Supportive Care in Cancer

, Volume 23, Issue 1, pp 95–102 | Cite as

Standardized cranberry capsules for radiation cystitis in prostate cancer patients in New Zealand: a randomized double blinded, placebo controlled pilot study

  • Katelin Hamilton
  • Noelle C. Bennett
  • Gordon Purdie
  • Patries M. Herst
Original Article

Abstract

Purpose

Acute radiation cystitis, inflammation of the bladder, is a common side effect in men receiving external beam radiation for prostate cancer. Although several treatments provide symptomatic relief, there is no effective treatment to prevent or treat radiation cystitis. Cranberry products have been associated with urinary tract health. This study aimed to determine the effect of highly standardized cranberry capsules (containing 72 mg proanthocyanidins [PACS]) compared with that of placebo capsules on the incidence and severity of radiation cystitis.

Methods

Forty-one men with prostate cancer participated in a double blinded randomized placebo controlled study. Men took one capsule a day at breakfast during treatment and for 2 weeks after treatment completion. Severity of urinary symptoms and the bother these caused were measured using the individual items of the urinary domain of the Modified Expanded Prostate Index Composite (EPIC).

Results

The incidence of cystitis was lower in men taking cranberry capsules (65 %) compared with those that took placebo capsules (90 %) (p = 0.058); severe cystitis was seen in 30 % of men in the cranberry arm and 45 % in the placebo arm (p = 0.30). Overall, the incidence of pain/burning was significantly lower in the cranberry cohort (p = 0.045). Men on the low hydration regimen who took cranberry had less pain/burning (p = 0.038), stronger urine steam (p = 0.030) and used significantly fewer pads/liners (p = 0.042), which was significantly different from those on the high hydration regimen (p = 0.028).

Conclusion

Men receiving radiation therapy for prostate cancer may benefit from using cranberry capsules, particularly those on low hydration regimens or with baseline urinary symptoms.

Keywords

Cranberry capsules Double blinded Placebo capsules Radiation cystitis Randomized 

Supplementary material

520_2014_2335_MOESM1_ESM.docx (17 kb)
Table S1(DOCX 16 kb)
520_2014_2335_MOESM2_ESM.docx (16 kb)
Table S2(DOCX 15 kb)
520_2014_2335_MOESM3_ESM.docx (17 kb)
Table S3(DOCX 16 kb)
520_2014_2335_MOESM4_ESM.docx (17 kb)
Table S4(DOCX 16 kb)

