Talk To Your Doctor Nurseor Care Team
If your bowel issues are bothering you and preventing you from doing your usual daily activities, speak to your doctor. This could be your family doctor, or doctor thatâs been treating the cancer . Your doctor may prescribe medications to help with either constipation or diarrhea. You can also speak with a nurse about getting help.
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How Effective Is Modern Radiation Treatment Of Prostate Cancer
Radiation therapy can give more radiation dose directly to the prostate than to surrounding healthy tissues, given the improvements in technology and imaging techniques. Physicians use various imaging techniques to see the prostate and surrounding tissues in three dimensions, so that the radiation beams can be tailored more precisely to the individual patientâs unique needs. Physicians can estimate and minimize the dose of radiation that will be received near the rectum, small bowel, bladder and hips during the course of radiation treatment to reduce the risk of side effects and complications. The goal is to safely provide a higher dose of radiation than even five years ago, which helps to improve the chances of cure. For similar stage and prostate cancer types, radiation therapy is as effective as surgery but with a different treatment process and different side effects.
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What Should I Avoid If I Have Diarrhea
- Avoid dried fruits, cruciferous vegetables , raw vegetables, whole grains, beans, and legumes.
- Avoid caffeine , alcohol, milk or milk products, chocolate, dried fruits, beans, or popcorn, as well as fatty, fried, greasy, or spicy foods.
- Avoid very hot and cold drinks.
- Avoid sugar free gum, candy, and foods that have sorbitol, mannitol, or xylitol.
If you are having problems with diarrhea after radiation, make sure to speak with your provider.
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Excluding Other Causes Of Gi Symptoms After Cancer Treatment
Different pathological processes can produce identical symptoms, for example diarrhoea has at least 13 different mechanisms.13 As demonstrated in the above case studies, GI symptoms after cancer treatment are complex and within a specialist setting, less frequently occurring diagnoses are made more commonly. However, other causes of GI symptoms and factors unrelated to cancer treatment, such as the psychological effect of a cancer diagnosis and its treatment, changes in diet, new GI disease or pre-existing underlying conditions, may also result in GI symptoms.79
Constipation Is Quite Normal After Prostate Cancer Treatment
Some bowel issues, like constipation are normal after treatment. They are especially common after surgery. Long-term bowel issues after treatment, however, are rare. If youâre experiencing some unusual or painful changes to your bowel habits, itâs important to speak to your care team.
Constipation can also put pressure on your bladder, making it more difficult to urinate . Let your team know if youâre struggling to empty your bowels .
Radiation therapy can cause issues besides constipation
After radiation therapy, you might experience changes to your bowel habits. These changes are usually temporary and include constipation, diarrhea and strong urges to relieve yourself. For more specific information, read about bowel issues after radiation therapy.â â
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What Can I Do To Stop Or Lessen The Diarrhea
- Take a fiber supplement, such as Metamucil , Benefiber, or Citrucel. There are store brand versions of these products, which may cost less.
- Eat bland and easy-to-digest foods such as chicken, fish, eggs, puddings, mashed potatoes, noodles, rice, yogurt, cottage cheese, cream of wheat, farina, smooth peanut butter, white bread, bananas, applesauce, canned fruit, and well-cooked vegetables.
- Soluble fiber is a type of fiber found in some foods that soak up fluid and can help ease diarrhea. Foods high in soluble fiber are:
- Fruits: Applesauce, bananas , canned fruit, orange, and grapefruit.
- Vegetables: Boiled potatoes.
- Breads & pastas: White rice and products made with white flour.
- Cereals: Oatmeal, cream of rice, cream of wheat and farina.
Yogurt and Kefir may be helpful, but if you are lactose intolerant you should avoid dairy.
Short Term Side Effects
Patients who receive any type of radiation therapy to treat their prostate cancer can have side effects. Short term side effects are ones that start during or shortly after your radiation treatment. Below is a list of possible short term side effects. Treatments can affect each patient differently, and you may not have these particular side effects. Talk with your care team about what you can expect from your treatment
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How Can I Reduce Skin Reactions
- Gently cleanse the treated area using lukewarm water and a mild soap such as Ivory, Dove, Neutrogena, Basis, Castile, or Aveeno Oatmeal Soap. Donât rub. Pat your skin dry with a soft towel or use a hair dryer on a cool setting.
- Try not to scratch or rub the treated area.
- Donât put any ointment, cream, lotion, or powder on the treated area unless your radiation oncologist or nurse has prescribed it.
- Donât wear tight-fitting clothing or clothes made from harsh fabrics like wool or corduroy. These fabrics can irritate the skin. Instead, choose clothes made from natural fibers like cotton.
- Donât apply medical tape or bandages to the treated area.
- Donât expose the treated area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle, or ice pack.
- Donât expose the treated area to direct sunlight. That could intensify your skin reaction and lead to a severe sunburn. Choose a sunscreen of SPF 30 or higher. Protect the treated area from direct sunlight even after your course of treatment is over.
