IMRT Effects- Post One Month

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Hope and Prayer
Regular Member

Date Joined May 2010
Total Posts : 59
   Posted 7/14/2010 11:46 PM (GMT -6)   
BF is having IBS related symptoms such as intestines irritable, loose stools and stabbing pain behind belly button area.  I feel they are radiation and intense workout related.  He feels that it may be radiation related or worst, abdominal lymphnode invasion even though PET from last month did not indicate uptake in that area.  Can you tell me what your effects were.  Thanks to all!
Boyfriend dx at age 44 with Stage 4 PC on 11/09. Gleason 4+5, 11 of 12 cores +; PSA 51.34
DaVinci surgery on 12/09

Gleason 4+5 confirmed. Lymph and vesicle invasion, right nerves spared.
pT3c N1 Mx
HT: Casedox and Lupron started 1/10

PSA 1/13/10 23.15 2/8/10 .37 3/18/10 <.05 5/14/10 <.02

Bone metastasis

Radiation: 42 sessions ending 6/10

Regular Member

Date Joined Mar 2007
Total Posts : 437
   Posted 7/15/2010 12:13 AM (GMT -6)   
I had SRT ending in March 2010,  but it was only 32 sessions and 64 gys...
I was a little constipated going into treatments as a side effect from simvastatin cholestorel medicine I had been started on and  ended up with some rectal proctitus which made bowel movements uncomfortable for awhile,  but it cleared up after 60 days.   I never had any pain or discomfort other than during the bowel movements.  There can be a lot of gas buildup...   did not bother me phsically,  but maybe it could cause pain to some folks? 
After 3-4 years of annual PSA 4-6, biopsy recommended
59 y/o
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 
12/2/2008 3rd Post-OP PSA at 20 months...   0.03
10/30/2009 4th Post-OP PSA at 31 months...   0.13 (moved and diff lab)
11/3/2009 Retest at my original lab...  0.11  (followup with Doc sched 11/10)
11/10/2009 Discussion indicated biochemical reccurrence and need for salvage radiation treatment. 
1/21/2010 Another PSA test at 34 months...  0.14
1/26/2010 IMRT Salvage Radiation Treatment started
                  32 sessions for 64 gys total.
3/12/2010 Finished 32 sessions...  No side effects to date except a little
tiredness.  Slight changes in bowel movements the last week...  
4/8/2010  Some rectal prostitis, but no change in urgency.  No urinary effects at all.  Now just waiting for the upcoming PSA test in June.
6/7/2010 First 3 month PSA result after SRT = 0.02   WAHOO!  as good as could ever be expected at the 3 month mark!  Thank You Jesus!

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2215
   Posted 7/15/2010 2:21 AM (GMT -6)   
Yes I definitely had odd BMs and strange aches and pains in the belly after RT.

I am 4 weeks on and it has got a lot better already.

But for the last month BMs have involved a lot of explosive farts, and a dozen small stools instead of one or two big ones, also there were up to four BMs a day. (My brother-in-law, who had RT about 6 yeras ago, said he felt like he was crapting like a goat.)

My aches and pains around the belly button was partly like a repeat of the ache that I had had after surgery, but it also felt like I could feel every twicth of my gut (peristalsis) as it moved near the area affected by RT. (Sometimes it was the whole area that ached, sometimes it was just one small sudden stabbing pain.

After surgery the solution was to do plenty of walking, so I tried the same after RT, but the complication after RT was that I felt so tired I could often only walk short distances, and slowly.
I also watched what I ate to avoid anything that might have given me belly ache anyway, and despite the complications it caused for my bladder carried on drinking plenty. But I still avoid fizzy drinks.
I also took one or two paracetamol(tylenol) each day which I think helped.

You clearly need to monitor the situation, as things like proctitis can occur.
And have you spoken to the docs about it, becasue there are meds that can help.

Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking of urine
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc. but...
Nov 17th 2009 PSA = 0.1
Can still get erections okay, and almost no leaking of urine, but since December 2009 I don't have orgasms, instead I just have intense pain in place where prostate used to be.
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)
June 11th 2010 finished RT - main side effect tiredness, but also the occasional small leak
June 27th My 50th Birthday - feeling better but still not 100% okay

Veteran Member

Date Joined Jan 2009
Total Posts : 2222
   Posted 7/15/2010 7:42 AM (GMT -6)   
Loose stools are fairly  common and perhaps the most common side effect of SRT. The intense workouts might be playing a part in the pain as well, but for safe keeping check with the Dr. Hopefully this too shall pass. Good luck.
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 7/15/2010 8:09 AM (GMT -6)   
I am about a year post IMRT and still have some isolated bouts with loose stools.  I think it is just a common side effect from the treatment.
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Gleason 7 (3+4)
1 positive margin (.3cm)
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable
05/13/09   PSA .18 (ouch)
Started IMRT June 13, 2009
Completed 37 treatments July 31, 2009 (66.6gy)
11/23/09 Post IMRT PSA .18
2/12/10   Post IMRT PSA 0.00

Veteran Member

Date Joined Nov 2008
Total Posts : 697
   Posted 7/15/2010 9:03 AM (GMT -6)   
Like the others said, it's almost certainly just a side effect. The bowel gets a little irritated from the radiation. In my case it faded away in the months following.

