Overview

Radiation or chemotherapy induced cystitis is a term used to classify non-bacterial cystitis occurring during or after cancer treatment. For a cancer patient who is going through radiation or chemo, onset of chronic cystitis can seriously damage the quality of life.

Symptoms

The condition usually develops in 3 phases:

  1. Acute phase - starts during treatment. Usually resolves after cancer treatment stops, although it may take a few weeks.
  2. Symptom-free period - can last anywhere from a couple of months up to 10-15 years after initial cancer treatment.
  3. Chronic cystitis phase, which can occur years later. Damage is irreversible and requires symptom management.

Symptoms can range from mild to life threatening, including:

  • Urinating more frequently
  • Urinary urgency
  • Pain in the pelvic region
  • Urinary incontinence
  • Blood in urine

The bladder damage may be so excessive that it causes bladder wall scarring, bladder atrophy (decrease in size), or in extreme cases sepsis (severe systemic infection).

Causes

Both radiation and chemotherapy induced cystitis develop as a side effect of cancer treatment.

Radiation used to treat many different types of cancer can cause inflammation in the bladder tissue. Similarly, chemotherapy can also cause damage, but through a different mechanism. The drugs used can break down into substances which damage the bladder while passing through it to be excreted.

These two main culprits can cause inflammation and cystitis in patient receiving:

  • Radiation treatment for bladder cancer
  • Radiation treatment for other pelvic cancers (prostate, ovaries, uterus or lower intestines)
  • Chemotherapy medications (Cyclophasphamide and Ifosfamide)
  • Bone marrow transplant (patients undergoing the transplantation receive high doses of chemo).

Diagnosis

If you develop cystitis during or after receiving cancer treatment, your doctor will probably order a urine culture. If there is no evidence of bacterial infection and especially if there is blood in your urine, you will likely be diagnosed with radiation or chemotherapy induced cystitis.

Treatment

If you are diagnosed with this type of cystitis, your treatment options will depend on how severe your symptoms are. For acute cystitis with mild symptoms, your doctor may recommend only lifestyle changes and symptomatic relief. Bladder rinses can also help.

Other therapy options include bladder instillations with 0.2% chondroitin sulphate, or hyperbaric oxygen therapy.

If all of these measures fail, your urologist may consider more aggressive methods, such as cystectomy.

How can Gepan help?

Gepan was clinically tested to check if it could be used as prevention of acute radiation cystitis. After showing a clear reduction of overactive bladder symptoms, further research found that even short term Gepan treatment can reduce side effects of cancer treatment and increase quality of life*. In this study, 80% of patients were symptom free or their symptoms were reduced. Haematuria, or blood in urine, was resolved in 100% of cases, and 93% of patients said that tolerance was good*.

Speak to your doctor about Gepan as treatment option for radiation or chemotherapy induced cystitis. You can download a patient information leaflet, or ask them to contact us for more information. If you have been taught how to self-instill, you can order Gepan directly from us.

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