Pelvic radiation disease

What is pelvic radiation disease?

Pelvic radiation disease (PRD) is a set of symptoms that can affect women who have undergone radiotherapy treatment for abdominal or pelvic cancers. This may include cervical cancer, uterine cancer, bowel cancer or prostate cancer. Having such treatment on this part of the body can treat the cancer present, however, it can also produce longer-term symptoms and side effects, such as diarrhoea or constipation, rectal bleeding, bloating, abdominal pain, increased urgency for passing urine, difficulty during sexual intercourse or difficulty passing urine. Symptoms can range in severity.

A woman is stood with her hands across her pevlic area. After radiotherapy treatment for pelvic cancers, pelvic radiation disease can sometimes result.

Prognosis

The prognosis of pelvic radiation disease varies. Whilst the symptoms can vary, with some clearing up on their own, others can persist and affect daily activities for years after radiotherapy treatment has finished. A lot of the symptoms caused can be challenging to live with and cause some embarrassment, making some patients feel frustrated and hopeless.

Symptoms of pelvic radiation disease

Symptoms of pelvic radiation disease can sometimes first appear during radiotherapy treatment, however, others might not appear until much later on, sometimes even years after radiotherapy treatment has finished. The symptoms will vary depending on which organ is affected.

Reproductive organs:

  • Vaginal dryness
  • Loss of libido
  • Painful intercourse
  • Erectile dysfunction

Bowel:

  • Faecal incontinence
  • Chronic diarrhoea
  • Bacteria overgrowth
  • Constipation
  • Abdominal pain
  • Rectal bleeding

Bladder:

Medical tests to diagnose pelvic radiation disease

As a lot of the symptoms of pelvic radiation disease can be symptomatic of other conditions, these must first be ruled out by diagnostic tests and medical history. If the patient has bowel symptoms, they may be given an endoscopy of their large bowel and an MRI scan of their small bowel. They may also have their stool tested to check for any infections. If the patient has bladder symptoms, it is likely they will be offered a cystoscopy to assess the bladder and urine tests as well.

What are the causes of pelvic radiation disease?

Pelvic radiation disease results from side effects of radiotherapy treatment for cancer. During radiotherapy treatment, whilst cancer cells are destroyed, surrounding healthy tissue cells can also be damaged.

Can pelvic radiation disease be prevented?

If a patient has a type of cancer that requires radiotherapy treatment in order to treat it, then this type of treatment cannot be avoided. There is ongoing research into how the effects of radiotherapy on the pelvic organs can be reduced.

Treatments for pelvic radiation disease

Treatment of pelvic radiation disease will depend on the organ affected and the symptoms experienced.

Reproductive organs:

To help manage problems such as vaginal dryness, painful intercourse or symptoms of early menopause, patients may be prescribed hormone creams, dilators or hormone replacement therapy. For men who have erectile problems, they will likely be referred to a specialist for further treatment options.

Bowel:

Medications can be prescribed for diarrhoea, constipation or bile acid malabsorption. If changes to diet are deemed helpful, the patient may be referred to a dietician. To help with faecal incontinence issues, pelvic floor muscle strengthening exercises can be helpful.

Bladder:

Urinary incontinence issues can be helped with pelvic floor exercises. If passing urine is a symptom, then special dilators can help to widen the urethra.

Which type of specialist treats pelvic radiation disease?

Pelvic radiation disease can be managed by several different specialists, depending on the symptoms experienced. However, treatment by involve gastroenterologists, gynaecologist, urologists, GPs or dieticians.

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