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1

Regular Member

Date Joined Dec 2009
Total Posts : 315
   Posted 7/15/2010 11:10 AM (GMT -6)   

Hi Hope, I am really sorry to hear about Peter's IBS. Just to relieve you and him, my dad during and a still after radiation (even though the side effects have been alleviated somewhat) had really bad naseau, diarrhea and urgency to use the bathroom. He did take an anti inflammatory- not sure but I think the name is Naprosyn, I know that it did help him alot. Maybe Peter can ask about it. Please keep us updated. Hope he feels better!


Father diagnosed Nov. 9, 2009
Open radical prostatectomy Dec. 21, 2009, post op pathology report T3a, Gleason 7
5 week post op psa .55
Combination therapy, hormone and IMRT. 40 sessions 72gy.
Hoping and praying for a cured dad.

Forum Moderator

Date Joined Jan 2010
Total Posts : 6947
   Posted 7/15/2010 1:39 PM (GMT -6)   
I am exactly 4 weeks out from my last of 39 IGRT sessions.
I have increasing bowel issues (had them the last few weeks of treatment, they continue to worsen gradually). Alf said it well.

I am sure that is the source of some intestinal and "gut" pains.

I couldn't exercise if I wanted too - dead tired by noon, take a nap, and dead tired by evening. After surgery I was walking 3 miles a day. Couldn't do a half-mile today for anything unless crawling counted.

Hope and Prayer
Regular Member

Date Joined May 2010
Total Posts : 59
   Posted 7/15/2010 2:48 PM (GMT -6)   
142- So sorry that you are so fatigued. I hope you get your energy back!

Alf-Thank you for the information and the laugh! BF describes the feeling as repeat of surgery as well. I guess the RT just made everything raw again even though its 4 weeks out. He was also drinking alot of fruit and veggie drinks first thing in the morning. Too much fiber and juices can irritate as well.

Lynne--Peter just spoke with your Dad. He was very happy to hear he is doing well. He did suggest Naprosyn/Alleve and slow down on fiber. I think it will help.
Thank you all!
Boyfriend dx at age 44 with Stage 4 PC on 11/09. Gleason 4+5, 11 of 12 cores +; PSA 51.34
DaVinci surgery on 12/09

Gleason 4+5 confirmed. Lymph and vesicle invasion, right nerves spared.
pT3c N1 Mx
HT: Casedox and Lupron started 1/10

PSA 1/13/10 23.15 2/8/10 .37 3/18/10 <.05 5/14/10 <.02

Bone metastasis

Radiation: 42 sessions ending 6/10

Veteran Member

Date Joined Jun 2007
Total Posts : 784
   Posted 7/16/2010 6:41 PM (GMT -6)   
I have continuing bowel problems nearly 2 years out from radiation therapy, when I discussed this with my oncologist he explained that there may be some scarring caused by the radiation, so just to be sure, I am scheduled for colonoscopy on 4th August.

Regards Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept. Totally dry since catheter removed
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA 30th April 0.4
PSA 30th July 0.5
PSA 27th Oct 0.4 (I am now 68)
PSA 11th March 09 0.5
PSA 3rd August 09 0.6
PSA 25th November 09 0.6 (I am now 69)
PSA 18th Jan 10 0.6

Hope and Prayer
Regular Member

Date Joined May 2010
Total Posts : 59
   Posted 7/19/2010 9:43 PM (GMT -6)   
Great idea. BF did colonscopy just before surgery in Jan.  I think he should do one again in near future.  Thanks for info.

Boyfriend dx at age 44 with Stage 4 PC on 11/09. Gleason 4+5, 11 of 12 cores +; PSA 51.34
DaVinci surgery on 12/09

Gleason 4+5 confirmed. Lymph and vesicle invasion, right nerves spared.
pT3c N1 Mx
HT: Casedox and Lupron started 1/10

PSA 1/13/10 23.15 2/8/10 .37 3/18/10 <.05 5/14/10 <.02

Bone metastasis

Radiation: 42 sessions ending 6/10

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2215
   Posted 7/20/2010 12:52 AM (GMT -6)   
Arranging Colonoscopies after treatment for PCa, be it surgery or RT, must not be done too soon as the whole rectum/bowel etc can be very delicate. So I suggest you check with uro and RT docs if/when it is okay to have another colonoscopy.

(I was able to cycle 25km yesterday in less than 2 hours, so a clear sign that my recovery is moving in the right direction so I am sure BF's will too.)

Veteran Member

Date Joined Aug 2009
Total Posts : 665
   Posted 7/20/2010 11:02 PM (GMT -6)   
I had to wait 6 months after my prostatectomy to get a colonoscopy, per my surgeon. Needed to allow the rectal wall to thicken.
Gleason, 3+4; PSA, 7.9
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
pT2c, prostate 60.2g, margins: negative; perineural invasion: present; lymphatic invasion: present; 3 lymph nodes removed, clear; seminal vesicle invasion: absent; Gleason 4 comprises 5-10% of carcinoma
PSA consistently <0.1 since surgery until Oct 09: 0.1; retested Oct 09, <0.1,
Jan 10, 0.2
retest Feb 1 confirmed 0.2
CT scan, bone scan Feb 10 both clear
PSA after, 2010: March, 0.17; April, 0.17; May, 0.24; June, 0.31; July, 0.29
Starting salvage IGRT on August 4, plan 72Gy

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