Anyone else have these SBRT side effects - mucous and blood rectal discharge - and rectal urgency?

I'm soon to be 55... completed my 5 sessions of SBRT at UCLA w Dr. King about two weeks ago (via the Rapid Arc system - not cyberknife) for prostate contained cancer - psa pre treatment was 21 - gleasons of 6 and 7.

Now, I am having somewhat painful urination (so taking Flomax 4 mg 1 X day) and bowel / rectal urgency (have to go - or at least feel like I have to go several times a day - as opposed to my pre treatment usual one time a day)

AND - I am noticing a mucousey somewhat bloody discharge floating around in the bowl... like I am sloughing off burned up or damaged chunks of rectal lining... my apologies for being graphic.

So I am concerned... any other SBRT patients in this forum community have such side effects? is this a short term thing? Is this common after SBRT radiation?

I know that bowel and rectal issues are noted as possible short term side effects of SBRT.. but have not heard of the sloughing off of bloody mucousey tissue?

Anyone else experience this? Does it go away?

Dave

Post Edited (dp3500) : 6/22/2015 11:53:02 PM (GMT-6)

I'll let you know. My first session is today.

Hi Dave,

Those are all very typical symptoms. Hopefully, they'll all resolve very soon. It's just from irritation of the lining of the rectum.

Don't strain on the toilet - that's a sure way to get bleeding hemorrhoids. That feeling that there's something up there that you can't force out is called "tenesmus" and is an illusion. Knowing that may help you ignore it. Metamucil may keep it soft or colace if you need more. For the next few weeks, never trust a fart.

How are things on the other side? If you find yourself getting up a lot at night to pee, you can ask for a scrip for an alpha-blocker like Flomax or Rapaflo.

I think I had those kinds of symptoms for about 2 weeks, but everyone has different sensitivity.

Ditto on the mucousy stools although it was also IMRT in my case. Looked gross but was never a problem and it quickly resolved. Good luck!

Thanks for the replies here... gives me some reassurance that this is typical (for some at least). I spoke to Dr. King at UCLA (excellent doc BTW if anyone is looking - top in his field - and very approachable and patient centered) and he also assured me these SE's are normal - and tend to resolve after a few weeks. Also - my SE's have actually diminished considerably since I wrote the original post.

Just curious: I understand SBRT can be done in 1-2 weeks, compared to 7-8 weeks for IMRT.'

When you do an actual SBRT tx., how long are you radiated? I know with IMRT, it seemed like roughly 75 seconds (can't remember exactly).

Mel

My treatments took about 5-10 minutes each after the initial positioning, but I practice Mindfulness and am very good at being still. Maybe I control my internal organ motion more than I think. King uses RapidArc on a superfast Truebeam linac. Position is checked against the fiducials before each quarter arc, so it's maybe 30 seconds of beam-on time between position checks. You can watch the stereoscopic X-rays on a monitor while it's happening - nifty!

This kind of system (called VMAT) is very fast. Normal IGRT/IMRT "step and shoot" systems are much slower - but they don't track intrafractional motion as was done here. CyberKnife is slower as well- the intrafractional checks are more frequent - the newer machines take about 40 minutes per treatment.