It is rare to develop severe, long-term side effects as a result of having radiotherapy. Your doctor will discuss the likelihood that you will experience side effects before you consent to treatment.
Sometimes, side effects can occur years after finishing a course of radiotherapy. Some of these may be permanent and can include:
- effects on fertility
- cosmetic changes to the skin
- tiny cracks in your pelvic bones (pelvic insufficiency fractures)
- an inability to control your bowel (bowel incontinence)
- swelling in your arms or legs (lymphoedema)
These are discussed in more detail below.
Infertility and early menopause
In women, radiotherapy to the pelvic area exposes the ovaries to radiation. In pre-menopausal women, this may cause early menopause (where a woman's monthly periods stop) and infertility (the inability to get pregnant). This is often very upsetting, particularly for younger women who want to have a family.
Before having treatment, your doctor will discuss all the options and available support with you. For example, it may be possible for some of your eggs to be surgically removed, frozen and stored until you are ready to have a baby.
However, this will not be possible if you need to have radiotherapy immediately and it is not available on the NHS in all areas.
Cosmetic changes to the skin
Long-term changes to the skin can occur after having radiotherapy. Some people notice that their skin is thicker, a slightly darker colour and, occasionally, dimpled (like the peel of an orange). These changes usually improve over time.
Pelvic insufficiency fractures
Radiotherapy to your pelvic bones can cause tiny cracks, known as pelvic insufficiency fractures, to appear in the bones of your pelvis some time after treatment has finished. Pelvic insufficiency fractures are more likely to occur in people who have osteoporosis, a condition that causes brittle bones.
Pelvic insufficiency fractures can be very painful, particularly during exercise. Resting should help to reduce the pain. You should report any new bone pain that you experience to your oncologist or GP.
Bowel incontinence
Bowel incontinence, sometimes known as faecal incontinence, is a rare side effect of radiotherapy to the pelvis. It is the inability to control your bowel movements which can result in faeces (stools) leaking from your rectum (back passage).
Bowel incontinence can be treated with dietary changes, medicines or a number of different surgical procedures. Read more about treating bowel incontinence.
Lymphoedema
Radiotherapy can damage your body’s network of channels and glands that make up the lymphatic system. One of the functions of the lymphatic system is to drain excess fluid from your tissues. If the lymphatic system is damaged, fluid can build up and cause swelling and pain.
This is known as lymphoedema and it often occurs in the arms or legs although it can also affect other areas, such as the chest. Lymphoedema is usually associated with women who have had radiotherapy for breast cancer.
It may be possible to prevent lymphoedema occurring using appropriate skincare techniques and exercise. If lymphoedema does develop, it can be controlled with early treatment in a specialised lymphoedema clinic.
Read more about lymphoedema, including the symptoms and how it is diagnosed and treated.