Questions To Ask Your Doctor Nurse Or Radiographer
You may find it helpful to keep a note of any questions you have to take to your next appointment.
- What type of radiotherapy will I have?
- How many sessions will I need?
- What other treatment options do I have?
- What are the possible side effects and how long will they last?
- What treatments are available to manage the possible side effects from radiotherapy?
- Will I have hormone therapy and will this carry on after radiotherapy?
- How and when will I know if radiotherapy has worked?
- If the radiotherapy doesnt work, which other treatments can I have?
- Who should I contact if I have any questions?
- What support is there to help manage long-term side effects?
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Dealing With Feelings Of Sadness
If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.
Talk to your GP, as counselling or medication even for a short time may help. Some people can get a Medicare rebate for sessions with a psychologist. Ask your doctor if you are eligible. Cancer Council may also run a counselling program in your area.
For information about coping with depression and anxiety, call Beyond Blue on 1300 22 46 36. For 24-hour crisis support, call Lifeline on 13 11 14.
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Outcome At Next Clinic Appointment
Mr H:
- Bowel frequency: 12×/day
- Stool consistency: type 4
- Daily urgency resolved
- Bowel frequency: 12×/day
- Stool consistency: type 4
- Daily urgency resolved
- Tenesmus resolved
- Perianal soreness resolved
In other words, identical symptoms require identical investigations but have a quite unpredictable outcome and quite different treatments are needed which could not have been guessed.
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Will Radiation Therapy Make Me Tired
Everyone has their own energy level, so radiation treatment will affect each person differently.
People often feel fatigue after several weeks of treatment. For most, this fatigue is mild. But some people lose a lot of energy and need to change their daily routine.
If your doctor thinks you should limit how active you are, theyâll discuss it with you.
To minimize fatigue while youâre receiving radiation treatment:
- Get enough rest.
- Pace yourself, and plan rest breaks throughout your day.
Things To Avoid With Diarrhea
- High insoluble-fiber foods, including fresh fruit with the skin or peel , raw vegetables , whole grain bread and cereals, beans, peas, and popcorn. Insoluble fiber worsens diarrhea.
- High-fat and greasy foods, including pizza, fried meats, bacon, french fries, mayonnaise, cheese, rich desserts, cakes, cupcakes, donuts, cookies, pastries, potato chips, gravy, and butter.
- Cowâs milk, because some treatments cause temporary lactose intolerance. Lactose intolerance causes diarrhea. Typically, lactose intolerance that develops during cancer treatment this will improve when you have finished treatment .
- Caffeinated drinks such as coffee, soda, or large amounts of black or green tea. Caffeine can worsen diarrhea.
- Strong spices and herbs, especially âspicy hotâ flavorings, such as cayenne pepper, hot sauce, salsa, and Tabasco sauce.
- Very hot and very cold foods. Temperature extremes can worsen diarrhea.
- Sugar-free food, gum, and candy, which contain sugar alcohols such as sorbitol. Sugar alcohols can worsen diarrhea.
- Tobacco and alcohol. These items worsen diarrhea.
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Talking About Bowel Problems With Your Doctor
Bowel problems can be embarrassing and life changing. Because of this, its common for men to avoid talking about these struggles with their healthcare team or partners. By not talking about these issues, feelings of fear or inadequacy may build up and cause significant mental, emotional, or physical complications.
For this reason, it is critical to talk with your doctor about potential treatment options that may be right for you, or for specific tips on how to manage what is going on. How much you share about your bowel struggles is completely up to you, however, enlisting the support of an intimate partner, spouse, or close confidant may help ease the burden and set expectations or plans to be followed in the event that you need help managing your bowel struggles outside of your home.
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Urethral Stricture As A Side Effect Of Radiation For Prostate Cancer
After radiation therapy to treat prostate cancer with external beam radiation including proton beam therapy and/or radioactive seed implants, the most common location of a urethral stricture is the membranous urethra. This is the part of the urethra just under the prostate and the urethra in this area is surrounded by a muscle called the external urethral sphincter, which is one of the sources of continence. An illustration of the urethra showing the location of this part of the urethra is found here.
When patients are referred to the Center for Reconstructive Urology with blockage of urine flow after treatment for prostate cancer, they often are not clearly aware of their specific diagnosis with regard to the urethral stricture location and stricture length, even if they underwent prior treatment . If they only had a cystoscopy it is not possible to know the length of the stricture. If imaging was performed and that imaging did not include both a film during injection of contrast and during voiding , there cant be a definitive diagnosis.
We evaluate the urethra using both cystoscopy and high definition accurate urethral imaging to first determine the exact stricture length and location. This comes before a discussion of all options .
With the gentle injection of X-ray contrast to fill the bladder , we can then obtain a film during urination called a voiding cystourethrogram
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What Can I Do To Take Care Of Myself During Imrt
Each persons body responds to radiation therapy in its own way. That’s why your doctor must plan, and sometimes change, your treatment. During radiation therapy, you need to take special care of yourself to protect your health and to help your treatment succeed.
