Bladder cancer after pelvic irradiation for cervical cancer

Pelvic irradiation for gynecologic malignancy is associated with several late neoplastic and nonneoplastic complications in the irradiated field; however, this association has been infrequently recognized in primary care literature. We present two cases of bladder cancer that developed 16 and 19 years, respectively, after pelvic irradiation for cervical cancer. The frequent occurrence in older women of cystitis, hematuria, and nonspecific bowel and bladder symptoms of a benign origin obscures identification of late neoplastic complications after pelvic irradiation. Based on experimental and epidemiologic evidence, we believe cost-effective screening methods should be investigated to allow earlier detection of neoplasms; and, in the interim, a high index of suspicion for bladder cancer is warranted in this growing population of high-risk patients.