For some of the symptoms of pelvic radiation disease (PRD) there are no medications or treatments that can help manage them. However, there are several changes that you can make to your lifestyle that may help lessen, control or relieve these symptoms.
Whilst there is no cure for lymphoedema, in many cases it can be managed by one of the following:
- Skin care – to keep the skin and tissues in good condition and to prevent/reduce the risk of infection
- External support/compression – in the form of elastic compression garments to help prevent the swelling from building up in the limb
- A programme of exercise and movement – to try and maximise lymph drainage without over exertion (this would cause the swelling to worsen)
- Simple lymphatic drainage (SLD) – a gentle massage technique that is based on the principles of manual lymphatic drainage (MLD). It involves the use of simple hand movements to try and move the swelling out of the affected area. It is designed to be carried out by patients themselves - or their relatives or carers.
Since many of the symptoms of PRD affect the bowel and bladder, making changes to your diet can help to manage and relieve these symptoms.
Your doctor may refer you to a dietician, who will be able to give you expert advice on this. The process can be a bit of an experiment to see which changes help you the most as there are several things you can try. Talking openly and frankly about your symptoms to your medical team will help them understand what is working for you and what is not.
- Fibre – too much or too little fibre in your diet can worsen PRD symptoms like wind, constipation, diarrhoea, bloating and abdominal pain. Controlling the amount of fibre you take in can help to control these symptoms
- Fat – lower fat diets have suggested to improve some of the symptoms of PRD, though some experts think more evidence is needed for this
- Lactose – a diet with less lactose (a sugar found in milk) has been suggested to help relieve some symptoms, though more evidence is needed for this.
Pelvic floor and toilet posture exercises
Many of the bowel and bladder symptoms of PRD can be significantly helped using some basic exercises that you can easily do at home. Pelvic floor exercises aim to target and strengthen the muscles that control your bladder and bowels, which are known as your pelvic floor muscles. Toilet posture exercises focus on how to correctly position yourself on the toilet when you are emptying your bowels in order to make this as easy as possible . Your health care team can provide you with more information and instructions on these exercises.
You can find out more about pelvic floor exercises on the NHS website.
Maintaining a healthy weight and doing regular exercise can help reduce symptoms in the bowel and bladder, it can also help reduce your chance of developing lymphoedema as being a healthy weight reduces the pressure on your legs helping to prevent swelling and fluid build-up. Regular weight-bearing exercise also helps strengthen bones, which can help prevent osteoporosis (where the bones are weakened causing them to become fragile and brittle). Maintaining a healthy weight also reduces the pressure on your bones helping to prevent factures.
Giving up smoking is also a good way to reduce some of the symptoms of PRD. Smoking irritates the lining of the bladder and bowel, which can make these symptoms worse.
For more information and support about quitting smoking, please visit the NHS Smokefree website.
Sex and intimacy
Going through treatment for cervical cancer can have many effects on your intimate and sexual relationships as it can affect you both physically and emotionally. Some changes to your sex life may require more specialised care, but other changes may be simple to improve and your Cancer Nurse Specialist will be able to offer you support and help.
Joanna L’s story
Joanna uses a mixture of medication and dietary changes to manage her PRD symptoms.
‘Perhaps because of the diet, or because three years have now passed since I finished treatment, my bowels are nearly back to normal. I have gradually reduced taking Loperamide from several times a week to maybe twice or even once a week or when something special is taking place the following day.’
Read more of Joanna L’s story.
- McGough C et al, 2004. Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy. British Journal of Cancer 90, 2278–2287.
- Stacey R et al, 2014. Radiation-induced small bowel disease: latest developments and clinical guidance. Therapeutic Advances in Chronic Disease 5 (1), 15–29.
- Andreyev HJN et al, 2015. Guidance: The practical management of the gastrointestinal symptoms of pelvic radiation disease. Frontline Gastroenterology 0, 1–20.