Whenever a man is treated for prostate cancer with radiation therapy, powerful x-rays are beamed into the prostate gland to kill the cancer cells. Most men receive about 35 treatments.These x-rays must pass through the rectal wall to reach the prostate below. There is always some damage to the lining of the rectum, sometimes it is permanent. In this patient, the damage was severe enough to cause rectal bleeding. In the first picture, you can see many small blood vessels which have come to the surface of the rectum. This condition is called radiation proctitis and often leads to chronic rectal bleeding. (Compare this to a normal colorectal lining). Because of a heart condition, this patient was placed on Coumadin, a blood thinner, which lessens clotting of the blood. This made his bleeding much worse and anemia developed. In the second picture, you can see how we used the colonoscope to lessen the loss of blood. During his scope exam, a special thin catheter called a heater probe was passed through the colonoscope. The tip of this catheter has a special computer controlled heating element. This allowed us to precisely coagulate many of these small fragile vessels without any pain or serious damage to the underlying colon wall. About 50 vessels were cauterized in about 20 minutes. You can see the white spots that resulted from the treatment. By using this simple outpatient technique, the Coumadin could be safely continued without rectal bleeding.

Text & Images Courtesy of Three Rivers Endoscopy Center
© Dr. Robert Fusco, Three Rivers Endoscopy Center, All Rights Reserved