After pelvic radiotherapy

After radiotherapy, your radiotherapy team will explain any follow-up you need. This will include telling you who to contact if you have problems or questions. They will also explain your risk of long-term side effects.

They may also give you advice about preventing these long-term side effects such as:

  • exercises to prevent weak pelvic floor muscles
  • how to prevent swelling called lymphoedema.

If you have any ongoing side effects or new symptoms, contact your team. You can do this at any time, even between appointments.

It takes time to recover and adjust after treatment. A healthy lifestyle can improve your well-being and help your body recover. Living a healthier lifestyle includes:

  • not smoking
  • eating healthily
  • keeping to a healthy weight
  • being physically active
  • staying within recommended alcohol guidelines.

You may find complementary therapies help you feel better and reduce stress and anxiety. Or you may want to talk about how you are feeling as you recover. You could talk to a friend or family member. Some people find meeting others in a similar situation helpful. There may be a local support group near you.

Follow-up

Your team will plan your treatment carefully to reduce the risk of side effects. But most people will have a few side effects during, or after, radiotherapy.

After your radiotherapy has finished, your oncologist or radiographer will tell you about your follow-up care. It will depend on the type of cancer and the type of radiotherapy you had. Your follow-up care may involve one of the following:

  • You may not need follow-up appointments. Instead you might get advice about problems to watch for and the details of someone to contact, if needed.
  • You might have regular follow-up appointments at the radiotherapy department, or your original hospital. These may be with the specialist who recommended the radiotherapy. The first appointment is usually 4 to 8 weeks after treatment finishes.
  • A nurse or radiographer may follow-up by telephone. They will check how you are by asking you questions. If they are worried about anything, they will arrange an appointment for you at the clinic.
  • You may have patient led follow-up. This means you do not have set appointments, but can contact the team and arrange one if you are worried. This may not be suitable for everyone. You still have any tests or scans that you need as normal.

Follow-up appointments are a good opportunity to discuss any problems or worries you have. It may help to make a list of questions beforehand so you do not forget anything important. If you feel anxious, it can help to have a friend or family member with you.

If you have any ongoing side effects or new symptoms, contact your specialist nurse, cancer doctor or the person you have been told to contact. You should do this at any time, even between appointments. Do not wait until your next scheduled appointment. You can just ask for an earlier one.


Well-being and recovery

You may have mixed emotions when you come to the end of your radiotherapy treatment. You will probably feel relieved, but you may also feel anxious and uncertain. Some people find they feel low after finishing the treatment. It can take time to get your confidence back, and to accept what you have experienced.

It may also take time to recover from treatment. You may feel tired for a while, and you may have lots of emotions to deal with. It is important to give yourself time to recover and adjust. You can call our support line and talk to one of our cancer support specialists. You can also ask your healthcare team for details of local support groups that may be able to help.


Lifestyle changes

When your treatment has finished, you may want to make some positive changes to your lifestyle. You may have already followed a healthy lifestyle before your treatment. But maybe now, you want to focus more on being as healthy as you can. There are things you can do to help your body recover. These can also help improve your well-being, and lower your risk of getting other illnesses and other cancers.

Giving up smoking

If you smoke, it is important to try to stop. Smoking can delay your recovery, and increases your risk of developing a second cancer.

Giving up smoking can be difficult, but there is lots of support available.

Healthy eating

After pelvic radiotherapy, some people may not be able to cope with as much fruit and fibre in their diet. But it is important to have a well-balanced diet that includes fresh fruit and vegetables. You should try to do this even if your appetite and interest in food has reduced. If changes in your bowel habits affect what you can eat, tell your cancer doctor or specialist nurse. They can refer you to a dietitian for advice.

Maintaining a healthy weight

Being overweight is a risk factor for some cancers and other health conditions. These include heart problems and diabetes.

Physical activity

Physical activity can be an important part of your recovery after treatment. It can:

  • help you feel better in yourself
  • help increase your energy levels
  • reduce the risk of heart disease, strokes and diabetes.

Talk to your cancer doctor or GP before you start exercising. Start slowly, and increase your activity over time.

Stick to sensible drinking guidelines

NHS guidelines suggest that both men and women should:

  • not regularly drink more than 14 units of alcohol in a week
  • spread the alcohol units they drink in a week over 3 or more days
  • try to have several alcohol-free days every week.

A unit of alcohol is:

  • half a pint of ordinary strength beer, lager or cider
  • one small glass (125ml) of wine
  • a single measure (25ml) of spirits.

There is more information about alcohol and drinking guidelines at drinkaware.co.uk

Within the first 3 weeks, I found there was very little that I fancied eating. I have a good friend who is an excellent cook and they got me eating again.

Anne


Complementary therapies

Complementary therapies may help you feel better and reduce any stress and anxiety you might have. Relaxation, counselling and psychological support are available at many hospitals. Some hospitals also offer:

  • visualisation
  • massage
  • reflexology
  • aromatherapy
  • hypnotherapy.

Complementary therapies are sometimes available through cancer support groups or your GP. Many complementary therapists also have private practices.

