Side-effects from radiotherapy to abdomen (tummy) and pelvis
Radiotherapy to the abdomen (tummy) and the pelvis can cause a number of side-effects, but they usually start to improve after treatment ends.
Diarrhoea
Diarrhoea is passing watery bowel motions (poos) more than 3 times a day. It is a fairly common side-effect of radiation to this area. You may also have bleeding or a mucous discharge from your back passage.
If you have diarrhoea with radiotherapy, we have tips to help you cope
Constipation
Constipation means not having a bowel motion often enough. This is common with radiotherapy to the tummy and pelvic area. You may also have stomach cramps and wind.
If you have constipation with radiotherapy, we have tips to help you cope
Tell your radiation therapist or nurse if you have any bowel changes. They can give you advice on how to manage them and prescribe medicine to help. These symptoms usually start to settle down a short time after your treatment has ended.
Bladder problems
Sometimes radiotherapy to your pelvis can cause difficulty with
passing urine. This can happen with both internal and external
radiotherapy.
Your bladder may become inflamed (cystitis) after treatment sessions. This may cause pain, discomfort or a burning sensation while passing urine.
You may also feel the urge to pass urine frequently, both during the day and at night. Sometimes you may find that you can only pass very small amounts of urine or none at all. Occasionally, blood may appear in your urine.
If you notice any of these changes, tell your doctor, radiation
therapist or nurse straight away, especially if you cannot pass urine.
- Drink as much fluid as possible to help relieve symptoms.
- Drink cranberry juice or lemon barley water. Cranberry juice may not be advised if you are on certain medication, such as a blood thinner, so check this with your doctor first.
- Avoid alcohol, tea, coffee, carbonated drinks and acidic fruit juices such as orange juice, as they may irritate your bladder.
Irritation to the ‘back passage’
Radiotherapy can cause irritation or itchiness to your rectum or ‘back passage’ (proctitis). This is a common side-effect if the area being treated is in your lower pelvis, such as for prostate or bladder cancer. If you have haemorrhoids (piles), radiotherapy may irritate them.
Loss of appetite and weight loss
Radiotherapy to your abdomen and pelvis can cause nausea and loss of appetite. This in turn may lead to weight loss.
Some people feel sick at the start of a course of treatment but find that nausea disappears within a day or 2. Tell your radiation therapist or your doctor if you suffer from nausea – they can give you medication to control it.
If eating becomes a problem for you, your dietitian or doctor can advise you. We also have tips to help.
Sexual problems after pelvic radiotherapy
Radiotherapy to your pelvic area can cause sexual problems.
Problems can be physical, but treatment can also affect your desire for sex. If you have an implant in your womb or cervix you won’t be able to have sex while the implant is in place.
It’s usually safe to have sex during and after radiotherapy
treatment, unless your doctor tells you not to. It’s important to use contraception during and after radiotherapy.
Possible sexual side-effects of pelvic radiotherapy
Radiotherapy to the pelvic area can cause erection problems by affecting the nerves or blood vessels in that area. You may find it hard to get or keep an erection strong enough for sex.
The problems might be short term or permanent. Erection problems usually happen in the first year after treatment.
Talk to your doctor if you’re worried about this or are having erection problems. There are treatments that may be able to help.
You may find that your orgasm has less semen or you have a 'dry' orgasm, where no semen is ejaculated.
You may have symptoms such as vaginal itching, burning or dryness. This can make sex uncomfortable. There are treatments like lubricants and hormonal creams to help with these problems, so tell
your specialist nurse, consultant or radiation therapist if you’re having these side-effects.
You may experience light bleeding during sex. This is because radiotherapy can make the lining of the vagina more fragile. It’s best to get any bleeding checked out, so let your medical team know if you have this side-effect.
Your vagina may become shorter or narrower if scar tissue forms after pelvic radiotherapy. Also, the walls of the vagina can become less stretchy and drier than before treatment. These changes may
make it uncomfortable to have sex.
Vaginal dilation may prevent the vagina becoming shorter or narrower by preventing scar tissue developing in the vagina. Dilation means ‘stretching and opening’.
Dilators are plastic tubes of different sizes that you use with a lubricant. You can also use a vibrator. Regular gentle sex can help too.
Your specialist nurse will talk to you about dilation and how to use a dilator or vibrator, if it might be helpful to you. You may feel embarrassed or uncomfortable about using a dilator. Your specialist
nurse or medical team will understand your concerns and will always respect your feelings.
If radiation causes your periods to stop, you may get menopausal symptoms like hot flushes, dry skin, dryness of your vagina, reduced sexual desire, night sweats and mood swings. These can affect you physically and mentally when it comes to having sex.
Most menopausal symptoms can be prevented or reversed by replacing the hormones that your ovaries previously made. This is called hormone replacement therapy (HRT). HRT can be given in
different ways. For example, in tablet form, through an implant device put under your skin or by a slow-release patch worn on your arm or leg. Talk to your doctor about HRT. It may not be suitable for you if your cancer type is sensitive to the oestrogen in HRT.
Fertility problems
Radiotherapy to the pelvis area can affect fertility. Infertility is quite common after radiotherapy to the pelvis.
Female fertility
Radiation to the pelvis can affect the ovaries. Some or all of the eggs stored in the ovaries may be destroyed and you may stop producing female sex hormones, which can lead to early
menopause. With lower doses of radiation, the ovaries may heal. But changes to fertility are more often permanent.
It is sometimes possible to do a small operation to move the ovaries away from the treatment area. This is called ovarian
transposition. Or you may be able to freeze eggs before treatment starts.
Male fertility
Sperm can be damaged or their number reduced if your testicles are in the area being treated by radiation. For example, treatment for prostate or bladder cancer. This can lead to temporary or permanent infertility. Talk to your doctor and your partner if avoiding infertility is important for you. It’s sometimes possible to store sperm before you have radiotherapy. The sperm can then be used at a later date.
Talk to your consultant before treatment starts if you were hoping to start a family or have more children after treatment, to see if there are any options open to you.
Contraception
It’s important to use contraception during radiotherapy treatment and for a time afterwards. Even if your treatment is likely to cause infertility, you may still be fertile for a while. Radiation can harm a developing baby, so it’s very important to avoid you or your partner becoming pregnant. Talk with your doctor about contraception.
Talk to a Cancer Nurse
Support Line
Our Daffodil Centres
