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December 21, 1994

Formalin Therapy for Radiation Proctitis

Author Affiliations

University of California—San Diego
Thomas Jefferson University Hospital Philadelphia, Pa

JAMA. 1994;272(23):1822. doi:10.1001/jama.1994.03520230032031

To the Editor.  —In the June 15, 1994, JAMA Questions and Answers1 regarding radiation proctitis with prostate cancer, no mention was made of a new application of an old technique: formalin therapy has been used for hemorrhagic cystitis for years. Rubinstein et al2 and Seow-Choen et al3 adapted this for radiation proctitis using 4% formalin. The patient is sedated, a local block is administered, and sponges moistened with 4% formalin are applied for 4 minutes to each bleeding area of the rectum. Care is taken to protect the perianal skin from any caustic effects of the formalin. We used this method for two patients and have had excellent short-term (3-month) results. Long-term follow-up is still needed; however, our two patients have not required additional transfusions after formalin application. We believe this treatment may offer relief to patients in whom conventional measures have failed and who would otherwise

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