Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies

Zwaans, Bernadette; Lamb, Laura E.; Bartolone, Sarah N.; Nicolai, Heinz; Chancellor, Michael B.; Klaudia, Stangel Wójcikiewicz

doi:10.1007/s11255-018-1970-2

Cited by 27 publications

(24 citation statements)

References 34 publications

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“…Hematuria can range from microscopic to macroscopic with blood clots that require blood transfusions. A patient's risk of developing RC increases with radiation dose and number of radiation fractions but these factors alone do not predict which patients will develop RC (Zwaans et al, ). Thus, there is a tremendous need for new and reliable RC therapies, biomarkers to predict patient susceptibility and to predict patient candidacy for early intervention.…”

Section: Introductionmentioning

confidence: 99%

Radiation cystitis modeling: A comparative study of bladder fibrosis radio‐sensitivity in C57BL/6, C3H, and BALB/c mice

et al. 2020

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A subset of patients receiving radiation therapy for pelvic cancer develop radiation cystitis, a complication characterized by mucosal cell death, inflammation, hematuria, and bladder fibrosis. Radiation cystitis can reduce bladder capacity, cause incontinence, and impair voiding function so severely that patients require surgical intervention. Factors influencing onset and severity of radiation cystitis are not fully known. We tested the hypothesis that genetic background is a contributing factor. We irradiated bladders of female C57BL/6, C3H, and BALB/c mice and evaluated urinary voiding function, bladder shape, histology, collagen composition, and distribution of collagen‐producing cells. We found that the genetic background profoundly affects the severity of radiation‐induced bladder fibrosis and urinary voiding dysfunction. C57BL/6 mice are most susceptible and C3H mice are most resistant. Irradiated C57BL/6 mouse bladders are misshapen and express more abundant collagen I and III proteins than irradiated C3H and BALB/c bladders. We localized Col1a1 and Col3a1 mRNAs to FSP1‐negative stromal cells in the bladder lamina propria and detrusor. The number of collagen I and collagen III‐producing cells can predict the average voided volume of a mouse. Collectively, we show that genetic factors confer sensitivity to radiation cystitis, establish C57BL/6 mice as a sensitive preclinical model, and identify a potential role for FSP1‐negative stromal cells in radiation‐induced bladder fibrosis.

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Section: Introductionmentioning

confidence: 99%

Radiation cystitis modeling: A comparative study of bladder fibrosis radio‐sensitivity in C57BL/6, C3H, and BALB/c mice

et al. 2020

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“…Cancer requires modifications in life plans, which can also impact the quality and comfort of life in a negative way [ 23 , 24 ]. The appearance of a disorder in regards to the urinary system in the form of urinary incontinence is one of the most commonly found side effects of combination therapy due to ovarian or endometrial cancer [ 10 , 11 ]. Therefore, it is also fully justified to assess combination therapy depending on its type, which is in turn determined by the location of the neoplastic lesion for urinary incontinence and the assessment of the quality of life after oncological treatment [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…In most cases, combination therapy decreases the quality of life for oncological cancer patients. Disorders arise within the digestive tract, nervous and hematopoietic systems, and additionally affect the mental state of patients [ 9 , 10 , 11 ]. One of the causes of a decreased comfort of life for these women are ailments that result from disorders in the urinary system, in which stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI) are all included.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Dysfunction in the Urinary System as Well as Comfort in the Life of Women during and after Combination Therapy Due to Ovarian and Endometrial Cancer Based on the SWL, II-Q7 and UDI-6 Scales

Opławski¹,

Smoczyńska

Grabarek

et al. 2021

JCM

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This work aimed to assess the influence of oncological combination therapy that was done on endometrial or ovarian cancer and how the urinary system is influenced as well as the quality of life in comparison to a group of female patients after the removal of the uterus with appendages due to endometrial cancer, which did not require the supplementation of therapy after operative treatment. The study included 87 patients with endometrial cancer, where, after the removal of the uterus, there was no need for conducting adjuvant therapy (C), as well as 92 female patients with endometrial cancer or 38 patients with ovarian cancer in whom combination therapy was conducted (group A, B). The assessment of the quality of life was conducted using the questionnaires: Satisfaction Life Scale (SWLS), Incontinence Impact Questionnaire, Short Form (IIQ-7), and Urogenital Distress Inventory (UDI-6) for three, six, nine, and 12 months after the conclusion of oncological treatment. It was observed that there was a statistically significant decrease in the quality of life in female patients who underwent combination therapy in comparison to a group in whose treatment only included surgery (p < 0.05). The risk of developing urinary incontinence increases alongside an increase in the scope of the operation and in the case of supplementing treatment with brachytherapy in comparison to chemotherapy.

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“…Primary RT therapy without surgery is often used for the treatment of colorectal or gynecological cancers, and can also result in voiding dysfunction. A total of 60% of cervical cancer patients, 45% of endometrial, 35% of vulvar, 100% of vaginal and 5% of ovarian cancer patients are treated primarily with radiotherapy 29 . It is also commonly used in combination treatments along radical pelvic surgery and chemotherapy.…”

Section: Pelvic Radiationmentioning

confidence: 99%

Management of voiding dysfunction associated with pelvic malignancies

Stabholz

Sandhu

2020

Int J of Urology

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Voiding dysfunction is common after surgical and radiation treatments in patients diagnosed with non‐urological pelvic malignancies. Presentation might vary with lower urinary tract symptoms and/or overactive bladder, urinary retention, or incontinence. We reviewed the most recent literature with the aim of describing various types of urinary dysfunction that manifest after radical treatments for non‐urological pelvic malignancies. Radical surgical or radiation treatment adversely affect other adjacent pelvic organ function, including viscera, pelvic musculature and the peripheral nervous system. This results in direct organ and indirect functional damage to the genitourinary tract. Multiple surgical and radiation modifications are available nowadays, allowing urologists to offer various treatments for better functional lower urinary tract outcomes. Diagnosing and understanding the type and severity of voiding dysfunction plays a key role in tailoring an appropriate treatment plan. The objective to better functional results relies on maintaining adequate bladder compliance and capacity while permitting volitional emptying, ideally through voiding. Management should routinely start with conservative measures, including pelvic floor muscle training with or without a combination of oral medication for urgency incontinence and clean intermittent catheterization for the management of urinary retention. Concomitant or isolated urinary incontinence can be further managed through multiple established surgical approaches. We attempted to address various treatment available for known lower urinary tract symptoms that might have been caused secondary to non‐urological pelvic surgery or radiation. We discuss different diagnostic and treatment modalities individualized for patients with various entities, to help achieve optimal urinary function and improve quality of life.

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Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies

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

Cited by 27 publications

References 34 publications

Radiation cystitis modeling: A comparative study of bladder fibrosis radio‐sensitivity in C57BL/6, C3H, and BALB/c mice

Radiation cystitis modeling: A comparative study of bladder fibrosis radio‐sensitivity in C57BL/6, C3H, and BALB/c mice

Assessment of Dysfunction in the Urinary System as Well as Comfort in the Life of Women during and after Combination Therapy Due to Ovarian and Endometrial Cancer Based on the SWL, II-Q7 and UDI-6 Scales

Management of voiding dysfunction associated with pelvic malignancies

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