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Old 10-09-2010, 02:09 PM   #1
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Radiation ulcerations

I posted this thread yesterday. I don't know where it got to so I'll try again. About three weeks ago I posted a thread concerning BM issues. I have been a problem with frequency and urgency. I did get response from a man who had similar problems but after a year and a half things seemed to more or less get back to normal.

Well it has been a year since my Brachytherapy and I finished the last of my IMRT sessions last Dec. I have been having BM issues since I started treatment. The past few weeks have been almost unbearable with a lot of pain and some bleeding.

Now I had a colonoscopy back in July, then my 1st annual follow-up at the Datolli Clinic. The colonoscopy showed no issues. At the Datolli they did a full CT scan, blood work and color doppler ultrasound. Everything looked great! The ultrasound tech. mentioned that I had a couple of hemmorhoids which accounted for a bit of bleeding after the test.

At the time I mentioned to DR. Sorace my BM issues. He recommended more fiber. I didn't help in the least.

As my BM's got more painful I thought it was time to deal with what I assumed to be a hemmorhoid issue. A week ago I went to see a anal/rectal specialist. The nurse practitioner took a look and confirmed that I had a couple of internal bleeders and set up an appt. for a banding procedure. I went in for the treatment Thursday. The doctor took a look, told me to get dressed and we needed to talk. Not what you want to hear.

He felt it was more than a 'roid issue. There was what appeared to be a lump or tumor inside the rectum in the frontal area. So we did a biopsy immediately that afternoon. Yesterday we did a MRI. I am waiting for the results Monday.

Now how likely is it that I might have developed colorectal cancer in such a short period of time. The other possibility of course is proctitis with ulcerations due to the radiation therapy. Of course I am hoping for that diagnosis.

Anyone else gone through this? and what is the treatment?

I have to say that the Datolli Clinic does great things in the treatment of prostate cancer, but I feel they are lacking in the post-treatment care. I had voiced these BM issues a couple of times, once to be told to take more fiber, then to be told to take less fiber. It would seem to me a flag should have gone up since it must be known that radition can severly impact urinary and rectal functions. I am disappointed. I feel the suffering I have been through these past couple of months and the hell I have been in these past 3 weeks could have/should have been avoided. Very worried.

 
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Old 10-09-2010, 05:49 PM   #2
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Re: Radiation ulcerations

Hi B,

I'm sorry you are having to go through all this, and I'm disappointed that the Dattoli center's side effect mitigation follow-up is not as good as their treatment efforts. Too often that seems to be the case, even with leading centers and doctors.

Unfortunately for him, fortunately for all other prostate cancer patients, Dr. Charles "Snuffy" Myers, MD, well known to many of us, had to deal with his own set of side effects from radiation. He chose an especially aggressive course of radiation for his challenging case (included metastasis), also from the Dattoli center, and he suffered a number of side effects. We are fortunate that he wrote in detail about them and his recommendations in his Prostate Forum newsletters. While he addresses such issues from time to time, I just checked the titles of back issues and four caught my attention. My impression is that all are available as back issues.

Volume 5 Number 9, "Radiation Therapy, PC-SPES Revisitied, and a St. John's Wort Warning," published in March 2001. Most of the first three pages are about radiation, and he includes a warning about colonoscopies for radiation therapy patients on page 3. Here's a brief excerpt: "... Colonoscopy without a biopsy appeared well tolerated. If you have had radiation therapy for prostate cancer and your physician recommends colonoscopy or sigmoidoscopy, make sure that adequate precautions are taken to avoid injury to the front part of the bowel located adjacent to the prostate gland. Like always, consult your radiation therapist before undergoing either procedure." It seems the Dattoli staff should have made this connection with the risks of colonoscopy after their treatment, but my experience is that sometimes such matters slip through the cracks if we do not point them out. Unfortunately, all too often we ourselves are clueless until too late.

Volume 5 Number 12, "Diet & Radiation Proctitis Revisited," published in June of 2001. The radiation discussion is on pages 4 - 7, and includes his first hand account of dealing with proctitis, including some risk from suppositories for wound healing and scar fromation. He also addresses some successful experiences with mesalamine suppositories for radiation proctitis.

Volume 7 Number 4 "Radiation Therapy: Part I," published about February 2003. Much of the issue was about "Radiation Damage to Normal Tissues."

Volume 7 Number 5 "Radiation Therapy: Part II," published about March - May 2003. The main focus was on preventing and treating radiation side effects. He included discussions of "Blood in Your Urine," "Rectal Pain, Spasms, & Itching," "Blood in Your Stool," and "Radiation-Induced Scaring," among other topics.

I hope this helps.

Take care,

Jim

 
The Following User Says Thank You to IADT3since2000 For This Useful Post:
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Old 10-09-2010, 09:19 PM   #3
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Re: Radiation ulcerations

Thanks for getting back to me in such a timely fashion, Jim. It is extremely comforting to know that there is someone out there ready and willing to be of assistance.

