About late effects

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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.

Late effects of pelvic radiotherapy

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 ended.

We have more information on the short-term side effects you may have during treatment.

Late effects are side effects that either:

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

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. Some women may also have changes to the vagina, and men may have difficulty getting or keeping an erection. You may have changes in the physical and emotional feelings associated with sex.

The impact of late effects varies:

  • They may be minor and not affect 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 have late effects, there are usually lots of things that can help you cope with them. This will help you live life as fully as possible. Some late effects improve over time and may eventually go away on their own.

Talking to your doctor

If the side effects of pelvic radiotherapy don’t go away, always let your cancer doctor or specialist nurse know. If you have any new symptoms or problems after treatment, it is also important to tell them.

The more information you give your doctor, the more likely they are to be able to help you. You may feel embarrassed about 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.

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 (anus). It can be frightening to have symptoms after treatment ends, and you may worry that the cancer has come back.

Your cancer doctor will assess your symptoms and explain whether they could be caused by the radiotherapy. You may need tests to rule out anything more serious, such as the cancer coming back or a new cancer. Sometimes symptoms are caused by other conditions not related to the cancer or its treatment.

Remember that you can arrange to see your cancer doctor or specialist nurse in between appointments, and you can contact your GP at any time.

Getting expert help

Depending on the late effects you have and how 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 some expert doctors who specialise in treating late effects of radiotherapy. But this is a specialised area, so there aren’t many of these doctors. You may have to travel to see one. A few hospitals have special clinics for people with late effects.

Your doctor or nurse can refer you to other specialists if needed.

For more information on the help available, contact the Macmillan Support Line free on 0808 808 00 00.

Back to Coping

Getting support

Find out more about our free support line, Macmillan nurses, information services and support groups near you.

Your emotions

Get help with the emotional issues you and your loved ones might face.

Relationships and sex

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Advanced cancer

Get help with treatment decisions associated with advanced cancer, and find ways to cope with symptoms, side effects, and emotional impacts.