Radiation Cystitis – What dat mean National Center for Biotechnology Information?
So, THEY say I might have Radiation Cystitis…I want to understand:
What it is?
Why do they think so?
When should I get treatment?
How can treatment help me? How can treatment hurt me?
Where do I get unprejudiced, advice on the subject?
Who is the best person to inform me going forward with treatment?
Which treatment, if I’m convinced to treat, should I choose?
When I write THEY, I mean the medical community as a whole. I’ve discovered a new term for the medical community I speak of: Dogmatic Medicine. There exist only certain medicines and certain surgeries that THEY bless. All non-protocol become heresy. All heretics of such are damned. Hope I’m not sounding too dogmatic right off the club. That being said…
Radiation Cystitis describes the side effect of inflammation and subsequent destruction to the urinary bladder after the use of radiation treatment of – in this paper – prostate cancer. When the primary tumor grows in other than the bladder, radiation leads to unintentional radiation exposure to the healthy bladder tissue. Damage from the treatment can either be acute (within six months) or delayed. Mild symptoms include increased frequency, urgency, painful or difficult urination, and microscopic blood in the urine (hematuria). These symptoms can resolve over time. Harsh symptoms such as urinary incontinence, visible (gross) blood in the urine, and progression of damage to the extent of abnormal urinary tract openings or dead bladder tissue. Radiation stops cell division in cancer cells (in a tumor) and normal cells (surrounding the tumor) and also decreases blood supply to the irradiated area.
In general, the incidence of delayed radiation effects is estimated at 5% to 10%, and severe hematuria occurs 5% to 8% of the time. Once the thin layer of cells inside the urethra die and shed, urine might irritate the urinary tract, veins swell and form scar tissue and vascular restrictions. Severe complaints may include frequency, urgency, dysuria, and blood in urine. Chronic effects can occur months to years later and are caused by thickening, hardening or scarring of tissue. Visible blood (Grade 2 cystitis symptoms), include symptoms which consist of any moderate frequency, generalized spider veins, intermittent visible bleeding, intermittent involuntary urination.
Finding out whether the condition should be labeled radiation cystitis involves cystoscopy and renal ultrasound. Myself, I received brachytherapy for prostate cancer in 1999. I currently experience some of the symptoms for Grade 2 cystitis. These symptoms, while transitory in the past, manifest now as daily nuisances. The fact that these symptoms accompany my daily life calls for action. Watching and waiting continues now for multiple weeks. The dogmatic universe… talks to me right now. I just gotta listen. I know I want the goodies (to live a while longer). Welcome to the goodie room.
Workup urinalysis attempts to rule out bacterial infection and cancer. Protocol requires complete blood count and chemistry panel when historic or gross hematuria presents. Further assessment calls for scoping the bladder and renal ultrasound. Specific drugs (anticholinergic ) relieve the symptoms of Grade 2 cystitis, which includes gross bleeding. First-line treatment involves bladder irrigation and possibly heat treatment. Noninvasive oxygen therapy relieves symptoms and stops progression, with development of new blood vessels.
Known as Hyperbaric Oxygen Therapy (HBOT), this therapy shows a 75% response rate. Patients treated within six months of hematuria onset had 96% complete or partial symptomatic resolution whereas those treated after six months had but a 66% response rate.
Possible symptoms or side effects after HBOT include fatigue and lightheadedness. More severe problems include: lung damage, fluid buildup or bursting (rupture) of the middle ear, sinus damage, changes in vision, causing nearsightedness, or myopia, oxygen poisoning, which cause lung failure, fluid in the lungs, or seizures. Side effects are generally mild as long as: therapy doesn’t last more than 2 hours, pressure inside the chamber measures less than 3 times that of the normal pressure in the atmosphere.
Failure of more conservative treatment measures leads to surgical removal of the bladder. Early detection and treatment improve outcomes.
Unprejudiced (read dogmatic) advice on what to do remains sparse as always when it comes to finding answers to medical treatment questions in these United States. Right now, the best person(s) to advise me comprise of my GP (my valued DO) and my new Urologist (my new found trust). The best treatment looks like HBOT but my opinion needs confirmation following the upcoming test results of the next days.
So how did I do?
- What it is? Delayed side effect from radiation treatment
- Why do they think so? Clinical studies and doctor experience
- When should I get treatment? When all the facts are in
- How can treatment help me? How can treatment hurt me? HBOT would help to stop the bleeding. It would hurt if HBOT is negligently applied.
- Where do I get unprejudiced, advice on the subject? Right now I’m twisting in the wind and must trust the medical establishment. You know…the one that treated me with radiation in the first, the other who told me I had a heart attack and the latest two who offer answers such as statins no matter what the question.
- Who is the best person to inform me going forward with treatment? I’m gonna go with answer “A”, my urologist…yeah…whatever he said.
- Which treatment, if I’m convinced to treat, should I choose? Least invasive and most trusted…HBOT…unless there’s more to know (teaser: There is…like bladder tumors).