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Radiation, Hemorrhagic Cystitis-

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Radiation and Hemorrhagic Cystitis is “Inflammation of the lining of the bladder caused by radiation therapy to the pelvis, including the bladder. Symptoms include pain and a burning feeling while urinating, blood in the urine, feeling a need to urinate often or right away, being unable to control the flow of urine…”

Radiation or hemorrhagic cystitis occurs when either/or chemotherapy or radiation causes inflammation to the bladder. According to the studies linked below, RC/HC can happen to:

  • prostate cancer survivors 
  • to survivors of gynecological cancers. 
  • anyone who undergoes cytoxan (cyclophosphamide)

But here’s the real issue in my experience. Most anyone who is diagnosed with cancer, any cancer, expects short term side effects such as nausea, alopecia, and fatigue. But cystitis from either radiation or chemotherapy is a long-term side effect that increases our risk of bladder cancer. 

I developed cystitis in the years following my conventional therapies for multiple myeloma. I underwent local radiation to my iliac crest for local bone lesions. In addition, I underwent two rounds of high dose cytoxan in preparation for harvesting stem cells.

Did I develop cystitis from the radiation or the cytoxan, or both? I experience bladder urgency about an hour after I urinate. I can sleep for about 3-4 hours before I wake to urinate. In order to fully hydrate I drink coffee, juice, water, etc. and slow and stop all liquids by dinner.

In short, I manage my bladder.

If you have undergone radiation to your pelvic region or you have had cytoxan, consider the therapies to reduce your risk of cystitis and bladder cancer.

  • hyperbaric oxygen
  • curcumin
  • lifestyle therapies

Are you experiencing irritable bladder symptoms? Have you undergone radiation to your pelvis area? Have you had cytoxan?

Scroll down the page, send me a question or comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

radiation cystitis

(RAY-dee-AY-shun sis-TY-tis)
“Inflammation of the lining of the bladder caused by radiation therapy to the pelvis, including the bladder. Symptoms include pain and a burning feeling while urinating, blood in the urine, feeling a need to urinate often or right away, being unable to control the flow of urine, bladder spasms, and pain in the pelvis. Some symptoms of radiation cystitis may go away after radiation therapy has ended, but others may continue over time.”

Cumulative Incidence and Clinical Risk Factors of Radiation Cystitis after Radiotherapy for Prostate Cancer

Objectives: This study aimed to evaluate the cumulative incidence of overall and severe radiation cystitis following external beam radiation therapy for prostate cancer and investigate the clinical factors predictive of radiation cystitis…

Results: The median follow-up period after radiation therapy was 56 months (range 5–81). The 5-year cumulative incidence of radiation cystitis and severe radiation cystitis was 16.2% and 3.0%, respectively. Multivariate analyses identified radiation therapy in the adjuvant/salvage setting was the sole risk factor associated with the development of radiation cystitis (hazard ratio: 2.75, p= 0.02).

Conclusions: Radiation therapy in the post-prostatectomy setting was associated with increased risk of radiation cystitis compared with radiotherapy as the primary treatment…”

Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies

“Pelvic radiation therapy for the treatment of gynecological cancers can lead to long-term collateral damage to the bladder, a condition termed radiation cystitis (RC). Late sequelae may take many years to develop and include incontinence and pain as well as hematuria. RC is a rare but potentially life-threatening condition for which there are few management and treatment options…


Treatment options are available for patients with radiation-induced hemorrhagic cystitis. However, most treatments are risky or only effective for a short timeframe and no therapy is currently available to reverse the disease progress.

Furthermore, no standardized guidelines exist describing preferred management options. Common therapies include

  • hyperbaric oxygen therapy,
  • clot evacuation,
  • fulguration,
  • intravesical instillation of astringent agents,
  • and surgery.

Novel developing strategies include Botulinum Toxin injections and liposomal-tacrolimus instillations. These treatments and strategies are discussed…”

Cyclophosphamide-induced intractable hemorrhagic cystitis treated with hyperbaric oxygenation and intravesical sodium hyaluronate

Cyclophosphamide is a well-known cause of hemorrhagic cystitis. However, the best treatment for hemorrhagic cystitis is still unknown…

Refractory cyclophosphamide-induced hemorrhagic cystitis can be life threatening. Various treatments have been reported; however, there is as yet no gold standard of therapy. A combination of different treatments that work by different mechanisms may increase the success rate. We suggest that combined cystoscopic fulguration (HBO and intravesical sodium hyaluronate) may be a useful treatment option for cyclophosphamide-induced hemorrhagic cystitis…”

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

“Late radiation cystitis is an adverse effect of cancer treatment with radiotherapy in the pelvic region. Symptoms of late radiation cystitis can be assessed with the Expanded Prostate Index Composite Score (EPIC). Previous reports indicate that hyperbaric oxygen therapy reduces symptoms from late radiation cystitis, but the evidence is predominantly based on non-randomised and retrospective studies. We aimed to assess whether hyperbaric oxygen therapy would mitigate symptoms of late radiation cystitis…

17 (41%) of 41 patients in the hyperbaric oxygen therapy group experienced transient grade 1–2 adverse events, related to sight and hearing, during the period of hyperbaric oxygen therapy.


Our results suggest that hyperbaric oxygen therapy relieves symptoms of late radiation cystitis. We conclude that hyperbaric oxygen therapy is a safe and well tolerated treatment…”

Antitumor effects of curcumin in human bladder cancer in vitro

“Bladder cancer is one of the major causes of cancer-associated mortality, with a high incidence. Curcumin, a polyphenol compound extracted from turmeric, has been identified to regulate tumor progression.

However, the therapeutic effect of curcumin in human bladder cancer has not yet been determined. In the present study, the effects of curcumin on cell growth, apoptosis and migration of bladder cancer cell lines were evaluated using an MTT assay, a Transwell assay and flow cytometry, and the associated mechanisms were investigated using western blot analysis.

Curcumin was identified to decrease the growth of T24 and 5637 cells in a dose- and time-dependent manner. The present study confirmed that curcumin is able to inhibit cell migration and promote apoptosis of bladder cancer through suppression of matrix metalloproteinase signaling pathways in vitro. The anticancer effects of curcumin on bladder cancer cells may benefit clinical practice in the future…”





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