same bowel problems that started a while after RT finished. Had, only a few (tried hard not to go out!!), bowel accidents whilst out for a walk, quite degrading, just couldn't make it home in time and yes sometimes excreted a bit without realising, in bed as well.

Anyway, it perhaps lasted 6-9 months (don't keep record like some) was advised to increase fibre intake and drink kefir milk by the consultant after being referred for colonoscopy to make sure all ok. I may have subconsciously reduced fibre intake?? Of course it may have settled down without changing things but more fibre & good gut health is good anyway?

It was explained as temporary damage from RT and been ok since just a bit different from pre RT so hopefully it's the same with husband.

Peter

User
Posted 15 Jan 2021 at 11:20

Cheers Peterco, yes hope its temporary same as you.

Thanks 

Mrs MAS

User
Posted 15 Jan 2021 at 12:12
Mrs MAS, it took the best part of a year for my bowels to settle down after I'd finished RT, but it did happen. It does for the vast majority of men.

Best wishes,

Chris

 
Forum Jump  
©2024 Prostate Cancer UK