The Consequences of Treatment Programme

Cancer treatment is often invasive and can have both short- and long-term consequences, some of which may arise years after treatment was administered.

The consequences of treatment include physical and psychological effects, such as chronic fatigue, sexual difficulties, mental health problems, pain, urinary and gastrointestinal problems and lymphoedema.

Failure to identify and manage these distressing problems effectively can compromise survival, recovery and quality of life for the patient and their carers.

Two women sit at a table looking at cancer information leaflets

Watch: Learn about the programme

Watch: Learn about the programme

About the consequences of cancer and its treatment

This programme aims to:

  • Improve education and awareness of this under recognised area amongst patients, carers and healthcare professionals.
  • Develop and promote innovative solutions to ensure consequences of treatment are identified and managed appropriately.

We are doing this by:

  • Developing education resources for professionals involved in the care of people affected by cancer. For more information see our resources.
  • Testing and evaluating new service models, working in partnership with professional bodies such as the British Society of Gastroenterology.
  • Supporting education events and training for professionals, including a series of local events to raise awareness of gastrointestinal consequences of treatment across the UK.

For more information on the work of the Consequences of Treatment Programme please download our full summary sheet [PDF].


For health professionals

Consequences of cancer toolkit (for primary care)

We have developed an easy to access and use consequences of cancer toolkit with the RCGP. It provides resources and information for primary care professionals to identify and manage the consequences of cancer treatment, and support patients to live well after a cancer diagnosis. It is designed to be used by any general practice in the UK, and is appropriate for everyone who provides or commissions services for people living with and beyond cancer. You can access it on the RCGP website


Guidance: Managing Persistent Upper Gastrointestinal Symptoms

This guidance document has been developed by the Gastrointestinal and Nutrition team at the Royal Marsden Hospital for all health professionals looking after people who have persistent upper gastrointestinal symptoms after any cancer treatment. Download the guidance.


Managing Lower Gastrointestinal Problems After Cancer Treatment: A Quick Guide for Health Professionals

Around 90,000 people are living with chronic gastrointestinal problems such as chronic diarrhoea, faecal incontinence, urgency, pain and bleeding – particularly following pelvic radiotherapy or surgery. This quick guide to help non-specialists identify and manage people experiencing these symptoms, which may not appear for months or even years after their treatment has completed. Download Managing lower gastrointestinal problems after cancer treatment: A quick guide for health professionals.

A top tips one-pager [PDF] is also available for quick reference.


Guidance: The Practical Management of the Gastrointestinal Symptoms of Pelvic Radiation Disease

Managing the long-term consequences of colorectal and anal cancer

Approximately 60% of people who are diagnosed with colorectal and anal cancer will survive more than five years after their treatment. Treatment for colorectal or anal cancer includes surgery, chemotherapy and radiotherapy, either alone or in combination depending on cancer stage and patient fitness. There is a growing need to improve management of the long-term consequences of these treatments in order to support patient recovery and optimise quality of life. The guide Managing the long term consequences of colorectal and anal cancer provides information for professionals on how to manage people who have been diagnosed with colorectal and anal cancer and to ensure that they are offered appropriate information, support and care so that consequences of their treatment can be minimised where possible.

Aimed at all professionals, the guidance has been endorsed by Beating Bowel Cancer UK, the National Colorectal Cancer Nurses Network, the UK Oncology Nursing Society, The Society and College of Radiographers, Bowel Cancer UK and the Association of Coloproctology of Great Britain and Ireland.


Guidance on Long-Term Consequences of Treatment for Gynaecological Cancer

Treating Erectile Dysfunction

Managing heart health during and after cancer treatment

Some cancer treatments can lead to heart problems, especially in patients with pre-existing cardiovascular (CV) risk factors.

The Managing heart health during and after cancer treatment guide provides basic recommendations on the management of heart health during and after cancer treatment. It is aimed mainly at primary care professionals, but will be useful to anyone involved in the care of people living with and beyond cancer.

The guide has been endorsed by the British Cardio-Oncology Society (BC-OS), the British Heart Foundation (BHF), The Society for Professionals with an interest in Cardiovascular Disease in General Practice (CVGP) and the United Kingdom Oncology Nursing Society (UKONS).

The guidance in this document is supported by The Royal College of Radiologists (RCR) (Faculty of Clinical Oncology) – October 2015.

A top tips one-pager [PDF] is also available for quick reference.


A Competence Framework for Nurses: Caring for Patients Living with and Beyond Cancer

Throwing Light on the Consequences of Cancer and its Treatment report

This provides, for the first time, estimates on the numbers of people in the UK suffering from distressing conditions as a result of their cancer treatment. It includes recommendations for healthcare professionals, service managers, commissioners, policy makers and researchers. Download the report or see our supporting summary document Cured, but at What Cost? [PDF].


For people affected by cancer

Macmillan toilet card

The toilet card is designed to help people suffering from bowel and bladder problems resulting from cancer treatment.

The card and key ring can be separated along the perforation, so they can easily be carried. It should be shown to gain access to a toilet when out in public.


Macmillan toilet card with pelvic radiotherapy symptom checklist

This is designed for people who have had pelvic radiotherapy. It includes trigger questions and a symptom checklist.

If anyone answers ‘yes’ to any of the trigger questions, then they should seek further support from a healthcare professional. They can complete the symptom checklist, so they have something to give the professional, rather than just speaking about it. It also comes with a Macmillan toilet card.


Coping with and after treatment - side effects and symptoms