The side effects of radiotherapy vary depending on the strength of the radiotherapy dose to the organs surrounding the cervix and uterus. Most side effects are temporary and can be managed by your health care team.
The most common side effects occur about halfway through the external radiotherapy. Side effects that occur after radiation are termed late side effects. Some women experience long-term side effects. The likelihood of side effects will be discussed with you as part of obtaining your informed consent to have the treatment.
Chemoradiation may cause more severe side effects than radiotherapy alone. The side effects include nausea, vomiting and a lowered number of white blood cells (which fight infection).
The side effects of radiotherapy can include:
- Diarrhoea. Radiation passes through the bladder and bowel to reach the cervix. This may cause diarrhoea and frequency of bowel movements, increased urge and slight faecal incontinence. Medication (some of which can be purchased over the counter) will be prescribed for this problem. For some women, the anti-nausea medication given with chemotherapy also relieves this particular side effect.
- Urinary frequency and cystitis. Most women experience frequency together with a burning feeling when passing urine (cystitis). Your nurse or doctor will check the urine and treat any infection present.
- Tiredness. You are likely to become tired during radiation therapy, especially in the later weeks of treatment.
- Loss of appetite. If you don’t feel like eating during treatment you can replace meals with nutritious high-calorie drinks available from the chemist.
- Loss of pubic hair. You may lose your pubic hair. It may grow back after the treatment ends, but it will usually be thinner. The radiation alone cannot affect hair or skin elsewhere.
- Menopause. Radiotherapy may cause your ovaries to stop working permanently (if you haven’t had them removed or relocated at the time of surgery). If you haven’t already been through menopause you may experience menopausal symptoms such as hot flushes, and you will not be able to become pregnant.
- Shortening and narrowing of the vagina. Radiotherapy may cause internal scar tissue to form, which sometimes shortens and narrows the vagina. This is called vaginal stenosis and can be prevented or minimised with the regular use of a vaginal dilator (also called a vaginal cylinder). During or after your treatment is finished you should be provided with a vaginal dilator and educated about its use. Regular use will make your follow-up vaginal examinations more comfortable and enable you to remain sexually active. Use of an oestrogen cream will help treat changes that can otherwise make Pap smears difficult to interpret.
- Skin changes. If the radiation is passing through the skin of the vulval area, this may become inflamed and irritated requiring local gels or creams for comfort. It is unusual for this to be very severe. Use lukewarm water to shower or bathe, rinse the area after passing urine, and use a non-soap wash. If you have ongoing problems, please discuss this with your doctor who may prescribe medication. Your nurse and therapist may be able to advise on general skin care and hygiene.
- Vaginal irritation and discharge. Some women experience mild vaginal irritation and discharge during and shortly after treatment. If your cancer has been causing vaginal bleeding, this usually stops after a few weeks of treatment, although sometimes it may initially worsen before getting better. If this is troublesome please talk to your nurse or doctor.
For general information about radiotherapy, see the Cancer Council booklet, Understanding Radiotherapy. It is available free by calling the Cancer Council Helpline (13 11 20).