I was diagnoised with stage 4 prostate cancer in April 2024, started Zoladex and Apalutamide in May and had SBRT in September the same year. My PSA has since been dropping from 85 to 0.042 ( June 2026). Things look good for me until recently when I discovered blood in stools. I see blood almost every other day, either in the form of blood streaks in stool or simply bleeding that wet the underwear. My doctor said it is likely SBRT induced. But how could that happen more than 2 years after? I am 87 3/4 and in relatively good shape except some Apalutamide side effects of tireness and hot flashes. Has that happened to anyone of you? Thank you in advance for sharing your experience.
Hello hkcl
I am so sorry to read of your issues. Don't forget I am not medically trained and these are just my thoughts:
* One side effect of SBRT is "Rare or mild rectal bleeding may occur" - Well it's a bit late for a side effect and it sounds like it's much more than "rare or mild".
*
My doctor said it is likely SBRT induced
Did he now - and is that your GP who I doubt has very much knowledge of radiotherapy.
* As far as I am aware the correct way to deal with this would be to ask for 2 stool samples and send them off for a "FIT Test" (Faecal Immunochemical Test). The GP normally does this to see what the result is and if invasive testing (a colonoscopy normally) is needed.
and yes, I have had 3 colonoscopies so I am aware of what is involved.
Regardless of your age (I hope I see 87and 3/4!) - I think that's shabby treatment from your GP and I think you need to be having a word with your Practice Manager. You can't just pass it off as a side effect - clearly you are worried and rightly so.
I hope the above helps - do let us know how you get on.
Best wishes - Brian.
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