References

  1. 1.
    New Zealand Cancer Registry (NZCR), Ministry of Health – Manatū Hauora, 2013. http://www.health.govt.nz/publication/cancer-selected-sites-2010-2011-2012
  2. 2.
    McCammon R, Rusthoven KE, Kavanagh B, Newell S, Newman F, Raben D (2009) Toxicity assessment of pelvic intensity-modulated radiotherapy with hypofractionated simultaneous integrated boost to prostate for intermediate- and high-risk prostate cancer. Int J Radiat Oncol Biol Phys 75:413–420PubMedCrossRefGoogle Scholar
  3. 3.
    Pervez N, Small C, MacKenzie M, Yee D, Parliament M, Ghosh S, Mihai A, Amanie J, Murtha A, Field C, Murray D, Fallone G, Pearcey R (2010) Acute toxicity in high-risk prostate cancer patients treated with androgen suppression and hypofractionated intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 76:57–64PubMedCrossRefGoogle Scholar
  4. 4.
    Cowan CC, Hutchison C, Cole T, Barry SJE, Paul J, Reed NS, Russell JM (2012) A randomised double-blind placebo-controlled trial to determine the effect of cranberry juice on decreasing the incidence of urinary symptoms and urinary tract infections in patients undergoing radiotherapy for cancer of the bladder or cervix. Clin Oncol 24:e31–e38Google Scholar
  5. 5.
    Antonakopoulos GN, Hicks RM, Berry RJ (1984) The subcellular basis of damage to the human urinary bladder induced by irradiation. J Pathol 143:103–116PubMedCrossRefGoogle Scholar
  6. 6.
    Engles CD, Hauser PJ, Abdullah SN, Culkin DJ, Hurst RE (2012) Intravesical chondroitin sulfate inhibits recruitment of inflammatory cells in an acute acid damage “leaky bladder” model of cystitis. Urology 79(2):483.e13-7PubMedCrossRefGoogle Scholar
  7. 7.
    Giberti C, Gallo F, Cortese PS, Shenone M (2013) Combined intravesical sodium hyaluronate/chondroitin sulfate therapy for interstitial cystitis/bladder pain syndrome: a prospective study. Ther Adv Urol 5:175–179PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Porru D, Leva F, Parmigiani A, Barletta D, Choussos D, Gardella B, Daccò MD, Nappi RE, Allegri M, Tinelli C, Bianchi CM, Spinillo A, Rovereto B (2012) Impact of intravesical hyaluronic acid and chondroitin sulfate on bladder pain syndrome/interstitial cystitis. Int Urogynecol J 23:1193–1199PubMedCrossRefGoogle Scholar
  9. 9.
    Hisano M, Bruschini H, Nicodemo A, Srougi M (2012) Cranberries and lower urinary tract infection prevention. Clinics 67:661–667PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Jepson RG, Williams G, Craig JC (2012) Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. doi:10.1002/14651858.CD001321.pub5 PubMedGoogle Scholar
  11. 11.
    Brown PN, Turi CE, Shipley PR, Murch SJ (2012) Comparisons of large (Vaccinium macrocarpon Ait.) and small (Vaccinium oxycoccos L., Vaccinium vitis-idaea L.) cranberry in British Columbia by phytochemical determination, antioxidant potential, and metabolomic profiling with chemometric analysis. Planta Med 78:630–640PubMedCrossRefGoogle Scholar
  12. 12.
    Cesonienė L, Daubaras R, Jasutienė I, Venclovienė J, Miliauskiene I (2011) Evaluation of the biochemical components and chromatic properties of the juice of Vaccinium macrocarpon Aiton and Vaccinium oxycoccos L. Plant Foods Hum Nutr 66:238–244PubMedCrossRefGoogle Scholar
  13. 13.
    Côté J, Caillet S, Doyon G, Sylvain JF, Lacroix M (2010) Bioactive compounds in cranberries and their biological properties. Crit Rev Food Sci Nutr 50:666–679PubMedCrossRefGoogle Scholar
  14. 14.
    Kylli P, Nohynek L, Puupponen-Pimiä R, Westerlund-Wikström B, Leppänen T, Welling J, Moilanen E, Heinonen M (2011) Lingonberry (Vaccinium vitis-idaea) and European cranberry (Vaccinium microcarpon) proanthocyanidins: isolation, identification, and bioactivities. J Agric Food Chem 59:373–3384CrossRefGoogle Scholar
  15. 15.
    Caillet S (2012) Free Radical-scavenging properties and antioxidant activity of fractions from cranberry products. Food Nutr Sci 03:337–347CrossRefGoogle Scholar
  16. 16.
    Rajbhandari R, Peng N, Moore R, Arabshahi A, Wyss JM, Barnes SP, Prasain JK (2011) Determination of cranberry phenolic metabolites in rats by liquid chromatography-tandem mass spectrometry. J Agric Food Chem 59:6682–6688PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Milbury PE, Cao G, Prior RL, Blumberg J (2002) Bioavailablility of elderberry anthocyanins. Mech Ageing Dev 123:997–1006PubMedCrossRefGoogle Scholar
  18. 18.
    Milbury PE, Vita JA, Blumberg JB (2010) Anthocyanins are bioavailable in humans following an acute dose of cranberry juice. J Nutr 140:1099–10104PubMedCrossRefGoogle Scholar
  19. 19.
    Ohnishi R, Ito H, Kasajima N, Kaneda R, Karyama R, Kumon H, Hatano T, Yoshida T (2006) Urinary excretion of anthocyanins in humans after cranberry juice ingestion. Biosci Biotechnol Biochem 70:1681–1687Google Scholar
  20. 20.
    Karlsen A, Retterstøl L, Laake P, Paur I, Bøhn SK, Sandvik L, Blomhoff R (2007) Anthocyanins inhibit nuclear factor-kappaB activation in monocytes and reduce plasma concentrations of pro-inflammatory mediators in healthy adults. J Nutr 137:1951–1954PubMedGoogle Scholar
  21. 21.
    Campbell G, Pickles T, D’yachkova Y (2003) A randomised trial of cranberry versus apple juice in the management of urinary symptoms during external beam radiation therapy for prostate cancer. Clin Oncol 15:322–328CrossRefGoogle Scholar
  22. 22.
    Bonetta A, Di Pierro F (2012) Enteric-coated, highly standardized cranberry extract reduces risk of UTIs and urinary symptoms during radiotherapy for prostate carcinoma. Cancer Manag Res 4:281–286PubMedCentralPubMedGoogle Scholar
  23. 23.
    Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG (2000) Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology 56:899–905PubMedCrossRefGoogle Scholar
  24. 24.
    Hedgepeth RC, Labo J, Zhang L, Wood DP (2009) Expanded Prostate Cancer Index Composite versus Incontinence Symptom Index and Sexual Health Inventory for Men to measure functional outcomes after prostatectomy. J Urol 182:221–227, discussion 227–8PubMedCrossRefGoogle Scholar
  25. 25.
    Conover WJ, Iman RL (1981) IRL. Rank transformations as a bridge between parametric and nonparametric statistics. Am Stat 35:124–129Google Scholar
  26. 26.
    Erickson DR, Herb N, Ordille S, Harmon N, Bhavanandan VP (2000) A new direct test of bladder permeability. J Urol 164:419–422PubMedCrossRefGoogle Scholar
  27. 27.
    Howell AB, Botto H, Combescure C, Blanc-Potard AB, Gausa L, Matsumoto T, Tenke P, Sotto A, Lavigne JP (2010) Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infect Dis 10:94. doi:10.1186/1471-2334-10-94, 2010;10:1–11PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Katelin Hamilton
    • 1
  • Noelle C. Bennett
    • 1
  • Gordon Purdie
    • 2
  • Patries M. Herst
    • 3
  1. 1.Radiation Oncology Department, Southern Blood and Cancer CentreDunedin HospitalDunedinNew Zealand
  2. 2.Department of Public HealthUniversity of Otago WellingtonWellingtonNew Zealand
  3. 3.Department of Radiation TherapyUniversity of Otago, WellingtonWellingtonNew Zealand

Personalised recommendations