Bone changes after pelvic radiotherapy

If radiotherapy damages the pelvic bones, it may increase the risk of fine, hair-line cracks (known as pelvic insufficiency fractures), which can be painful|. The pain is normally in the lower back when you’re moving around, and it can make walking difficult. The pain isn’t usually there when you’re resting or sleeping.

Always let your cancer doctor or nurse know if you have pain or aching in the bones. This can be caused by a number of conditions, but it’s very important to get it checked. Damage to the bones is a rare late effect of pelvic radiotherapy, so it’s more likely to be caused by something else.

If you have symptoms that last for more than a few weeks, your doctors will need to do tests, such as a bone scan or MRI scan. A special scan called a DEXA scan can also be done to check the strength of your bones.

Treatment Back to top

Pelvic insufficiency fractures don’t usually need to be treated with an operation, but you’ll be referred to a specialist bone (orthopaedic) doctor for advice. Your doctor will prescribe regular painkillers| to control the pain and you may be given drugs called bisphosphonates| to strengthen the bones. You may also be advised to take calcium and vitamin D supplements for your bone health.

A physiotherapist will show you how to limit stress on the bones and will give you exercises to do. If you’re having problems with day-to-day tasks, an occupational therapist can advise you on equipment to make things easier.

Bone health Back to top

You may want to know more about keeping your bones healthy|. Although radiotherapy damage to the bones is rare, other factors may contribute to bone changes. Men taking hormonal therapy drugs for prostate cancer| are more at risk of bone thinning (osteoporosis). The bones naturally lose some strength with age, so this may be a factor. It’s important to follow your doctor’s advice if you have any bone problems.

What you can do:

• Keep physically active to keep bones strong, but if you have bone problems ask your doctor for advice.
• Keep to a healthy weight to avoid strain on your joints.
• Eat healthily to get plenty of calcium and vitamin D, and avoid too much caffeine.
• Avoid smoking - it’s bad for the bones and it increases the risk of certain cancers and other illnesses.
• Drink alcohol within sensible guidelines, as alcohol can interfere with the balance of calcium in the body. Current guidelines recommend that men should drink no more than 21 units of alcohol a week.