Q. I had prostate cancer two years ago and went through 42 radiation treatments. The result of this is colon and rectum damage. I’m still passing a lot of blood. I was told there isn’t much treatment to help this problem. What is your opinion? is there any medicine that could help?
A Your complication of radiation therapy is called radiation proctitis (prock-TIE-tiss). Only a thin layer of tissue separates the rectum from the prostate gland. some radiation is bound to pass into the rectum and damage the rectal lining. that causes pain and bleeding. it appears within six weeks of treatment and lasts for a year or so. usually, it resolves on its own.
However, chronic radiation proctitis appears nine to 14 months after treatment. The lining of the rectum is quite severely injured, and the rectum is scarred. some blood vessels are lost; others become fragile and bleed. Diarrhea, rectal pain, loss of rectal control, bleeding and bowel obstruction are some of the possible complications. It’s a difficult condition to have, and it’s a difficult condition to treat.
If stool has become hard and difficult to evacuate, stool softeners are helpful. If the rectum has become so narrow stool cannot exit, a doctor can dilate the rectum with balloons. Rectal enemas containing prednisolone (a cortisone drug) along with oral sulfasalazine often bring some relief.
Hyperbaric oxygen has been used. However, the equipment needed to administer oxygen under pressure isn’t widely available. Surgery might be needed for symptoms that are not improving.
The doctor who was in charge of your treatment ought to know what is available in your area. Medical people are on guard to prevent this, but it is not always preventable.
Q. I was surprised to find a topic in your column that directly relates to the work I do. A reader, identified as A.S., shared that she had been diagnosed with pulmonary hypertension and was having problems obtaining the medication her doctor had prescribed. The problem was that out-of-pocket costs were too expensive. The letter hit home. I work for a charitable organization that provides financial assistance to people in her situation, and her illness, pulmonary hypertension, is one of the diseases we support. our address is: Caring Voice Coalition, 8249 Meadowbridge Road, Mechanicsville, Va., 23116, 888-267-1440, caringvoice.org. would you please pass along this information.
A. Thank you for your letter. I was unaware of your organization. I will mention it as many times as I can. Illnesses covered by Caring Voice are alpha-1 antitrypsin deficiency, chronic granulomatous disorder, complex partial seizures, Huntington’s disease, idiopathic pulmonary fibrosis, infantile spasms and pulmonary arterial hypertension (high blood pressure in the lungs). Grants are available only to U.S. citizens.
Q. My son is due for surgery on an umbilical hernia. I am worried. I’d like to know more about it, including recovery time. He lives on the West Coast, and I live on the East Coast.
A. All hernias are a protrusion of abdominal tissues or abdominal organs through a defect in the abdominal wall. The abdominal wall includes muscles and ligaments. Umbilical (bellybutton) hernias are common in infants. They often correct themselves. Umbilical hernias that develop in adulthood require surgery if they are large or painful.
The operation should not take your son off his feet for any length of time. Unless he does heavy physical labor, he might be back to work in two or three weeks.
It’s touching to hear from a woman who hasn’t lost her maternal instincts for a grown adult who lives thousands of miles away.
Q. My doctor showed me my X-rays. My neck bones, he said, are reversed, and my spine bones look like an accordion. He wants to give me three treatments a week, which will cost $3,000 a year. He also says I have the symptoms of multiple sclerosis. I am 66. I manage to do things, but it is painful. will this condition worsen without treatment? will I end up in a wheelchair? could I simply remain the same as now?
A. I don’t know what the doctor means when he says your neck bones are reversed and your spine looks like an accordion. I wouldn’t consider three weekly treatments that amount to a yearly output of $3,000 without seeking a second opinion. If you want a specialist, see a rheumatologist or an orthopedic surgeon.
I suspect you have osteo-arthritis of the spine, a condition that happens to many, many people with age. it hardly ever progresses to the point where a patient requires a wheelchair. You’re more likely to remain just as you are. Osteoarthritis progresses slowly for most people. Incidentally, MS usually starts at much younger ages.
Write to Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475.