Possible side effects

You may develop side effects over the course of your treatment, but these usually disappear a few weeks or months after your treatment ends. Your doctor, nurse or radiographer will discuss this with you so you know what to expect. They can also answer questions about any side effects you might have during or after treatment. There are often things that can be done to help.

Side effects may include:

  • skin changes
  • bowel changes
  • bladder changes
  • tiredness
  • vaginal discharge

External radiotherapy causes more side effects than internal radiotherapy. But many women have a combination of both treatments. If you only have internal treatment, the most common side effects are bowel and bladder changes.

Radiotherapy to the pelvic area can sometimes cause side effects months or years after treatment. These side effects may include changes to bowel or bladder, changes to the vagina and lymphoedema (swelling) in one, or sometimes, both legs.

Let your health care team know if you notice any of these changes as there are lots of ways to manage them.

Side effects of radiotherapy

You may develop side effects over the course of your treatment. These usually disappear gradually over a few weeks or months after treatment finishes. Your doctor, nurse or radiographer will discuss this with you so you know what to expect. Let them know about any side effects you have during or after treatment. There are often things that can be done to help.

It's not unusual to feel worse before you start to feel better. Some people can find this a very difficult time and they may feel low or even depressed for a while. The clinical oncologist can advise you about what to expect.

External radiotherapy causes more side effects than internal radiotherapy. But many women have a combination of both treatments. If you are only having internal treatment, the most common side effects are to the bowel and bladder.


Skin changes

The skin in the area being treated sometimes gets dry and irritated. Avoid using perfumed soaps or body wash during treatment as they could irritate the skin. You’ll be given advice on looking after your skin. Your doctor can prescribe cream to soothe it if it becomes sore.

You may lose some of your pubic hair. After treatment, it will usually grow back, but may be thinner than it was before.


Bowel changes

Radiotherapy to the pelvis may irritate the bowel and cause diarrhoea and soreness around the back passage. Your doctor will prescribe anti-diarrhoea medicine to help control this.

Make sure you drink plenty of fluids if you have diarrhoea. Eating a low-fibre diet may help reduce diarrhoea. This means avoiding wholemeal bread and pasta, raw fruit, cereals and vegetables during and for a couple of weeks after treatment.

‘Side effects vary from person to person. I had diarrhoea and some nausea. This was managed with medication. Get plenty of rest and drink plenty of water.’ Mary

Mary


Bladder changes

Radiotherapy can also irritate the bladder, which makes you want to pass urine more often and causes a burning feeling when you pass urine. Your doctor can prescribe medicines to reduce these symptoms. Drinking at least two litres (three pints) of fluid a day will also help.


Tiredness

Tiredness (fatigue) is a common side effect and may continue for months after treatment is over. During treatment, you’ll need to rest more than usual, especially if you have to travel a long way for treatment each day. But it’s good to do gentle exercise, such as walking, when you feel able to. Once your treatment is over, gradually increase your activity and try to balance rest periods with exercise such as walking. This will help build up your energy levels.


Vaginal discharge

You may have a slight vaginal discharge after treatment has finished. If it continues, or becomes heavy, let your clinical oncologist or specialist nurse know. 

We have more information about the possible side effects of pelvic radiotherapy.


Possible late effects

Radiotherapy to the pelvic area can sometimes cause long-term side effects (late effects). However, improvements in how radiotherapy is given have reduced the risk of some late effects. If they do happen, there are lots of ways in which they can be managed or treated.

Vaginal changes

Radiotherapy to the pelvic area can cause vaginal dryness and narrow the vagina. This can make having sex or an internal examination uncomfortable. Your specialist nurse will usually talk to you about ways of trying to prevent narrowing (such as using vaginal dilators) and creams to treat dryness. We have more information about vaginal changes after radiotherapy.

Bowel and bladder changes

Some women may develop permanent changes to the bowel or bladder. If this happens, symptoms generally develop from six months to two years after radiotherapy treatment, although in some people it may be years later. If your bowel is affected, you may have to go the toilet more often than usual, or you may have diarrhoea.

Sometimes, the bladder shrinks after radiotherapy and can’t hold as much, so you’ll need to pass urine more often. The blood vessels in the bowel and bladder can become more fragile, and if this happens you may get blood in your urine or bowel movements. Always tell your cancer doctor or specialist nurse if this happens so that the bleeding can be checked out.

Less common effects

Radiotherapy and surgery to remove the pelvic lymph nodes may increase the risk of getting swelling (lymphoedema) in one, or occasionally both, legs. This isn’t common, but you can read more information about ways to reduce the risk of lymphoedema.

We have more information about managing the late effects of pelvic radiotherapy in women.

Back to Radiotherapy explained

Radiotherapy for womb cancer

Radiotherapy uses high-energy x-rays to destroy cancer cells. You may have radiotherapy as a treatment for womb cancer.

Who might I meet?

You will meet many different specialists before, during and after radiotherapy treatment.