What Researchers Did
Researchers described two cases of metastatic breast cancer patients who developed severe hemorrhagic cystitis after receiving combined oral cyclophosphamide and capecitabine chemotherapy, along with a literature review.
What They Found
They found that two metastatic breast cancer patients developed severe hemorrhagic cystitis after receiving cyclophosphamide and capecitabine therapy, with one patient (67 years old, 60.8g cyclophosphamide) experiencing only temporary relief from HBOT and requiring a ureterostomy, while the other (65 years old, 78.4g cyclophosphamide) had complete cessation of bleeding after HBOT. The authors emphasize that severe hemorrhagic cystitis can occur even at low doses and recommend periodic urine occult blood testing.
What This Means for Canadian Patients
Canadian patients with metastatic breast cancer receiving cyclophosphamide and capecitabine chemotherapy should be aware of the potential for severe hemorrhagic cystitis, a serious side effect. While hyperbaric oxygen therapy (HBOT) may offer relief for some, as seen in one case where bleeding ceased completely, its effectiveness can vary, and other interventions may be necessary.
Canadian Relevance
Hemorrhagic cystitis is a condition for which hyperbaric oxygen therapy is recognized by Health Canada as a potential treatment option.
Study Limitations
As a case report, this study's findings are limited by the small number of patients examined, which prevents generalizable conclusions.