Pelvic insufficiency fractures (PIFs)
What are pelvic insufficiency fractures (PIFs)?
Pelvic radiotherapy and PIFs
Radiotherapy can sometimes cause changes to the bone in the area being treated. It is most likely to happen when radiotherapy is given to the pelvic area. Changes to the bone may mean the pelvis cannot cope with the normal stresses put on it. This may increase the risk of small cracks or fractures. PIFs are most likely to happen in the first 2 years after pelvic radiotherapy.
Radiotherapy treatment may be used to treat cancer of the:
- womb
- cervix
- prostate
- bladder
- anus
- rectum.
You are more likely to have a PIF after pelvic radiotherapy if you:
- are over the age of 50
- are post-menopausal
- have a higher risk of osteoporosis.
Looking after your bones can help to reduce your risk.
Symptoms of PIFs
PIFs do not always cause obvious symptoms. They may show up on a scan that is done for another reason.
If they do show symptoms, they can range from a mild ache to severe pain. There may be pain in the lower back or pelvis when moving. This can make walking difficult. Pain is not usually a problem when resting or sleeping.
If you have pain in a bone, always tell your GP or cancer doctor. They can arrange tests to find out what is causing it and give you treatment if needed.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our bone health and cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
National Institute for Health and Care Excellence. NICE. Osteoporosis - prevention of fragility fractures. Management, Prescribing information, Background Information. Available from: https://cks.nice.org.uk/topics/osteoporosis-prevention-of-fragility-fractures [accessed April 2024].
National Osteoporosis Guideline Group UK. Clinical guideline for the prevention and treatment of osteoporosis 2021. National Institute for Health and Care Excellence. NICE accredited. Available at: https://www.nogg.org.uk/sites/nogg/download/NOGG-Guideline-2021-f.pdf [accessed April 2024].
Coleman R, et al. European Society for Medical Oncology. Clinical Practice Guidelines – Bone health in cancer: ESMO Clinical Practice Guidelines. Ann Oncol. 2020. Available from: https://www.esmo.org/guidelines/guidelines-by-topic/supportive-and-palliative-care/bone-health-in-cancer-patients [accessed April 2024].
European Society for Medical Oncology. Patient Guide on Bone Health. Cancer can affect bone health in several ways such as by spreading to the bones (bone metastases) or cancer treatment causing bone loss, which makes the bones more fragile and likely to fracture. 2022. Available at: https://www.esmo.org/for-patients/patient-guides/bone-health-in-cancer [accessed April 2024].
Date reviewed
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