Standardized cranberry capsules for radiation cystitis in prostate cancer patients in New Zealand: a randomized double blinded, placebo controlled pilot study
- 760 Downloads
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.
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).
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).
Men receiving radiation therapy for prostate cancer may benefit from using cranberry capsules, particularly those on low hydration regimens or with baseline urinary symptoms.
KeywordsCranberry capsules Double blinded Placebo capsules Radiation cystitis Randomized
This research was funded by grants from the University of Otago and the Health Otago Charitable Trust and by the Southern Blood and Cancer centre. Cranberry and placebo capsules were provided free of charge by Naturo Pharm LTD.
Conflict of interest
The authors declare no conflict of interest. Although Naturo Pharm LTD provided the capsules, the firm had no input into study design, execution, analysis or publication of this research.
- 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.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.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.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
- 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
- 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
- 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
- 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
- 25.Conover WJ, Iman RL (1981) IRL. Rank transformations as a bridge between parametric and nonparametric statistics. Am Stat 35:124–129Google Scholar
- 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