I was made aware of the concerns relating to colonoscopies after radiation therapy. I wasn't given any specifics. I was told to inform my GI doctor that I had received treatment for PC. This I did. It was 2 weeks later that I reurned to the clinic for my first annual follow-up exam. I provided them with the full report including photos from the examination. I am sorrily disappointed they didn't make any connections.

This morning I spoke with a radiation oncologist, a brother of a very dear friend. He felt strongly that it is ulcerations and not colorectal cancer and advised me not to submit to a biopsy. Too late for that. His concern was that a biopsy can needlessly lead to additional bleeding. Fortunately that has not been a problem.

The problem now is, "what is my next step?" I will research the articles you have suggested, certainly. And Monday I will call the Clinic, although at this point I feel like I am being considered a nuisance. I still need to get the results back. How will they(The doctors there and here- I am in Boston) decide and how do I decide what the proper course of treatment should be.

It is a problem living at a distance from the clinic where I was treated. Can't just drop in and say I have a problem.

Thanks once again, Jim. I'll keep you posted.

 
Old 10-09-2010, 10:26 PM   #4
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Re: Radiation ulcerations

Quote:
Originally Posted by IADT3since2000 View Post
Hi B,

I am furious. Why do I have to go to you, Jim, to get this information. I should be upset with the my GI Dr. who may have caused the damage, though I informed him of my treatment. I should be upset and am upset with the Clinic for not making the connection sooner and steering me in the right direction. And I am very upset with the anal/rectal man who immediately assumed he was looking and colorectal cancer and started cutting me up. We don't know that it isn't yet but it seems unlikely. Now who do I trust to treat this condition?

I did a little research with the articles of Dr. Myers that you suggested. thank's again.





I'm sorry you are having to go through all this, and I'm disappointed that the Dattoli center's side effect mitigation follow-up is not as good as their treatment efforts. Too often that seems to be the case, even with leading centers and doctors.

Unfortunately for him, fortunately for all other prostate cancer patients, Dr. Charles "Snuffy" Myers, MD, well known to many of us, had to deal with his own set of side effects from radiation. He chose an especially aggressive course of radiation for his challenging case (included metastasis), also from the Dattoli center, and he suffered a number of side effects. We are fortunate that he wrote in detail about them and his recommendations in his Prostate Forum newsletters. While he addresses such issues from time to time, I just checked the titles of back issues and four caught my attention. My impression is that all are available as back issues.

Volume 5 Number 9, "Radiation Therapy, PC-SPES Revisitied, and a St. John's Wort Warning," published in March 2001. Most of the first three pages are about radiation, and he includes a warning about colonoscopies for radiation therapy patients on page 3. Here's a brief excerpt: "... Colonoscopy without a biopsy appeared well tolerated. If you have had radiation therapy for prostate cancer and your physician recommends colonoscopy or sigmoidoscopy, make sure that adequate precautions are taken to avoid injury to the front part of the bowel located adjacent to the prostate gland. Like always, consult your radiation therapist before undergoing either procedure." It seems the Dattoli staff should have made this connection with the risks of colonoscopy after their treatment, but my experience is that sometimes such matters slip through the cracks if we do not point them out. Unfortunately, all too often we ourselves are clueless until too late.

Volume 5 Number 12, "Diet & Radiation Proctitis Revisited," published in June of 2001. The radiation discussion is on pages 4 - 7, and includes his first hand account of dealing with proctitis, including some risk from suppositories for wound healing and scar fromation. He also addresses some successful experiences with mesalamine suppositories for radiation proctitis.

Volume 7 Number 4 "Radiation Therapy: Part I," published about February 2003. Much of the issue was about "Radiation Damage to Normal Tissues."

Volume 7 Number 5 "Radiation Therapy: Part II," published about March - May 2003. The main focus was on preventing and treating radiation side effects. He included discussions of "Blood in Your Urine," "Rectal Pain, Spasms, & Itching," "Blood in Your Stool," and "Radiation-Induced Scaring," among other topics.

I hope this helps.

Take care,

Jim

 
Old 11-21-2010, 07:41 PM   #5
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Re: Radiation ulcerations

Jim, I follow the board and the postings and have posted a few threads myself. I am dealing with some very seriuos issues right now. I wish I could post a thread but for the life of me I cannot find the new thread button. Help me out. Thank you. Bwhitney

 
Old 11-22-2010, 01:44 AM   #6
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Re: Radiation ulcerations

To start a new thread, go to the Cancer:Prostate forum front page that lists all the messages. In the upper left, under the title "Cancer: Prostate Message Board" is a button that reads "New Thread." Click on it to start a new thread.

BTW, I got my colonoscopy done a week before my radiation therapy just to avoid the kind of problem you had. My Radiation Oncologist said not to have one for at least 3 months after therapy, and I had a lot less rectal dose than you did. The rectal tissue gets friable from the radiation. You have to let it heal before you shove a tube through it. If he created an ulcer, they can laser it closed. I think you are quite justified in thinking the doctor who did your colonoscopy was an idiot.

 
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