Not all complementary therapies are suitable for people who have just finished radiotherapy. It is important to check with your healthcare team first if you are thinking of having one.


Look after your pelvic floor muscles

Pelvic floor muscles support the organs in the pelvis. They are important for bladder and bowel control. Radiotherapy to the pelvis can weaken these muscles. They are also naturally weakened as you get older.

You may be advised to do regular pelvic floor exercises after pelvic radiotherapy. It is important to do pelvic floor exercises correctly. So you will usually be referred to a physiotherapist or specialist nurse, who will teach you how to do them.


Reduce the risk of lymphoedema

Lymphoedema is swelling that happens because of a build-up of fluid in the body’s tissues.

Surgery to remove lymph nodes, or radiotherapy to the lymph nodes can cause lymphoedema. If you have both treatments, the risk is higher.

There are things you can do to lower your risk of lymphoedema. These include protecting the skin on your legs and feet, being active and keeping to a healthy weight. Here are some things you can do to help:

  • Keep skin clean and supple by moisturising regularly. Your specialist nurse or cancer doctor can tell you which creams to use.
  • Wear long trousers if you are gardening.
  • If you get any cuts or grazes on your feet or legs, use antiseptic cream and cover them up. If the area becomes red, warm or swollen, see a doctor straight away.
  • Wear well-fitting footwear and do not walk around barefoot.
  • To avoid cuts, use nail clippers instead of scissors to cut your nails.
  • Avoid standing for long periods and put your feet up if you are sitting down.
  • Use a high factor sun cream (30 SPF) and cover up in the sun. This will protect the skin on your legs and feet.

Always tell your cancer doctor or specialist nurse if you have a swelling in your feet or legs. The earlier lymphoedema is diagnosed, the easier it is to manage.

My husband was given exercises and massage as well as a compression bandage to wear at night. These worked really well and the swelling went right down and has stayed down.

Julia


Late effects of pelvic radiotherapy

Late effects are side effects that either:

  • begin during, or shortly after treatment and last longer than 6 months – these are sometimes called long-term effects and might become permanent
  • begin months, or even years after treatment.

Many people who have pelvic radiotherapy never develop late effects. Or if they do, the late affects are mild and do not interfere with their daily lives. Newer ways of giving radiotherapy are designed to reduce the chance of developing late effects as much as possible.

The risk of getting late effects depends on different things. These include the type of cancer you have had, the dose of radiotherapy you have had and other cancer treatments you have had. Your cancer doctor or specialist nurse can tell you more about your risk.

If late effects develop, you can often have effective treatment. Or you can manage the effects to make them easier to deal with. Some late effects improve over time, and may eventually go away on their own. The most common late effects after pelvic radiotherapy are changes to how the bowel and bladder work.

Things to watch for

Always tell your cancer doctor or specialist nurse if any side effects do not go away. You should also contact them if you develop any new symptoms or problems after you finish treatment.

You should tell them if you:

  • have any bleeding that looks like it is in your stools, or have blood in your urine
  • have any bleeding from the vagina
  • have loose stools, diarrhoea or constipation
  • feel you need to go to the toilet although your bowel is empty (tenesmus)
  • have difficulty emptying your bowel
  • need to empty your bowel (poo) at night, need to empty your bowel urgently, or have accidents (incontinence)
  • need to pass urine often or urgently, leak urine (incontinence), or have pain or difficulty passing urine
  • have pain or difficulty having sex, or problems getting back to your usual sex life.

You should also tell them if you notice symptoms in other parts of the body, including:

  • swelling in one or both legs
  • pain in your hips or pelvis when you are walking.

You may feel embarrassed talking about problems related to your bowel, bladder or sex life. But doctors and nurses are used to talking about intimate problems like these. Do not let embarrassment stop you getting help. Your cancer doctor will assess your symptoms to see if radiotherapy is causing them. Sometimes, you may need tests to find the cause of your symptoms.

Getting expert help

To help with late effects, you may be referred to a doctor or nurse who is an expert in that area. This depends on the late effects you have and how they affect you. For example, if you have bowel problems, you may see a gastroenterologist. This is a doctor who specialises in bowel problems.

There are also some expert doctors who specialise in treating late effects of radiotherapy. But this is a specialised area, so there are not many of these doctors. You may have to travel a longer way 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 free Macmillan Support Line.

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


Your feelings

It is common to feel lots of different emotions during and after treatment. It is normal to have a low mood at first. As you recover and get back to your everyday life, any negative feelings usually get easier to deal with. Talking with family and friends often helps. If things do not improve, or you feel anxious or depressed, tell your doctor or nurse. They can arrange more support for you if you need it.

Some people find meeting others in a similar situation helpful. There may be a local support group near you. Our cancer support specialists can tell you about what is available in your area.

Cancer can turn your life upside down. You can experience just about every emotion a human being can feel – a real rollercoaster of ups and downs.

Iain

Back to Pelvic radiotherapy explained

What is pelvic radiotherapy?

The pelvis is the lower part of the tummy between the hips. Radiotherapy to this area is called pelvic radiotherapy.

Side effects during treatment

You may have side effects during and shortly after your treatment. The healthcare team will help you manage these.