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Rectal bleeding after radiation therapy for prostate cancer: endoscopic evaluation
E M Moore1, T J Magrino, P A Johnstone
1General Surgery Department and the Clinical Investigation Department, Naval Medical Center San Diego, Suite 5, 34800 Bob Wilson Dr, San Diego CA 92134-1014, USA.
Radiology
|September 30, 2000
Summary
Rectal bleeding is common after prostate cancer radiation therapy. Endoscopy is crucial to identify causes beyond proctitis, ensuring proper diagnosis and treatment for patients experiencing hematochezia.
Area of Science:
- Oncology
- Gastroenterology
- Radiation Oncology
Background:
- Prostate cancer radiation therapy can lead to gastrointestinal side effects.
- Rectal bleeding (hematochezia) and proctitis are potential complications.
- Understanding the frequency and causes of these symptoms is vital for patient management.
Purpose of the Study:
- To determine the incidence of proctitis and hematochezia following prostate cancer radiation.
- To assess the clinical significance of these symptoms post-treatment.
- To investigate the underlying causes of rectal bleeding.
Main Methods:
- Retrospective analysis of 63 patients treated with radiation for prostate cancer.
- Evaluation of symptoms including heme-positive digital rectal examination (DRE) and hematochezia.
- Endoscopic evaluation of the sigmoid colon or colon for 26 symptomatic patients.
- Statistical analysis using Fisher exact test and Kaplan-Meier method.
Main Results:
- Rectal bleeding occurred in up to 80% of definitively treated patients by 3 years post-radiation.
- Proctitis was diagnosed in only 14 patients; other conditions were found in 6 patients.
- The frequency of rectal bleeding was similar in patients with proctitis and those with other identified diseases.
Conclusions:
- Hematochezia and positive DRE findings are common after definitive radiation therapy for prostate cancer.
- Endoscopic evaluation frequently reveals causes of bleeding other than proctitis.
- Symptomatic patients require thorough investigation to exclude serious coexistent conditions.