Friday, August 24, 2012

Post Treatment Colonoscopy: An Update

As reported in my previous entry, proton radiation permanently damaged a small segment of my colon. This diagnosis triggered an immediate research effort on my part. I am particularly interested in its long term implications. My research is incomplete and ongoing. In view of the potential interest to others, however, I feel compelled to file this interim report based exclusively on the opinions of Dr. A. N. Swer.
Dr. Swer is a practising physician with a Phd. in microbiology from Harvard University. His specialty is nuclear medicene. His interest in prostate cancer and proton therapy has been augmented by personal experience with both. Based on a photograph posted on the internet Dr. Swer's colon looks a lot like mine. In response to several of my concerns, Dr. Swer opined, in part, as follows:
"I would consider angiodysplasia to be the word for the tissue changes that are associated with radiation proctitis. Since the procedure that cured my bleeding, I have not worried about my angiodysplasia (which is likely worse than yours). My bleeding didn't start until many months after the treatment though I imagine that a great many men who have had photon or proton radiation for Pca have angiodysplasia of one degree or another and one pattern or another, with or without problems from it. I haven't seen a publication documenting this, however, I think it would be quite interesting ... I can't guarantee that you will never bleed, but also my guess is that area will never heal..."
"Radiation for Pca likely creates a small increase in the risk of cancer in tissues that it doesn't kill, including but not limited to the adjacent bowel. The overall increase is probably lower with proton than with photon therapy. That consideration goes in the plus column for choosing protons...
In short, I think your gastroenterologist is right on target, including scheduling you for follow-up colonoscopy; and my final word of advice, for what it's worth is: Don't worry."
Dr. Swer's expert opinion may not qualify as the clean"Bill of Health" I may have hoped for , but
it is not the proverbial "Kiss of Death" it could have been. More specifically my worst fears have been substantially amelioriated.In retrospect at this juncture the worst part of my colonoscopy mini-adventure is the complete absence of any expectation of permanent colon damage. None of my research before, during or after treatment prepared me for this outcome.

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