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What is Hemorrhagic Cystitis (HC)? Hemorrhagic cystitis is related and is often used synonymously with RC. Hemorrhagic cystitis refers to the same urinary symptoms (gross hematuria in the bladder) as RC which may result from either anticancer radiation therapy and/or certain types of anticancer chemotherapy - so all radiation cystitis cases are hemorrhagic cystitis, but not all hemorrhagic cystitis cases are radiation cystitis. Sometimes radiation cystitis is referred to as "radiation-induced hemorrhagic cystitis" or  "radiation-related hemorrhagic cystitis".


Image: Appearance of radiation cystitis via cystosopy.


About Radiation Cystitis

Radiation Cystitis Causes: Radiation therapy is an important management tool for the treatment of pelvic malignancies. For reasons not entirely understood, some patients that receive radiation therapy are at risk of developing RC. The risk and severity of RC depends on a variety of factors including total dose of radiation and area of the bladder affected.


The bladder exhibits slow cell-turnover, and is therefore considered a late-responding tissue following chemotherapy and radiation damage. This means that progressive and irreversible damage can appear after a latency period of months to years. The standard of care for hemorrhagic cystitis range from no treatment, bladder irrigation under hospitalization and surgery in serious cases. We are not aware of any FDA-approved therapies at this time.


Radiation Cystitis Symptoms: RC is a debilitating and chronic urological disorder with common symptoms including hematuria, bladder pain, and urinary frequency.  Additionally, dangerous blood clots can form and obstruct the outflow of urine.  Acute symptoms of RC may be so severe as to disrupt the radiation treatment regimen of the patient.  Alternatively, RC may become a chronic condition with symptoms flaring up months or even years after radiation therapy has been completed.


The chronic phase of RC  tends to involve the full thickness of the bladder wall with vascular endothelial cell damage, ischemia, and collagen deposition.  Hematuria and bladder wall hemorrhage are the two key cardinal symptoms for RC.

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