Colonoscopy and SRT

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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 7/28/2010 10:29 PM (GMT -6)   
This is just something I've wondered about. I have read that one can have complications (bleeding, fistulas, etc.) as a result of having a colonoscopy post-SRT.
 
Well, down the road I might have SRT in my future. I do get routine colonoscopies. My doc. said every 10 years based on my last few (clean) colonoscopies. So, my next one is due in about 5 years. Suppose in a year I see that I am heading for SRT. Would it make sense to squeeze in a colonoscopy BEFORE the SRT?
 
Mel

63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week). As of 6/22/10, I would say I am 100% continent, but I do have (controllable) significant urgency.

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.

Second post-op PSA on 6/21/10--0.02--Not too bad!


John T
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Date Joined Nov 2008
Total Posts : 4269
   Posted 7/28/2010 10:44 PM (GMT -6)   
You can get a colonospocy after SRT, but be sure your doctor is aware that you have had radiation. He cannot take a biopsy of any area that shows sign of radiation damage or you will have real problems. As long as it is a normal colonosocy it's not an issue.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 7/29/2010 9:53 AM (GMT -6)   
John T:
 
That's NOT a good situation. If it's clear, then in retrospect I didn't need a colonoscopy.
 
The point of a colonoscopy IS to take a biopsy of anything suspicious.
 
So it sounds like I SHOULD have one before doing SRT.
 
Mel

63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week). As of 6/22/10, I would say I am 100% continent, but I do have (controllable) significant urgency.

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.

Second post-op PSA on 6/21/10--0.02--Not too bad!


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 7/29/2010 10:22 AM (GMT -6)   
I would wait the 5 years. However, you could always call the doctor and get his opinion. I turned 50 earlier this year so will be having my first one. I am somewhat concerned about having one since I've already had PC. I am just a worrier....
 
Age 48 at diagnosis
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue


ejn
Regular Member


Date Joined Jun 2010
Total Posts : 87
   Posted 7/29/2010 2:41 PM (GMT -6)   
squeeze one in?? That was great.  Sounds like a ride at 6 Flags.  If it were me I would wait the 5 years on that one, but that's me.  Certainly call your doc and get his opinion.

Age @ DX  53

Pre OP PSA: 1/2008=5.9, 2/2010=6.0 (free=9%)

Biopsy, 4/10/2010 This was my 2nd Biopsy.  The Uro put me out and took 36 samples.  3 samples positive 1%, 2%, 2% no evidence of perineural invasion. T1c

Dx Date  April 2010

Gleason:  3+3=6
CT Scan: Negative
DaVinci:  Coming up 8/11/10, Dr David Bryan, SSM DePaul-St Louis
 


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 7/30/2010 7:46 AM (GMT -6)   
Hi Mel,

I had a colonoscopy about 12 weeks after my final radiation treatment. I did not have any problems and a benign polyp was removed. I let the doctor know that I had just completed raditation treatment and that a portion of it was "full pelvic" before getting the exam. The report came back as clean with a notation that the lower bowel had multiple "angio ectasias". I never found this term as shown but the best I could determine is that this was stiffening of blood vessels in the intestinal track. This can occur even without radiation and can cause bleeding. So far, I have seen no evidence of this either.

Best thing is to ask radiologist and the doctor who will do the colonoscopy for advice. Theirs is professional and mine is anecdotal.

Best of luck to you.
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Two years on Lupron completed 01/2010.
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 were full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones
PSA 05/10 .42 Rising a little as the lupron wears off. Last lupron shot 01/10.
PSA 06/10 .322 Maybe the .42 reported in May was in error?

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