Bernadette M M Zwaans1,2, Laura E Lamb1,2, Sarah Bartolone1, Heinz E Nicolai3,4, Michael B Chancellor5,6, Stangel-Wójcikiewicz Klaudia7. 1. Department of Urology, William Beaumont Hospital, Royal Oak, MI, USA. 2. Oakland University William Beaumont School of Medicine, Rochester, MI, USA. 3. Departamento di Urología, Universidad de Chile, Santiago, Chile. 4. Hospital Clínico San Borja Arriarán, Santiago, Chile. 5. Department of Urology, William Beaumont Hospital, Royal Oak, MI, USA. michael.chancellor@beaumont.org. 6. Oakland University William Beaumont School of Medicine, Rochester, MI, USA. michael.chancellor@beaumont.org. 7. Department of Gynecology and Oncology, Collegium Medicum Jagiellonian University of Kraków, Kraków, Poland.
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.
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.
Authors: Bernadette M M Zwaans; Marissa Grobbel; Alexander L Carabulea; Laura E Lamb; Sara Roccabianca Journal: Acta Biomater Date: 2022-03-14 Impact factor: 10.633
Authors: Alexander Krischak; Jakob Kowaliuk; Sina Sarsarshahi; Wolfgang Dörr; Miriam Kleiter Journal: Strahlenther Onkol Date: 2021-03-10 Impact factor: 3.621