Hemorrhagic Cystitis aka Irritable, Urgent, Frequent, Painful Bladder-

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 “Grade I Hemorrhagic Cystitis can cause disabling symptoms, e.g. frequency, urgency and pelvic pain, often localised to the bladder or urethra…”

I underwent two rounds of cytoxan/cyclophosphamide chemotherapy in preparation for my haematopoietic stem cell transplant (HSCT) for my newly diagnosed multiple myeloma. Cytoxan has become a frequently prescribed induction chemotherapy for newly diagnosed myeloma patients.

Side effects come with toxic chemotherapy. Fine. I get it. My problem is with my oncologist not telling me about  the fact that my two cycles of cytoxan would result in some degree of Hemorrhagic Cystitis aka dysuria, painful urination, etc. Not to mention the fact that cytoxan/cyclophosphamide increases my risk of bladder cancer someday…

Insult to injury in my case was the fact that cytoxan therapy didn’t work. Cytoxan therapy in the fall of 1995 left me with what I imagine is HC grade I or II as I have had no bleeding that I know of and I have not been diagnosed with bladder cancer. Yet.

The point of this post is to alert readers of this painful and perhaps deadly side effect of cytoxan chemotherapy. The study below cites everything from cranberry juice to intravesical hyaluronic acid to hyperbaric oxygen as being preventative therapies for HC. For the record I underwent HBOT years after my cytoxan therapy. It didn’t help.

I am both a cancer survivor and cancer coach. If you have been diagnosed with cancer and you would like to learn more about side effect identification and prevention please scroll down the page, post a question or comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Hemorrhagic cystitis

Hemorrhagic cystitis or Haemorrhagic cystitis is defined by lower urinary tract symptoms that include dysuria, hematuria, and hemorrhage. The disease can occur as a complication of cyclophosphamide, ifosfamide and radiation therapy…”

Chemical- and radiation-induced haemorrhagic cystitis: current treatments and challenges

“The most frequently reported causal factors are radiotherapy to the pelvic area, where HC has been reported in up to 20% of patients, and treatment with cyclophosphamide and bacillus Calmette-Guérin, where the incidence has been reported as up to 30%…

The best evidence exists for intravesical hyaluronic acid as an effective preventative and active treatment, and for hyperbaric oxygen as an equally effective treatment option…

In transplantation settings, HC is typically associated with haematopoietic stem cell transplant (HSCT),..

With a tendency towards more aggressive treatment of cancer, including the use of HSCT, chemical- and RT-induced HC can be considered an increasingly important clinical issue, not least because it is a challenging condition to treat…

Incidence and Reported Predisposing Risk Factors

Image result for image of hemorrhagic cystitis cyclophosphamide

HC has multiple potential causes, including chemical toxins and radiation. As well as variability in the propensity of the causative factor to induce HC, differences in definition criteria are in part responsible for the wide range of reported incidences [7], with some degree of HC affecting up to 100% of patients in some studies

Although most studies focus on severe (grades III–IV) HC, grade I HC can cause disabling symptoms, e.g. frequency, urgency and pelvic pain, often localised to the bladder or urethra...


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