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Coping with GI Side Effects of Radiation Therapy

Posted Aug 24 2008 1:49pm
ANNOUNCER: Bob Patterson drives a tour bus for a living, and he can't go to the bathroom whenever he might like.

In the Spring of 2001 that became a problem, for Mr. Patterson developed severe diarrhea following treatment for colon cancer.

BOB PATTERSON: I didn't have any hard stools. It was just like oatmeal. And that wasn't very controllable at all because you know I'd feel like I have to go. It was just like constant you'd better run into the bathroom, because you didn't know what was going to happen.

STEPHEN ROSENOFF, MD: He was finding that now he really couldn't function very well. If he ate a meal, he would have three movements or more after that meal. He was afraid to have any kind of a snack. He wasn't sure if he was going to have to go to the bathroom. This was negatively impacting both his social life and making it very difficult for him to function as a tour bus driver.

ANNOUNCER: Bob Patterson's diarrhea was the result of a triple assault on his body. His colon was shortened by cancer surgery. Chemotherapy damaged cells in the intestine and colon. And Mr. Patterson underwent radiation treatment.

STEPHEN ROSENOFF, MD: The radiation can cause injury to the small bowel and the rectal area. And a consequence of that can be diarrhea, or, at some times, what we call rectal incontinence which means that a patient may not control-they may sense when they have to go to the bathroom, but they can't get to the bathroom in time and sometimes not even sense when they're going to have to go to the bathroom.

ANNOUNCER: Doctors often treat such diarrhea with common drugs, like Imodium and Lomotil. But these don't resolve the underlying problem with chemotherapy- and radiation-induced diarrhea.

STEPHEN ROSENOFF, MD: A major component of both radiation- and chemotherapy radiation-induced diarrhea is what we call secretory, which is a weeping of fluids out into the gut.

ANNOUNCER: Dr. Rosenoff had had good results with other patients with similar problems, with a drug called octreotide, or Sandostatin. And he offered it to Mr. Patterson.

BOB PATTERSON: Well, I remember it was a great relief. He said, "I think we have something that can do that. It can handle your problem." So we tried it.

STEPHEN ROSENOFF, MD: How octreotide works is it has anti-secretory and anti-exudative properties, so it not only interferes with a secretion and exudation in the gut so it reduces this fluid load. Most of the fluid resorption occurs in the small bowel and the beauty of the octreotide, or Sandostatin, is that it slows both the small bowel as well as the large bowel.

ANNOUNCER: Bob Patterson is now taking monthly injections of a long-acting version of Sandostatin called Sandostatin LAR. He still has problems with diarrhea, but they are much more manageable.

BOB PATTERSON: I mean, I still have a problem in that whenever I eat, I have to go to bathroom within an hour or maybe from an hour to two hours after eating; I'm in the bathroom three or four times. But at least it's solid now, which means I can hold it or can control it a little bit where I couldn't before.

ANNOUNCER: Luckily, Mr. Patterson has been with his company long enough to have his choice of assignments.

BOB PATTERSON: Even now, I'm a little selective in that one of the nice things-we do a lot of senior citizens. They want to stop every two hours, so that's good. You get some sports teams and they don't want to ever want to stop. They're all college kids and they think they should drive for seven hours without going to the bathroom. So if I think they're going to be like that, I don't do the trip.

ANNOUNCER: Bob Patterson is back at work, with his diarrhea under control. He remains in good health.

STEPHEN ROSENOFF, MD: Mr. Patterson is now almost three years out since his initial operation and he remains in a complete remission, that is, there's no sign of cancer or recurrence.

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