Possible late effects on the bowel or bladder

Most people have side effects during, and for a few weeks after rectal cancer treatment. Usually these effects gradually lessen and disappear. But some people may have side effects that continue months after treatment and sometimes become permanent. Other people may develop delayed side effects of treatment months or years later. These effects after treatment is over are called long-term effects or late effects of treatment.

Tiredness and difficulty concentrating are common late effects. Other possible effects vary depending on the type of treatment you had.

Surgery and radiotherapy can both cause changes in bowel, bladder or sexual function. Chemotherapy may cause changes in sensation to hands and feet (peripheral neuropathy).

Not everyone has, or gets, these late effects and many get better over time. It’s important that you let your doctor or nurse know if side effects you had during treatment aren't going away, or if you develop new problems after treatment has finished. There are things that may help to manage or treat late effects.

Long-term and late effects

You may come across different terms to describe side effects that happen or are still present after treatment is over.

There are two commonly used terms:

  • long-term effects
  • late effects.

Long-term effects begin during or shortly after treatment and don’t go away in the six months after treatment. They may go away eventually on their own, with symptoms gradually reducing for up to a year or two after treatment ends. Sometimes long-term effects are permanent.

Late effects are a delayed response to treatment. They don't appear during treatment, but can happen months or even years later.

In this information we use the term late effects to include both long-term and late effects.

There are often things that can be done to manage or treat long-term or late effects. Let your cancer doctor or nurse know if side effects you developed during treatment aren't going away, or if you develop new symptoms or problems after treatment is over.

Possible late effects of rectal cancer treatments

The main treatments for rectal cancer are surgery, radiotherapy and chemotherapy.


Surgery for bowel cancer involves removing some of the colon and/or rectum. Some people have surgery to create a new opening in the abdomen – a colostomy or ileostomy (also known as a 'stoma'). This may be temporary or permanent. All of these operations cause changes in how the bowel works.

Surgery can cause changes in the tissues of the abdomen (tummy). The skin may be less stretchy and the abdominal wall less strong. Weakness in the muscle of the abdomen can lead to a hernia developing months or years later. Sometimes scar tissue inside the abdomen – called adhesions – may cause pain or discomfort or, may narrow the bowel.

If you have a stoma, as well as learning new skills to manage this, you'll also need time to adjust to the changes in your body. How long this takes varies from person to person. Specialist nurses, called stoma care nurses, are available to help and support you with this.

After rectal surgery some people may have changes in how their bladder works or sexual difficulties.


Radiotherapy to the rectum and surrounding tissues (pelvic radiotherapy) often causes bowel symptoms that get better within a few weeks of treatment ending. But it can also cause late (delayed) effects months or years after treatment. Possible late effects include changes in bowel function, bladder function, or sexual difficulties.


Some chemotherapy drugs can cause changes in sensation, such as pins and needles or numbness in your hands and feet. These changes may take several months to get better and for some people are permanent.

Cancer treatment can also cause more general changes in how you feel. You may be more tired than usual for many months after treatment or have difficulty concentrating or remembering things. These side effects usually improve gradually over time.

Back to Long-term and late effects

Changes in how your bowel works

Treatment for rectal cancer may lead to changes in how your bowel works. These can usually be managed successfully over time.

Managing bladder problems

There are ways to manage changes in the way your bladder works. It’s important to talk to your doctor if you’re having problems.