Day 3 After Brachytherapy - Some rectal bleeding

This forum was very helpful to me earlier. My husband Rick had brachytherapy three days ago. Today he has some rectal bleeding, not gushing but on toilet paper and some in toilet each time he goes to bathroom. I spoke to Radiation Nurse just before cancer clinic closed and she said it's possible probe aggravated internal hemorrhoid, to watch, go to emergency if we are concerned. How do I know whether to be concerned? We live 3+ hours from Clinic in small Canadian mountain community, we have a small hospital but no specialists. Am I just being hysterical? Have others experienced? I would like to know if I should just breathe or act (those seem my only choices).

Thank you for your reply Michael. I will keep monitoring the page.

I had LDR brachytherapy too and didn't have any rectal bleeding.

It's a very common symptom - they should have told you to expect that. It will resolve on its own. As long as the blood is bright red and isn't gushing out so much that you fear he will faint from blood loss, there is nothing he needs to do about it. Below is a handout I give to men in my PC support group who are about to have radiation:

What to expect after prostate radiation

Urinary, rectal and sexual side effects of treatment are usually mild and transient, although they may be worse if you are especially sensitive to radiation, are an older man, or had symptoms before you started radiation therapy. Some side effects described below may occur in many men starting anytime from a week to a month after treatment and continuing for weeks or months. The duration and intensity vary greatly between men.

If any of those symptoms interfere with your day-to-day living, call your doctor. He may be able to prescribe medication that can help alleviate those symptoms.


Urinary

Total incontinence is uncommon. There may be some leakage or dribbling. Other common side effects are irritation, burning or bleeding while urinating, feeling like you have to urinate immediately even when you know your bladder isn’t full, having to wake up several times during the night to urinate, or having to urinate frequently during the day. You may pass small amounts of blood or blood clots; however, if you are bleeding copiously when you urinate, contact your doctor immediately.

A rare but potentially serious side effect is urinary retention. If you find that you can’t urinate even though your bladder feels full, go to the Emergency Room of the nearest hospital immediately and tell them you are suffering from urinary retention. They must catheterize you to allow the urine to flow out.


Rectal

There may be a feeling like you have to pass a stool but you cannot, and this feeling may recur often. This is called tenesmus. You should be aware that that feeling is from inflammation in your rectum (proctitis), not from actual stool there, and if you strain, you may create hemorrhoids. You may have frequent bowel movements. There may be blood in your stools or blood may drip out. Hemorrhoids may occur. Sometimes stool may leak out, especially when you are passing gas. Stool may be loose, or it may be especially hard.

If you have diarrhea for more than a few days, call your doctor. If the bleeding is copious, call your doctor.


Sexual

Semen will usually dry up soon after treatment, although there may be small amounts of fluid. Occasionally, you may see some blood in that fluid or a few drops of blood may drip out after orgasm.

You may notice that, over time, erections are not as hard or as long-lasting. To protect the blood vessels supplying your penis with blood, your doctor may have prescribed Viagra or a similar medication. You should continue to take that medication for at least 6 months after the end of treatment, even though it seems like you don’t need it.

Testosterone levels often drop following radiation, but may eventually return to normal levels. Because of this, you may notice a drop in the level of your sexual desire/libido. Some men experience difficulty reaching orgasm.

If any of the symptoms are bothersome, you may want to consult with a doctor who specializes in Sexual Medicine.

I agree with the rest of those who have weighed in. Some blood is quite common but resolves itself in a relatively short period of time. None of us are Doctors, that said, for peace of mind a call to your RO would not hurt.

Keep us posted.

This coming May, it will be seven years ago that I had low dose Brachytherapy. I was experiencing just a bit of blood in my stool and had it checked out with a flexible sigmoidoscopy about three years ago. Was determined was some radiation proctitus and a few roids. I just make a concerted effort to eat things that will not require hard grunting and hard stools. Still have slight blood streaks on stools but I'll just live with it as I certainly prefer NOT to have to go through any more surgery for roid removals. Since I was concerned about possible blood infection due to stools frequently having tiny traces of blood on them, my Doc indicated the chance of such infection is quite remote. I hope she is correct.