Rectal bleeding rates following specialized radiation treatments

This study examined the effect of specialized radiation treatments on patient-reported rectal bleeding. The authors found very low rates of rectal bleeding immediately after treatment and at 2 years.

Radiation therapy is a common treatment of localized (confined) prostate cancer. Radiation therapy involves directing high-energy rays at the tumor site to kill cancer cells. These can be directed from outside the body using specialized technqiues such as intensity modulated radiation therapy (IMRT) or stereotactic body radiation therapy (SBRT). Both use precise radiation beams that target the specific shape of the tumor. A radiation source can also be placed inside the prostate (brachytherapy). 

While these radiation techniques are believed to be precise, damage to surrounding healthy tissue can still occur. This can sometimes lead to rectal bleeding or bowel complications. A better understanding of such side effects may improve treatment satisfaction and quality of life.

The aim of this study was to analyze data on patient quality of life and rectal bleeding in patients undergoing specialized radiation treatment.

The records of 865 men were analyzed. 18% of men were treated with IMRT. 30% were treated with low-dose brachytherapy. 52% of men underwent SBRT. Questionnaires assessed side effects at 1 to 2 months, 6 months, 12 months, and 24 months after treatment. 

Overall, 14% of men reported troublesome bowel problems following 1 to 2 months of treatment. Only 1.9% reported rectal bleeding. 19% of men reported bothersome rectal pain or urgency, while 14% experienced increased bowel movements. Rectal bleeding was a rare side effect at 24 months with only 2.6% of patients experiencing bleeding.

A new, adapted questionnaire was found to be accurate in capturing patient quality of life and was comparable to previous versions.

The authors concluded that specialized radiation treatments were associated with very low rates of rectal bleeding.