Hyaluronic Acid Gel For Vaginal Stenonis?

6.2. Hyaluronic Acid Therapy for Vaginal Side Effects after RT In Addittion To Dilator Use

In addition to dilator use, I came across this study and was wondering if anyone has ever heard of using a gel with HA.  I know I have fread about HA causing cancer cells to grow bit I thought that was if you took supplements.  I will certainly inquire with my RO but was curious if anyone had come acrss this annd had any thoughts.  Thanks.  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066324/. 

In preventing and neutralizing vaginal injuries after RT for gynecological and anorectal cancers, hyaluronic acid (HA) represents one of the most inventive ways to improve vaginal health in cancer survivors. Local application of HA favors epithelial regeneration, promotes vaginal trophism, elasticity and adequate lubrication. In addition, it sufficiently lessens sticking of the vaginal walls, consequently reducing the development of adhesions, obliteration of the vagina and VS HA is a polysaccharide and part of the of glycosaminoglycans participating in tissue repairment and the regeneration processes. HA is an essential part of the extracellular matrix, which is involved in the repair processes by maintaining sufficient amounts of hydration which assists in the process of cell migration [37]. Due to its high molecular mass, HA is not absorbed when applied on the skin or mucosa. It acts by modeling an invisible, thin and penetrable, visco-elastic outer surface film. This reticular film restores the moisture in the mucosa maintaining the main components of a youthful and healthful tissue, like smoothness, tonicity and elasticity [38]. To this day, HA is extensively used in the clinical practice of various medical branches due to its high level of safety, no contraindications or reports of interactions with other medications [39]. Different vaginal products with HA have been studied with promising results in non-cancer women after menopause [40,41,42].

Several authors investigated the effect of local HA administration and reported reduced treatment related symptoms and vaginal atrophy in patients treated with RT for gynecological cancers. Cassaro et al. examined 45 women with gynecological cancer treated with EBRT with/without vaginal BT. Local treatment with vaginal ovules containing HA reduced dyspareunia, vaginal atrophy, lack of moisture, VS and adhesions [43]. In a study conducted by Dinicola et al., 45 women with cervical cancer treated surgically, with chemotherapy, BT and EBRT received local treatment with HA. Biopsies two months later showed substantially reduced inflammation, fibrosis, cell atypia, bleeding and mucositis [44]. Markowska et al. investigated 37 patients with endometrial cancer after a vaginal BT with complaints of dyspareunia, inflammatory, necrotic lesions and adhesions in the vagina. The patients were administered HA vaginal suppositories, and 86.5% of enrolled patients reported vaginal health improvement after the treatment [45]. In a recent study done by Carter et al. 43 patients with a history of endometrial cancer at least one month after RT (EBRT or vaginal BT) were administered HA containing gel. HL moisturization daily for the first two weeks, and then three times a week until 12–14 weeks significantly improved sexual function and vulvovaginal health [46]. Delia et al. attempted to assess the ability of HA to reduce the side effects of RT for 180 cervical cancer patients. Women in the control group reported the onset and worsening of all symptoms from moderate to severe (inflammation, dryness, dyspareunia), whereas in the group treated with HA suppositories, nearly 90% of women reported none or mild grade symptoms [47]. A study conducted by Laliscia et al. enrolled 126 patients with endometrial cancer who underwent adjuvant vaginal BT and aimed to analyze the effect of HA ovules in the prevention of acute and late vaginal toxicities. The study’s results suggested that patients with intermediate risk endometrial cancer receiving adjuvant vaginal BT after surgery benefited clinically from local HA treatment [48].