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Review
. 2018 Oct;50(10):1745-1751.
doi: 10.1007/s11255-018-1970-2. Epub 2018 Aug 21.

Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies

Bernadette M M Zwaans  1   2 , Laura E Lamb  1   2 , Sarah Bartolone  1 , Heinz E Nicolai  3   4 , Michael B Chancellor  5   6 , Stangel-Wójcikiewicz Klaudia  7
Affiliations
Review

Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies

Bernadette M M Zwaans et al. Int Urol Nephrol. 2018 Oct.

Abstract

Purpose: Given that more cancers are being diagnosed earlier and that treatment of cancer is improving, health issues of cancer survivors are becoming more common and apparent. Pelvic radiation therapy for the treatment of gynecological cancers can lead to long-term collateral damage to the bladder, a condition termed radiation cystitis (RC). Late sequelae may take many years to develop and include incontinence and pain as well as hematuria. RC is a rare but potentially life-threatening condition for which there are few management and treatment options.

Methods: There are limited data in the literature regarding the effects of radiation on the bladder after gynecological cancer therapy and we hereby review the literature on cancer survivorship issues of pelvic radiation for gynecology literature.

Results: Treatment options are available for patients with radiation-induced hemorrhagic cystitis. However, most treatments are risky or only effective for a short timeframe and no therapy is currently available to reverse the disease progress. Furthermore, no standardized guidelines exist describing preferred management options. Common therapies include hyperbaric oxygen therapy, clot evacuation, fulguration, intravesical instillation of astringent agents, and surgery. Novel developing strategies include Botulinum Toxin injections and liposomal-tacrolimus instillations. These treatments and strategies are discussed.

Conclusions: In this review, we will present current and advanced therapeutic strategies for RC to help cancer survivors deal with long-term bladder health issues.

Keywords: Bladder; Cancer survivorship; Gynecology cancer; Hemorrhagic cystitis; Inflammation; Radiation cystitis.

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Conflict of interest statement

Conflict of interest Dr. Chancellor is the founder and Chief Scientific Officer of Lipella Pharmaceuticals, Inc. The remaining authors declare that they have no relevant conflicts of interest.

Figures

Fig. 1
Fig. 1
Late symptoms of radiation cystitis in pelvic cancer survivors
See this image and copyright information in PMC

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