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01-10-2018 | Urology - Review

Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies

Authors: Bernadette M. M. Zwaans, Laura E. Lamb, Sarah Bartolone, Heinz E. Nicolai, Michael B. Chancellor, Stangel-Wójcikiewicz Klaudia

Published in: International Urology and Nephrology | Issue 10/2018

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.

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Title: Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies
Authors: Bernadette M. M. Zwaans
Laura E. Lamb
Sarah Bartolone
Heinz E. Nicolai
Michael B. Chancellor
Stangel-Wójcikiewicz Klaudia
Publication date: 01-10-2018
Publisher: Springer Netherlands
Published in: International Urology and Nephrology / Issue 10/2018
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-018-1970-2

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Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies

Abstract

Purpose

Methods

Results

Conclusions

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Abstract

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Conclusions

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