Your consultant has advised a course of radiotherapy to your groin(s) and/or vulva as part of your cancer treatment.

This information has been written to help answer some of the questions you may have about the side effects of radiotherapy.

We hope you will find this helpful but if you have any further questions relating to your treatment, please do not hesitate to ask any of the staff who are looking after you at the Northern Centre for Cancer Treatment (NCCT).

Early side effects are temporary and affect most patients. The side effects generally develop during the course of your treatment. Sometimes side effects can last for several weeks, however usually they settle within three to four months. Side effects can include all or some of the following:

Side effects on the skin

During treatment patients may experience changes in the skin over the area that has been treated. The skin may:

• feel tight and uncomfortable
• become pink or red
• become dry and flaky
• be sore and/or itch

Your skin will be checked by your radiographers during radiotherapy and you will be given advice on skincare. You will also be seen once a week by a member of the team who will examine your skin and advise on any creams if necessary.

Skin care – what can I do to help?

We recommend that you take special care of your skin during radiotherapy and up to six weeks after, as the skin reaction may continue after treatment has finished.

• Keep the area cool. Wear loose, preferably cotton clothing that does not rub the skin and will allow air to circulate.
• Do not expose the treated area to the sun. Do not use a sunbed as this could make the reaction worse.
• You can have a bath or a shower during treatment, but don’t soak in the bath for a long time and avoid very hot water. You may wash your skin in the treated area using a simple, non perfumed soap applied gently with your hands and rinsed well with warm water. Avoid using flannels or sponges. Pat the area dry with a soft towel or let the skin dry naturally.
• Do not use talcum powder, bubble baths, bath salts, shower gels or body lotions on the treated area as they tend to be highly perfumed and can dry or irritate the skin. You may be given a moisturising cream to soothe the skin from the radiographers or nurses, or your oncologist may prescribe a cream if needed.
• If the vulva is included in the treatment area this can become very sore as it is sensitive to radiation. Your doctor or nurse will advise you how to manage this.

Inflammation of the bladder lining

Radiotherapy to the groin may cause irritation to the lining of the bladder, which can make you feel that you want to pass urine frequently. You may also feel a burning sensation when you pass urine. It helps to drink plenty of water and other fluids to make your urine more dilute. Let your doctor or nurse know if you have this problem as they will first need to make sure you do not have a urine infection.

Diarrhoea

Radiotherapy to the groin(s) may irritate the bowel and cause your stools to be loose or may cause diarrhoea. If you develop this problem tell your doctor or nurse as they can give you some medication to help treat this. It is important to drink plenty of water to replace the fluid lost through diarrhoea.

Tiredness and Fatigue

Radiotherapy can sometimes make you feel very tired especially towards the end of your course of treatment and for a number of weeks afterwards. It may be a while before you feel able to do some of your usual activities. You should rest as much as you need to although gentle exercise may help. Fatigue is something nearly everyone with cancer feels. It affects people differently and it is important to tell the health care team if you are feeling more tired than usual. There are some physical causes, such as anaemia that are readily treatable.

Please ask for a booklet on "Fatigue" at the Information Centre in NCCT which will give you tips to help with this.

Your progress

You will be seen by a member of your specialist team once a week during your treatment. This will be an opportunity to discuss any concerns or problems you may have.

Please tell your treatment radiographers if you have any problems between appointments.

As the skin of the vulva is very sensitive to radiation it can become discoloured (reddened or darker) and swollen. This can happen months or even years after radiotherapy. The swelling can be reduced by gentle, upwards massage which you can be taught to do by a nurse specialist or physiotherapist. Unfortunately the discolouration of the skin is permanent.

You may also develop a swelling in either or both legs (called lymphodema). Management of this condition requires a referral to a specialist. Please ask your doctor or nurse for more information.

Your emotions

It is important to make time for yourself. Emotions associated with the reactions to a diagnosis of cancer may come to the surface at various stages during your treatment.

Don’t worry if you feel low, this is normal. If you need to talk to someone please ask, we are here to help.

Sex

Having surgery and/or radiotherapy for cancer of the vulva may have an effect on your sex life. However when you are tired or have worries about your cancer, your sex drive can be affected. This is personal to each individual and may be an aspect of your life about which you have concerns. You may have questions you wish to ask. Please talk to your radiographer, doctor or the nurse specialist if you would like to talk about these issues in private.

There is more information available on this subject in the Information Centre at NCCT.

The side effects of radiotherapy can continue for several weeks after treatment has finished. Continue with your skincare routine until any changes return to normal.

You will be sent a follow up appointment to see your specialist team usually between 6 to 12.weeks after finishing treatment.

If you are worried about side effects after treatment has finished, please contact your nurse specialist for further advice.

Useful contact telephone numbers:

Northern Centre for Cancer Treatment Information Centre
Telephone:  (0191) 256 3596 or (0191) 256 3597
Monday to Friday from 10am to 4pm

Janet Pickering Gynae/Oncology Specialist Nurse
Telephone:  (0191) 256 3295

CancerBACUP
Telephone:  020 7613 2121 / freephone 0808 800 1234
CancerBACUP

Macmillan Cancer Relief
020 7840 7840
Macmillan Cancer Relief