Managing salvage radiation side effects

My husband just finished his second week of salvage radiation. We had hoped that the side effects--if there were going to be any--wouldn't kick in for a couple of weeks, but that's not the case. First week was nausea and retching, but that has been controlled by Prilosec and Tums. (They think the radiation exacerbated his acid reflux.)

This week was really bad gas and cramping which they said was not uncommon. Doctor said to take Gas-X so that's been added. Tonight he has very bad diarrhea.

I know that everyone's experience is different, but do you have any tips for managing the side effects? Should he go on the BRAT diet for a couple of days to see if that calms things?

Melaine said...
My husband just finished his second week of salvage radiation. We had hoped that the side effects--if there were going to be any--wouldn't kick in for a couple of weeks, but that's not the case. First week was nausea and retching, but that has been controlled by Prilosec and Tums. (They think the radiation exacerbated his acid reflux.)

This week was really bad gas and cramping which they said was not uncommon. Doctor said to take Gas-X so that's been added. Tonight he has very bad diarrhea.

I know that everyone's experience is different, but do you have any tips for managing the side effects? Should he go on the BRAT diet for a couple of days to see if that calms things?

Melaine

I have C Diff right now and have a Oncologist Dietitian and my Cancer Doctor working with me. I have lost 20lbs of weight from severe diarrhea. I am drinking 2 - 3 G2 with a 1/4 tsp of salt added, this helps with electrolytes loss keeps you hydrated also. In the morning before anything to drink or eat I use Metamucil mix with ginger ale.( I thought it tasted like dirt with water ) The fibre in this helps to slow down your digestive tract by soaking up the moisture. I have also been using the BRAT diet, with some chicken for protein.

I am trying to re challenge chemo docetaxel a 2nd time, but I cannot start with diarrhea.

I did not have any digestive issues with ART after surgery (some after diagnosis though) so hard to say where his are coming from. Kept fiber intake up and drank lots of water to keep on schedule. Always behaved on weekends and kept the same diet going for 7-8 weeks. Consistency is a key item for the duration. Caffeine and alcohol can cause issues so best to stop them when having GI issues.

Metamucil and Citracal is easy, make quick smoothies with fruit, yogurt and liquid with a heaping tablespoon in a small blender. Still do it most days for lunch.

Diarrhea is best treated with white rice and baked chicken but you can also plug up the system with it. I guess you have to treat the symptoms as they occur but try to get to a constant diet that seems to work for him and stay with it. Good luck.

It will get better as your body adjusts to the radiation

I was given a special low gas low fiber diet for the weeks leading up to, during, and a month after adjuvant radiation. Still I began to experience diarrhea the second week, which continued throughout treatment. My RO told me to have Activia twice a day, otherwise no changes to diet.

Six months later I had a colonoscopy and was Dx'd with radiation colitis. I did a lot of research and had to reduce or eliminate many foods, including fruits and veggies. It's called a "low residue" diet or the white diet as it consists of mostly white foods... white bread, white potatoes, baked chicken breast, and lots of white rice. I would have either cream of rice or rice chex for breakfast or snacks thru the day.

I don;t understand those who say that one should increase their fiber intake. I can only guess that these are people who possibly had elimination issues to start with. My GP told me to take imodium but that only caused rebound constipation. Ultimately my gastro started me on Questran or cholestyramine for a condition called BAM or bile acid malabsorption. That did the trick. I took it with dinner for about a year and everything cleared up. When we ate out I would put some of the powder in a plastic bottle, add water in the restaurant and shake to mix it.

There seems to be so much misinformation on this, and the issue is easily dismissed by those who have never had it that I started a Facebook support group named "radiation colitis and pelvic radiation disease". We have a few hundred members.

Just wanted to say my heart goes out to everyone suffering on the forum. I hate PCa and all the side effects. I have not felt the same since my treatment either. I have both reflux and ibs. Hang in there my friends.

Melaine - My pubic area started itching like crazy about a week after ART treatment began. I called the office and the doctor on duty said that it is not from the radiation so early and might be something else, just put medicated cream on it. On Monday, I asked the techs about it and they said it is from the radiation and sometimes happens early on. Nothing you can do except put high quality cream on it and it should go away in a week or two. They were right of course.

If you mention this to your DH, he will start itching down there so please don't. If he does, you will know that it happens and not a big deal until he scratches too much and makes a mess of everything.

Mumbo said...
Melaine - I might clarify that Metamucil is a soluble and bulk producing fiber that absorbs water which may explain why the nurse recommended it vs. insoluble fiber which is basically indigestible material and softens stool.

RobLee - My comments about fiber were not meant to solve diarrhea or other similar issues so I apologize about that. The BRAT and low residue diets are for slowing up the system. Most people need a balanced diet to stay regular of which adequate fiber intake is part of. For me, higher fiber intake helps a lot as well as sufficient water each day. I find the low fiber diets tended to plug me up which is not good either so I only use when afflicted or going in for a colonoscopy. Every GI issue is a different deal it seems or there would be one solution for all.

After posting about fiber I was worried that perhaps I should have included a bit more information for clarity.

We are discussing diarrhea during radiation, and I realize that everyone's needs are different. But psyllium (Metamucil) as I understand it can ferment in the bowel causing gas and bloating... just the opposite of the what the "radiation diet" calls for. In this regard, Citrucel does not, and may be better for occasional use. I am certainly not an authority on this, just going by what I've read. But I am certain that since my experience following radiation, and even today, that I must limit the amount of fiber that I consume, else I experience a blow out. So I eat half a cob of corn, a few blueberries at a time, a small serving of beans, etc. I know not everyone is like this. But again, we're talking about a specific experience here,

Melanie... I didn't mention it, but I also had to cut out most dairy. Previously I loved ice cream and milk shakes, but for the past four years I am limited to a bit of milk in my coffee and an occasional yogurt. Sadly I've had to give up some favorite foods. Again, this doesn't happen to everyone. Some men experience radiation proctitis or enteritis. In my case it was radiation colitis, which is further up in the colon. Then six months later I had a small bowel resection to remove a mesenteric mass which my gastro suspected might have been carcinoid cancer. Fortunately it was non malignant. All this happened within the first twelve months following radiation. Coincidence? It's a puzzle. Just saying, when it comes to GI after effects from GU surgery and radiation, I took the grand prize. It was a hectic time and I had to do a lot of research on my own because I wasn't getting much in the way of solid medical advice.

Hopefully your husband's experience will be more of a passing thing, as is most often the case.

Post Edited (RobLee) : 2/17/2022 8:18:50 AM (GMT-7)