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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 35578
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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My 35 year old daughter had treatment for 1b1 stage cancer,

Customer Question

My 35 year old daughter had treatment for 1b1 stage cancer, chemo/radium, they told her last august all scans were clear. Past few months shes had blleding from back passage, they gave her steroid suppositories for late affects of radium. She was fine then got quite a heavy bleed so they are going to do a colonoscopy. Then last night she took a bleed from the vagina for the first time, she has pain in lower abdomen, not bad pain. Her oncologist is going to see her on monday and said he would have a gynocologist with him. Can you tell me your thoughts on this bleeding please. Lorraine.
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Chip replied 4 years ago.
Hi--just to be clear here was this cervical or uterine cancer that she was treated for?
Expert:  Dr. David replied 4 years ago.
This is Dr. David

Thank you for requesting me.

I am sorry for your daughter's diagnosis of cervical cancer.

sounds like she had some possible radiation proctitis or internal hemorrhoids which caused some rectal bleeding. hopefully the steroid suppository has helped calm that inflammation down. if she continues to have rectal bleeding, she might need to have a colonoscopy to look up into her rectum and see how much radiation proctitis is going on there and the GI doctor can perform fulguration of the area to burn and scar areas of bleeding to stop the bleeding.

often times for young women who receive radiation and chemotherapy for early cervical cancer, they can have stoppage of their periods because the ovaries are suppressed by the radiation and chemotherapy. in some rare cases, the ovaries wake back up and their periods start back up again. this could have happened to her after many months after her treatments. so her vaginal bleeding could have been a period bleeding after many many months of no period.

this needs to be checked. she can have a gyn examination to look at the cervix to make sure the cancer has not come back and she can have blood work to check on her estrogen levels. and if her estrogen levels are back up to normal, it is likely she could even have her monthly periods come back

let me know if you have other questions.
Expert:  Dr. Chip replied 4 years ago.
Hi Lorraine--I was the original expert above that first responded to you. While this could be radiation proctitis and her period returning, let me give you all the other possibilities here and please let me know if you need me to continue after this. Let's say that the rectal bleeding could be from the radiation--this could be more than just from the rectum and she could have more of her colon involved in this where the lining of the colon is thinned and can bleed. That can be treated with cortisone as with suppositories and enemas and oral prednisone if needed. That said, this may be something else like colon polyps, colitis unrelated to the radiation therapy, or even a bleeding diverticulum or something called an arteriovenous malformation of the colon wall. As for the vaginal bleed, it could be a cervical polyp but it could also be from uterine fibroids or endometriosis. She'll obviously need the colonoscopy and a pelvic ultrasound and vaginal exam as well. That gives you all the other possibilities here and I just wanted to let you know that this all may not be related to her cervical cancer and her radiation treatment. Please let me know if you need more information than what I've provided here