Pelvic Cancer: Radiation Therapy

What is radiation therapy for cancer in the pelvis?

Radiation therapy uses high-energy radiation (X-rays) to shrink or destroy a tumor in the pelvis or help you feel better. The pelvis holds organs such as the rectum, vagina, uterus, ovaries, and bladder. If you have cancer in or near these organs, your healthcare provider may want you to have this procedure. Radiation therapy is a treatment given by a radiation oncologist.

Some alternatives to radiation therapy are:

• having chemotherapy (medicine used to destroy cancer cells)
• having surgery to try to remove the cancer
• choosing not to have treatment

You should ask your healthcare provider about these choices. Also, you should ask the radiation oncologist how your cancer may affect you and what stage your cancer is in.

How should I prepare for this procedure?

Follow your healthcare provider's instructions. You should wear clothes that are easy to take off.

You will probably be told to empty your bladder two hours before you go in for treatment. Then you will probably be told to drink 4 cups of water or other liquid and not empty your bladder again until the treatment is over. This will help protect your bowel from radiation.

What happens during the procedure?

First you will need to take off the clothing covering your pelvis. The radiation therapist will ask you to lie on a treatment table like the one you used during the simulation session. The therapist will use the marks made on your body earlier to make sure the radiation is aimed at the correct place(s). She or he will help you lie in the correct position and leave you alone in the treatment room. The therapist will watch you on a TV monitor and you can talk with the therapist over an intercom. You will hear the radiotherapy machine buzz for about 30 seconds as it works. You may have one or more of these treatments from other angles.

The treatment is painless. Each session takes between 15 and 30 minutes. When the treatment is done the therapist will help you off the table and you may go home.

The usual course of radiation therapy is 5 days a week for 4 to 7 weeks. During the weeks of treatment the therapist will weigh you and may do tests, such as blood cell counts, to check the effect the radiation therapy is having on your body.

Sometimes radiation therapy may be given to you during an operation for the cancer to get better results from the cancer treatment.

What happens after the procedure?

After getting radiation therapy treatments you may notice some of the following side effects:

• Skin changes: The skin in the treatment area may become red or peel like a sunburn. You may want to wear loose, soft clothing. You should protect your skin from the sun, using clothing and a sunscreen with a sun protection factor (SPF) of 15 or higher. Try to keep hot or cold things, such as heating pads or cold packs, away from the treated area. The staff will give you a skin lotion or an ointment to use on the treatment area.
• Nausea: Radiation therapy causes some people to get sick to their stomachs. You could try eating soda crackers, dry popcorn, or warm soda to calm your stomach. If you have loose stools or diarrhea, drinking clear liquids could help. Your healthcare provider may prescribe certain medications to help stop the nausea.
• Sore bladder, rectum, or vagina: If your bladder is sore and you have to urinate more often, you should drink 2 quarts of water each day. Drinking cranberry juice may also help. If your rectum is sore, you should ask the radiation therapist for some ointment. You may have a discharge from your vagina, or your vagina may feel sore. Your healthcare provider may give you some medicine for these problems.
• Fatigue and loss of appetite: The more treatments you have, the more rest you may need. You may also notice you do not feel like eating very much. Your body may have a hard time making red blood cells, so you should eat more foods with iron. You should eat soft foods and avoid very hot, very cold, or spicy foods and caffeine. You could try high-calorie drinks or puddings to help keep you from losing too much weight. Eating small meals more often may be helpful. Avoid drinking alcohol and avoid all tobacco products.

After your last session, the therapist will wipe off the ink marks on your body. You should talk with your radiation oncologist and the staff about your diet and caring for your skin and yourself.

The radiation keeps acting on the cancer for several weeks after treatment. The side effects should go away a few weeks after the end of therapy. Women who have uterine cancer may have a radiation implant in their uterus later.

You should ask your radiation oncologist how active you can be and how often you should return to the radiation and oncology clinic for checkups. You should keep on seeing your primary care provider for your other healthcare needs.

What are the benefits of this procedure?

The cancer may be destroyed or slowed down. When you have other medical problems and cannot have surgery, radiation therapy is another good way to treat the cancer. Radiation therapy may have fewer side effects than treatment with anticancer drugs.

What are the risks associated with this procedure?

• There is a risk of hurting the healthy cells and forming scar tissue.
• Your skin could be injured or get darker.
• Your bowel or bladder could be injured.
• This treatment could make you sterile.
• Your vagina could become dry or shrink.
• If you are having both radiation therapy and chemotherapy, you may have more side effects.
• The radiation therapy may not destroy all the cancer.
• The cancer may recur.

You should ask your healthcare provider how these risks apply to you. The technology for giving radiation treatment has improved so that there are fewer side effects and less risk of damage to other tissues.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You start vomiting.
• You are having a lot of diarrhea.
• You have pain when you urinate.

Call during office hours if:

• You continue to have bowel or bladder irritation longer than 2 to 3 weeks.