If an oncologist has advised a course of radiotherapy to the pelvis as part of treatment for gynaecological cancer, this page has been written to give you general information and aims to answer some of the questions often asked by patients and their carers.
We hope you will find this helpful. If you have any further questions relating to your treatment, please ask your radiographer, specialist nurse or oncologist at the Northern Centre for Cancer Care (NCCC).
Possible short term (acute) side effects
Acute side effects are temporary and affect most patients. The side effects generally develop during the second half of the course of treatment, last for several weeks after the treatment has finished and then usually settle within the next few months. If you are having chemotherapy as well the effects may start earlier and be a little worse.
How might radiotherapy affect me?
It can make your skin dry, red and sore. This includes your vagina or anus.
It can cause irritation to your bladder causing cystitis.
It can cause irritation to your bowel and give you diarrhoea or may make you feel sick.
It can make you feel more tired than usual and you may feel a little low.
The only hair you will lose is on the skin areas being treated. It will almost certainly grow back later.
Some people have more side effects than others. Everyone is different.
Is there anything I can do to prevent them?
You can't prevent them but you can help make some of them better. This page tells you how.
How should I look after my skin?
Your skin may gradually get pink and then red. This is particularly so in skin folds such as your groin area and between your buttocks and your vaginal area. The skin may flake or peel as you get near the end of your course of treatment. This may carry on for a while afterwards.
You need to be gentle with your skin, even if you think it doesn't look sore. If you do this right from the start of your treatment you may be able to delay the onset of any side effects or make them less unpleasant should they happen.
Follow these tips….
You may bathe but avoid long or hot showers and baths. Don't soak the treated area.
Wash the skin gently. All you need is warm water and a mild unperfumed soap such as baby soap or Simple soap.
Don't use bubble bath, salts, antiseptic, and shower gel or body lotion on the treated area. They can make the skin dry and sore.
Pat your skin dry - don't rub. Avoid rough flannels and towels. Take care where skin is extra sensitive such as skin folds.
Try not to scratch the skin.
Avoid tight clothes, which could irritate the skin. For example wear cotton knickers and skirts or baggy trousers.
Keep the treated area out of the sun and don't use a sun bed. Sun can damage the skin.
If your skin is sore, don’t use any of your own creams on it. Your doctor may give you a cream to use. Smooth it on gently.
Some marks are needed to enable the radiographers to give you your treatment accurately. Usually tiny permanent skin marks will be applied with your permission. You can have these removed once your treatment is completed if you wish. Please ask the radiographers for more information about permanent skin mark removal. If you have temporary (pen) marks please be careful not to wash them off during your treatment.
What should I do if I get diarrhoea?
Treatment can irritate your bowels and give you frequent loose bowel movements. This can make you feel tired and sick and your body may lose fluids.
Here's what to do….
If you are taking laxatives, stop.
Tell your doctor, nurse or radiographer, as certain medication can be very helpful.
Try a change of diet…Stop eating high fibre foods such as fruit, green vegetables, wholemeal bread and wholegrain cereals. Instead eat foods like white bread, cornflakes and potatoes with no skin.
Drink plenty of fluids to replace the ones your body is losing. Tea, fruit squash, milk and fizzy drinks are all ok.
The feeling of sickness can be helped by eating little and often. Try a fizzy drink - tonic water is good.
If you don't feel better, please tell us. We can give you more tips on eating and drinking. We can also ask a dietician to give you advice.
How could the treatment affect my bladder?
Treatment may irritate your bladder and cause you to pass urine more often. Passing urine may also feel uncomfortable.
Here's what to do….
Tell your nurse, doctor or radiographer if your urine is cloudy or smelly. You may need some medication.
Drinking lots of fluids helps to dilute the urine and flush the bladder. Don't be tempted to drink less.
Avoid acid fruit juices, coffee, alcohol and smoking as these can irritate the bladder.
Tell your nurse if you are leaking urine, for example when you cough or sneeze, as she may be able to offer some help.
Can I have sexual intercourse?
Sex is not harmful to you and it will not cause the cancer to return. You may find you are not interested in the sexual aspect of your relationship whilst you are having treatment. This could be due to soreness or how you are feeling. Please speak to us if you need help in dealing with your feelings at this time. Radiotherapy may cause dryness, loss of elasticity and narrowing of your vagina. You may be able to help to stop this by using a vaginal dilator after treatment has finished. Sexual intercourse can also help to prevent this from happening. Your nurse will discuss this with you and give you more information.
How will this affect my fertility?
If you have not had an operation before your radiotherapy it will be necessary to use contraception. It is very important that women are not and do not become pregnant whilst undergoing radiotherapy. Please inform a member of staff immediately if you think you may be pregnant. You will be asked (if appropriate) to confirm that you are not pregnant by one of the radiographers before starting treatment.
You may have had an operation, which has stopped your ability to have children. In addition radiotherapy to the pelvis will cause menopause (change) in almost all cases, which means you will be unable to have children.
When your treatment has finished you may need to use hormone replacement therapy (HRT). Your nurse or doctor will discuss this with you and any other issues you may have.
What can I do if I feel tired or low?
It is normal to feel this way, especially later on in your treatment. Make time for yourself and get plenty of rest. Do the things you enjoy - and accept offers of help from friends and family!
If you feel low, it may help to talk to someone about it. Please don't be afraid to ask us. There are many people here who can help you.
What else can I do to help myself during treatment?
You can help by doing these things….
Do not smoke. It doubles your risk of getting side effects.
Follow all the tips in this leaflet and any other advice we give you.
Tell us if you are worried about your side effects or if you feel unwell or if you have any problems or questions.
Will the side effects go away when I finish treatment?
You may still have the side effects for a while. They may even get worse for the first two weeks or so after treatment. Carry on with your gentle washing routine until your skin is back to normal. Carry on with using the advice on this page until your symptoms stop.
Possible long-term or permanent effects of treatment
Usually the side effects affecting your bowel and bladder settle down within a few weeks of finishing treatment but they may never be the same as they were before the treatment. If you continue to have problems tell your doctor or nurse when you next speak to them.
What happens when the treatment has finished?
You will be given a discharge letter with a copy for your GP summarising any side effects you may have and any creams or medication you have been prescribed at NCCC. Your doctor will see you about 6-8 weeks after your treatment has finished, to check how you are feeling.
You will be seen approximately every three months for a year or two, then less often. At the appointment the doctor will ask questions about how you are feeling and may need to do an internal examination.
Very occasionally you may need to have blood tests or a scan but this does not happen routinely. Please ask if you have any questions, we are here to help you.
If you have not received an appointment to see your doctor within a month of completing treatment, please contact the appropriate secretary:
How can I get more help and advice?
There are many people here who can help you. When you are home your district nurse or GP can help you.
You can contact the nurse specialist if you have any worries after your treatment has finished.
Gynae-Oncology Nurse Specialist
Northern Centre for Cancer Care
0191 213 8338
Northern Centre for Cancer Care Macmillan Information and Support Centre, 0191 2138611
Opening hours Monday to Friday from 9am to 4.30pm