Radiation Cystitus and Blood in the Urine
Ok everyone here we go…..This article has been inspired by events that are evolving as I write this. I have had some symptoms lately that have been disturbing to me and my search for answers has been a little enlightening to say the least. I have been waiting for some sort of resolution so I could present my findings here to help others who may come along with a similar path to mine.
The treatments for prostate cancer and every mans journey is slightly different (How true is that statement.) After diagnosis and depending on the treatments one chooses, brings into play a multitude of possible side effects that impact on the quality of life of a patient. What I offer here is an insight into a possible side effect that I believe is not fully appreciated by those undertaking radiation treatment for prostate cancer. When I began to experience these side effects of radiation therapy I was astounded as to the repercussions that were possible in the events I am about to relate. I was also surprised at the amount of relevant information available on this issue when a person actually goes looking for these answers and information. So here for everyone’s interest is a run down on the possibility of contracting radiation bladder cystitis.
I have now been diagnosed with this complication after ongoing recurrent urinary infections and the development over the past six months of episodes of gross hematuria. At the very beginning I thought I was aware of the side effects and complications but I certainly was not fully aware of the complete implications that these may have on a patient. I have since correlated a fair amount of information on this subject and would like to share this here for future reference for any other unfortunate radiation patients faced with the same prognosis.
Radiation Cystitis is a rare complication of the bladder caused by treatment of radiation therapy to the pelvic region. Reports indicate it may occur in approx. 7% to 10% of prostate cancer patient’s undergoing this procedure (Guess who drew the short straw). The side effects of treatment can be immediate and acute or perhaps develop months or years after completion of treatment. In some cases radiation side effects can be resolved fairly easily but in other cases they may be more difficult to treat and this can have lasting effects on a patients quality of life and there is a possibility of mortality from urinary blockages causing kidney problems and a life threatening infection called urosepsis.
Modern radiotherapy techniques have improved the focus of the beams and can be modulated so that less radiation is delivered to the more sensitive areas around the prostate. This reduces the likelihood of long-term tissue damage but problems can still occur. Radiotherapy can damage the soft tissue and blood vessels lining the bowel or bladder and this reduces the blood supply to these areas so that when treatment is completed, these blood vessels and soft tissue do not have enough blood supply to support efficient healing causing necrosis.
In my case I developed recurring pelvic and urinary infections since my TURP procedure in 2012. I completed IMRT radiation treatment in December 2012 and my PSA remains at 0.02 as of today so things appear OK on the prostate cancer side. However for the past six months I have experienced some bleeding along with clots in my urine from time to time which culminated in February this year with a massive bleed. The event was very painful and distressing, as for several hours I continued to bleed and pass clots, some of which blocked my urethra until the pressure became strong enough to pass them through.
Last week after many previous delays I finally had a procedure called a cystoscopy, which diagnosed radiation induced bladder wall bleeding with multiple telangiectasia ( spider vein type blood vessels) noted on bladder wall. The urologist has now referred me to a radiation oncologist. .From my understanding the only real successful treatment available for this condition is treatment in a hyperbaric oxygen chamber
I have now outlined this subject from a first hand point of view and it now only needs me to follow this up after my next consultation with the radiation oncologist and any subsequent treatment. My lovely wife and carer has reminded me of the following and it is worth repeating here as I finish up this article.
After my prostate cancer diagnosis and regarding the decision-making process we had to make. We made our decision at that time based on advice from specialists and our own rushed but thorough learning curve of radiation coupled with ADT. We were aware of the radiation consequences just as we were aware of the surgical and ADT consequences but realistically way back then, we believe there was no other alternative. Today having come this far down the track and experiencing most of the side effects we read about then and now, we are now faced with this issue needing to be dealt with: BUT WE AGREE THAT WE WOULD STILL MAKE THE SAME TREATMENT DECISION TODAY.
I look forward to bringing an update to this forum on my ongoing treatment for this condition as it occurs.
Lee aka Popeye