Why Are There Marks On My Skin
Your radiation therapist will make small marks resembling freckles on your skin along the treatment area. These marks provide targets for the treatment and are a semi-permanent outline of your treatment area.
Donât try to wash these marks off or retouch them if they fade. The therapist will re-mark the treatment area when necessary.
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Early And Late Effects Of Radiation Therapy
- Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. Theyre usually gone within a few weeks after treatment ends. The most common early side effects are fatigue and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.
- Late side effects can take months or even years to develop. They can occur in any normal tissue in the body that has received radiation. The risk of late side effects depends on the area treated as well as the radiation dose that was used. Careful treatment planning can help avoid serious long-term side effects. Its always best to talk to your radiation oncologist about the risk of long-term side effects.
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Side Effects Of External Radiotherapy
Radiotherapy to the prostate can cause some side effects, such as loose or watery poo and passing wee more often.
Side effects tend to start a week or 2 after the radiotherapy begins. They gradually get worse during the treatment and for a couple of weeks after the treatment ends. But they usually begin to improve after around 2 weeks or so.
These side effects vary from person to person. You may not have all of the effects mentioned.
Side effects can include:
You might feel tired during your treatment. It tends to get worse as the treatment goes on. You might also feel weak and lack energy. Rest when you need to.
Tiredness can carry on for some weeks after the treatment has ended but it usually improves gradually.
Various things can help you to reduce tiredness and cope with it, such as exercise. Some research has shown that taking gentle exercise can give you more energy. Its important to balance exercise with resting.
Your skin in the treatment area might get sore, or redden or darken. Following these tips can help with this:
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Managing Constipation Diarrhea And Other Bowel Problems
In some instances, normal bowel functioning and control will be regained after treatment and post-recovery. But if this process isnt occurring as fast as anticipated, or isnt happening at all, there are a few interventions and lifestyle changes that can help manage bowel problems. Several of these options include:
- Anti-diarrheal agents
- Avoiding foods that may irritate the digestive system
- Creating a bowel movement schedule and retraining your bowels
If Youre Getting Radiation Therapy To The Chest
Radiation treatment to the chest may cause side effects such as:
Radiation can also cause other problems in the heart or lungs.
Heart complications
Getting radiation to the middle portion of the chest can raise your risk of heart disease. This risk increases with higher radiation doses and larger treatment areas in this part of your body. Radiation can also cause hardening of the arteries , heart valve damage, or irregular heartbeats.
Radiation pneumonitis
Radiation pneumonitis is inflammation of the lungs that can be caused by radiation treatment to the chest . It may occur about 3 to 6 months after getting radiation therapy. Its more likely if you have other lung diseases, like emphysema . Common symptoms of radiation pneumonitis include:
- Shortness of breath that usually gets worse with exercise
- Chest pain, which is often worse when taking in a deep breath
Sometimes there are no symptoms, and radiation pneumonitis is found on a chest x-ray.
Symptoms often go away on their own, but if treatment is needed, it is based on trying to decrease the inflammation. Steroids, like prednisone, are usually used. With treatment, most people recover without any lasting effects. But if it persists, it can lead to pulmonary fibrosis . When this happens, the lungs can no longer fully inflate and take in air.
Be sure you understand what to look for, and tell your cancer care team if you notice any of these side effects.
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Management Of Bowel Dysfunction
Short of treating individual symptoms as needed, there are few, if any, treatment options for bowel dysfunction following radiation therapy. Laser therapy can stop rectal bleeding caused by radiation. Anti-diarrheal agents can help with loose bowel movements. Increasing fiber intake through whole grains, fruits and vegetables, or fiber supplements can also help.Avoiding foods that might irritate the gastrointestinal tract is important, but complete elimination of fibrous, bulky foods can lead to constipation and straining, which in turn can exacerbate rectal bleeding.
What Will Happen During My Daily Imrt Treatments
Before each radiation treatment, you may need to change into a hospital gown or robe. You should wear clothing that is easy to take off and put on again.
In the treatment room, you will be asked to lie down on the treatment table. Your radiation therapist will use the marks made on your skin during your simulation appointment to find the treatment area and to put you in the right position for your prostate cancer treatment. You will be in the treatment room about 15 to 30 minutes each time you go. You will only get radiation for one to five minutes. Getting IMRT is painless. It is just like having an x-ray taken. You will not hear, see, or smell the radiation.
The radiation therapist may put special shields between the machine and certain parts of your body to help protect your healthy tissues and organs. You need to stay very still during your treatment so that the radiation reaches only the area where it is needed and the same area is treated each time. You may breathe normally during your treatment.
The machine used to give you your radiation treatments is very large, and makes noises as it moves around your body to aim at your treatment area from different angles. The machine may scare you at first. Remember that the machine is moved and controlled by your radiation therapist. If you have concerns about anything that happens in the treatment room, talk to your radiation therapist or health care team.
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