Last reviewed: February 2007
For general information about Cancerbackup's Discussion topics please see the introductory page.
This discussion topic explores the management of long-term side effects of pelvic radiotherapy. It aims to discuss and summarise the issues and is written for health professionals. Helpful resources, such as organisations, books and websites are also included. The information may also be of interest to patients, but information written specifically for patients can be found in the pelvic radiotherapy section.
Around 13,000 people in the UK have pelvic radiotherapy for cancer each year (1). Radiotherapy to the pelvic area may cause long-term changes in the structures and organs in the pelvis (2-10). The risk of side effects varies according to the site to which the radiotherapy is given and the type and dose of treatment.
Most people will have some change in the way that their bladder or bowel works and the treatment may also cause changes in the genital area and in the physical and emotional feelings associated with sex. The impact of these side effects varies from person to person.
Many people are embarrassed to talk about these changes and so may not receive the help they need to resume a normal life as far as possible. After radiotherapy, it is very important that patients are explicitly asked about any bowel, bladder or sexual effects. Research has shown that patients value the opportunity to discuss side effects but are often too embarrassed to raise these issues without encouragement (9).
Until recently there has been little research into the side effects of pelvic radiotherapy and ways of managing them. However, the side effects can often be effectively managed. This section outlines the various difficulties that patients may face after pelvic radiotherapy and the strategies for managing them.
References
1. Royal College of Radiologists. December 2006.
2. Pelvic radiotherapy and its gastrointestinal side effects: Hobson's choice? Gastrointestinal nursing 2005; 3; 7: 18-24
3. Radiation Oncology: Management Decisions (2nd edition). Chao et al. Lippincott Williams and Wilkins, 2002.
4. Vaginal stenosis in patients treated with radiotherapy for carcinoma of the cervix. Brand AH, Bull CA & Cakir B (2006), International Journal of Gynaecological Cancer, 16, 288-293.
5. Interventions for the physical aspects of sexual dysfunction in women following pelvic radiotherapy. Denton AS, Maher EJ. Cochrane Database of Systemic Reviews, 2006.
6. How patients manage gastrointestinal symptoms after pelvic radiotherapy Gami B et al.. Alimentary Pharmacology Therapy 2003; 18: 987-994
7. Supportive Care in Radiotherapy. Faithfull & Wells, Churchill Livingstone, 2003.
8. Pelvic radiotherapy increases risk of pelvic bone fractures. JAMA 2005;294:2587–2593, 2635–2637
9. Stead ML (2004). Sexual function after treatment for gynaecological malignancy. Current Opinion in Oncology 16: 492-495
10. Living with bowel problems after radiotherapy: a scoping study commissioned by the national Association for Colitis and Crohn's Disease. Judy Wilson. March 2006.