Rectal pain due to radiation?

I've been having fairly acute pain in the rectal area when having my morning constitutional and I've thought it was just one of those things since I have those "h" things (think Preparation H.) Then I was wondering if this could be a side effect of the radiation I had a couple of years ago. I've read that SEs can start long after the radiation therapy. I have a colonoscopy scheduled for September so I think i can hang on until I see the GI doc.

Thanks Rob, I'll look into that.

Sorry to hear about your pain, John_TX.

This is yet another example of the old saying that prostate cancer and PC treatments are the "gift that keeps giving!"

Your case illustrates one of the scenarios of how it is that late-term radiation side effects get under-reported in the literature...your RT was several years ago, but you aren't going back to the radiation oncologist for follow-up; you'll go to a GI doc. That's common, as the other comments also demonstrate.

Hope you get the pain resolved promptly.

For me the GI's procedure did the trick. It wasn't a 100% fix, but now it's manageable with little attention to diet, drinking water, miralax, and walking.

I recall my RO warning about GI problems. Two years later when I went to PCP for a GI referral her first reaction was, "Radiation proctitis, it's a known side effect. sorry you have that, but the GI will be able to help."

You might want to see if you can get in to the GI a little earlier. No point in suffering longer than needed.

Andrew

I think Nkinney could be right in his statement that late-term radiation side effects get under-reported in US. Probably also the case for RP late-term side effects.

Allen might know of studies about long-term adverse effects after RT and RP compared with the background population in US. This scandinavian study Long-term adverse effects after curative radiotherapy and radical prostatectomy: population-based nationwide register study concludes that:

"In conclusion, the risk of all diagnoses and procedures indicating an adverse effect was modestly but significantly elevated after both RT and prostatectomy up to 12 years after treatment. The risk of urinary incontinence was much higher after RP, whereas the risk of all diagnoses and procedures, and specifically other LUTS and gastrointestinal adverse effects, was higher after RT."

John_TX, I hope your problems will resolve.

Gemlin said...
I think Nkinney could be right in his statement that late-term radiation side effects get under-reported in US. Probably also the case for RP late-term side effects....

...John_TX, I hope your problems will resolve.

Ditto, John !

That is a most valuable study, Gemlin. Thanks for posting the link.

IMO, it’s conclusions are spot on, and Nkinney is correct. Late term effects are under studied, dismissed by too many ‘professionals’, and woefully ignored right here. Lots of complex reasons, one of which is false ‘feel good’ bravado.

Gemlin-

The issue is NOT whether there are chronic effects of surgery or radiation that can continue - it's very rare to have chronic effects for radiation but they do occur. The issue is whether NEW adverse effects due will appear after a long while that have never occurred before. The answer seems to be no - for both surgery and radiation, whatever side effects will occur have mostly occurred within the first 2 years of treatment.

The Swedish registry data could have been analyzed to show this, but wasn't. They would have to show when the adverse effect first occurred - but they didn't do that. However, we can see that the pattern is similar for those who got RT and those who were cancer free, indicating the overriding effects of aging. Also, doctors are much more attentive to patients who have been treated and come in for f/u monitoring compared to he matched controls who were not watched by treating physicians.

A better illustration is seen in the ProtecT trial where patients were randomized to RT, RP or AS (so there is no statistical guesswork needed to match controls). Also, it includes patient-reported outcomes - a much more reliable source of data than the registry data.

/pcnrv.blogspot.com/2016/09/patient-reported-outcomes-from-protect.html

Table 1 - incontinence was a minor issue after RT and was similar to AS and did not decline over time.

Table 2 - urinary obstructive symptoms peaked at 6 months and then returned to baseline levels that were similar to men who had AS.

Table 3 - Bowel function decreased at the 6 month time point and then returned to close to baseline, and close to AS and RP.

Table 4 - Erectile function declined most at 6 months post-treatment, and then increased but not to baseline levels. Erectile function deteriorated slightly in both AS and RT as men aged.

One can make the case that almost all radiation adverse events that will ever occur, will occur within the first 6 months.

In fact, the strongest predictor of problems later on is the patient's status at baseline. So, men who had rectal, urinary or erectile problems before starting radiation are more likely to have them afterwards. Age is also a strong predictor. In my case, I had hemorrhoids before radiation, and they only got worse afterwards.