Literature Review: Dietary and Pharmaceutical Interventions for Bowel Preparation in Prostate Cancer Irradiation
Prostate cancer is the most common form of cancer in Canadian men, with an estimated incidence of 23,3000 new cases in 2020 alone. With so many prostate cancer patients receiving radiation therapy as a treatment modality, there is a desire to limit the frequency and severity of patient side effects. In order to reduce the severity of these side effects, it is important that patients follow bladder and bowel preparation prior to radiation treatment on a daily basis. Bladder and bowel preparation are essential steps in the treatment of almost all patients receiving radiation to the pelvic region. Changes to these organs can affect anatomical positioning and, thus, accuracy of radiation delivery. It is important to note that anatomical reproducibility and prostate motion are key players in prostate cancer treatment since rectal size may be easily changed by gas or bowel content. In an effort to regulate these factors, a high-fiber or anti-flatulent diet, perhaps in conjunction with other interventions, may be applied to reduce rectal size and, therefore dose to the rectum. Instances of these interventions include, microenema prescriptions, a high fiber or anti-flatulent diet, pharmaceutical interventions and milk of magnesia (MoM). The standard protocol at the Princess Margaret Cancer Center establishes that the bladder should be comfortably full, and the rectum empty so that organs at risk are positioned away from the treatment field. In this case, hydration, regular bowel movements and an anti-flatulent diet are recommended.
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