About late effects

Occasionally, some side effects of pelvic radiotherapy don’t completely go away, or side effects develop months or years later as a result of the radiotherapy. These are called long-term or late effects.

These affects may be mild and not affect you much from day to day. Or they may be more troublesome and interfere with your daily life. They may also have an effect on your feelings or work. Some of these effects may eventually go away or improve on their own. Others can be managed or treated successfully.

Depending on the late effects you have and how much they affect you, you may be referred to a doctor or nurse with expertise in that area for example a bladder or bowel specialist. There are also doctors who specialise in treating late effects of radiotherapy but you may need to travel to see one as there aren’t many of these.

Always let your cancer doctor or specialist nurse know if the side effects of radiotherapy don’t go away, or if you develop new symptoms or problems after treatment is over.

Long term and late effects

Most people have side effects during radiotherapy and for a few weeks afterwards. Usually these gradually improve over a few weeks or months after treatment has finished

Late effects are:

  • side effects that begin during or shortly after treatment and don’t go away within six months (sometimes called long-term effects) – occasionally these effects become permanent
  • side effects that don’t affect you during treatment but begin months or even years later, as a delayed response to treatment.

Some late effects improve over time and may eventually go away on their own.

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

The most common late effects after pelvic radiotherapy are changes to the way the bladder and bowel work. Other late effects include:

  • lymphoedema
  • bone changes
  • effects on your sex life
  • effects on fertility
  • slight increased risk of second cancer.

Women may also experience early menopause and changes to the vagina.

The impact of late effects varies:

  • They may be minor, not affecting your day-to-day life much.
  • They can be more troublesome or difficult to live with, and can restrict or interfere with your day-to-day life.

If you do have late effects, there are usually lots of things that can help you cope with them, so that you can live life as fully as possible.

Late effects of pelvic radiotherapy

Hear about some possible late effects of pelvic radiotherapy and advice on how to deal with them in the long term.

About our cancer information videos

Late effects of pelvic radiotherapy

Hear about some possible late effects of pelvic radiotherapy and advice on how to deal with them in the long term.

About our cancer information videos


Talk to your doctor

Always let your cancer doctor or specialist nurse know if the side effects of radiotherapy don’t go away, or if you develop new symptoms or problems after treatment is over. The more information you can give your doctor, the more likely it is they will be able to help you. You may feel embarrassed at the thought of talking about problems with your bowel, bladder or sex life. But doctors and nurses are very used to discussing intimate problems like this, so don’t be put off.

It can be frightening to get symptoms after treatment and you may worry that the cancer has come back. Some of the symptoms of late effects are similar to symptoms you may have had when you were diagnosed with cancer (for example, blood in the urine or bleeding from the back passage).

Your cancer specialist will assess your symptoms and explain if they’re likely to be a result of the radiotherapy. You may need to have tests to find out the cause and to rule out anything more serious, such as the cancer coming back or a new cancer.

Your symptoms may be due to another condition not related to the cancer or its treatment. Remember you can always arrange to see your cancer specialist or specialist nurse in between appointments and contact your GP at any time.


Getting expert help

Depending on the late effects you have and how much they affect you, you may be referred to a doctor or nurse with expertise in that area. For example, if you’re having bowel problems you may be referred to a doctor who specialises in bowel problems, called a gastroenterologist. There are also doctors who specialise in treating late effects of radiotherapy. This is a specialist area, so there aren’t many of these doctors – you may need to travel to see one. A few hospitals have special clinics for people with late effects.

Your doctor or nurse can also refer you to a specialist nurse or physiotherapist for continence advice, or to a relationship or sex therapist if needed. The Bladder and Bowel Foundation can also put you in touch with a specialist nurse or a physiotherapist


Work

For most people, returning to work is a big step in their recovery. Many companies have an occupational health service for their employees, which can offer support in various ways to people returning to work. Occupational health departments may also offer counselling, before and after your return to work, which is completely confidential.

Late effects such as tiredness, or bowel and bladder changes, may make work more difficult for you. There are laws protecting the rights of workers who are affected by illnesses such as cancer. Your employer has a duty to make ‘reasonable adjustments’ to your workplace and working practices to ensure that you aren’t at a disadvantage compared with others.

You can read more about these and other information on returning to work in our work and cancer section.


Your feelings

It’s not unusual to find it difficult to cope with some of your feelings months or even years after treatment, especially if you have late effects. These can often become easier to cope with in time and with the right support.

Feeling alone

Some late effects can be embarrassing or difficult to talk about and this can make you feel isolated. You may also feel as if you don’t have much contact with the hospital or know anyone else having the same problems. Our section on getting help and support has information that may help you.

Uncertainty

You may worry that some of your symptoms are a sign of the cancer coming back. After cancer treatment, it’s also common to feel anxious about aches and pains that you wouldn’t have worried about before. Understanding more about how late effects can be managed and where to get support can help.

Anger

It’s natural to feel angry when you’ve had cancer, especially if you’re coping with the effects of treatment. Don’t feel bad about this. Talking to people you trust when you’re feeling angry rather than bottling up strong feelings can be a relief. If you don’t feel able to talk to people close to you ask your doctor about seeing a counsellor.

Depression

Coping with the late effects can be physically and emotionally demanding. Sometimes this can make you feel sad or depressed. Some signs of depression are: feeling low in mood; having no interest or enjoyment from the things you’d normally enjoy; and feeling helpless or hopeless. If you think you may be depressed, talk to your doctor. They can refer you to a counsellor or psychologist and prescribe a course of antidepressant drugs for you.

We have more information about how to get help and support with feelings in our section on your emotions.

Back to Late effects of pelvic radiotherapy

Bladder changes

Pelvic radiotherapy can damage the bladder and the muscles around it. This can change how the bladder functions. Talk to your doctor about any symptoms you may have.

Bowel changes

Late bowel effects of pelvic radiotherapy are usually managed or treated successfully. Talk to your doctor if you notice any symptoms.

Late effects and sex life

Pelvic radiotherapy can have some late effects on your sex life. Your doctor or nurse can give you advice on how to manage these.