High-dose rate intraluminal brachytherapy in ano-rectum for haemostasis in a case of metastatic infiltrating cancer prostate

Management of rectal bleeding due to various underlying malignant pathologies is a difficult situation, especially in the setting of metastatic disease. Palliative radiation is generally offered to such patients to achieve hemostasis. We report a patient diagnosed with metastatic prostate carcinoma which was infiltrating the rectal mucosa. Fifty-four year old patient, with a case of metastatic prostate carcinoma presented with rectal bleeding. On evaluation, he had a friable growth from the anal verge to 10 cm with severe bleeding. We gave intraluminal high-dose rate brachytherapy using an endoluminal vaginal/rectal cylinder applicator. A dose of 6 Gy, weekly for three weeks was delivered. High-dose-rate brachytherapy was immediately well tolerated. The bleeding stopped completely by day 4 and by day 7 patient was passing yellow stools. Intraluminal high-dose-rate brachytherapy has been proven as an effective palliative treatment in achieving hemostasis from rectal bleeding.