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About pelvic radiation disease (PRD)
Pelvic radiation disease (PRD) is a term used to describe a group of long-term side effects that can be caused by pelvic radiotherapy treatment. This includes external radiotherapy, brachytherapy and chemoradiation.
We know that PRD can have a big impact on your life after cervical cancer treatment. We hope the information on this page can help you understand more about PRD and feel in control of your current situation and the next steps.
What is PRD?
PRD is a term used to describe a group of long-term effects someone might experience after radiotherapy or brachytherapy for any type of cancer. In this information, we are talking about PRD after cervical cancer treatment.
PRD effects are usually related to the:
- bladder
- bowel
- vagina.
However, PRD can affect any of the tissues, organs, bones and lymph nodes in the pelvis – the area between your hipbones.
There is no official time after cervical cancer treatment that effects are described as PRD. Most healthcare professionals consider PRD to be:
- symptoms that begin during or shortly after treatment and last for at least 3 months
- new symptoms that begin months or years after treatment.
What causes PRD?
When you have radiotherapy or brachytherapy to treat cervical cancer, radiation is used to kill the cancer cells. This can sometimes cause damage to nearby healthy cells. The body trying to repair this damage can cause inflammation. Inflammation means the cells and tissue becoming red, painful, heated and swollen. This is the most likely cause of short-term symptoms, which many women and people with a cervix experience during treatment. These usually get better within a few weeks or months of treatment finishing.
However, the body’s healing process can continue after radiotherapy has ended. In this case, the inflammation is around for a longer time, so can cause longer-term symptoms. These long-term symptoms are grouped under the term pelvic radiation disease or PRD.
These symptoms can include:
- changes to the bowel, bladder or vagina
- damage to the pelvic bones
- hormonal changes, which may cause early menopause
- in rarer cases, swelling in the legs, stomach and genitals (lymphoedema).
How common is PRD?
About 22,000 people are treated with pelvic radiotherapy each year . The Pelvic Radiation Disease Association (PRDA) estimates that at least 100,000 people in the UK currently experience ongoing effects after their treatment .
We surveyed more than 600 members of our community who have had treatment for cervical cancer and found that:
- over 8 in 10 (88%) experienced at least 1 long-term symptom
- over 6 in 10 (63%) experienced at least 3 long-term symptoms
- over 2 in 10 (24%) experienced at least 6 long-term symptoms .
So it’s fair to say that long-term symptoms, including symptoms of PRD, are common after cervical cancer, although how much it can affect you varies.
It can be difficult to get a PRD diagnosis, so it is possible that more people have PRD that we don’t know about – and they may not know it themselves.
How might PRD affect you?
You might experience the effects of PRD at any time after radiotherapy or brachytherapy, including months or years after treatment. Sometimes these symptoms only happen for a short time or can be mild. They may even go away on their own over time. However, we know many effects can be more severe or last for a longer time.
Either way, any of the effects of PRD can affect your day-to-day quality of life – from practical issues like needing the toilet more frequently, to the emotional impact of living with physical reminders of the cervical cancer and its treatment.
PRD and COVID-19
It may feel particularly difficult to deal with PRD along with the COVID-19 pandemic. We are all adjusting to a different way of life, with changes to how we access healthcare, how we interact with loved ones, and the availability of facilities like public toilets.
If you’ve been shielding, you may feel especially isolated. And if it’s been a while since you finished treatment, you may feel unsure about how to get support for any new symptoms.
It’s important to remember that healthcare services are still open for anyone who needs them. If your PRD symptoms are interfering with your day-to-day life, there is no reason to struggle on your own. There are medical treatments and self-management techniques to help you deal with many of the late effects of pelvic radiotherapy, so don’t be afraid to ask for help.
More information and support about PRD
We know that PRD that have a huge impact on your life and you may feel frustrated or upset, especially if you are struggling to get a diagnosis. Accessing support can be difficult, but try to use the healthcare professionals that are there to support you – whether that is your GP or a practice nurse or your clinical nurse specialist (CNS).
If you are not sure where to turn, you can give our free Helpline a call on 0808 802 8000. Our trained volunteers can talk through your options or simply listen to what’s going on.
Check our Helpline opening hours >
Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.
Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it.
References
- Morris, K. and Haboubi, N. (2015). Pelvic radiation therapy: Between delight and disaster. World Journal of Gastrointestinal Surgery. 7;11. pp.279-288.
- Halkett, G. et al (2017). What pelvic radiation disease symptoms are experienced by patients receiving external beam radiotherapy and a high-dose-rate brachytherapy boost for prostate cancer? Journal of Contemporary Brachytherapy. 9;5. pp.393-402.
- Pelvic Radiation Disease Association (2020). Information for health professionals. Web: https://www.prda.org.uk/information-health-professionals/. Accessed October 2020.
- Ibid.
- Jo’s Cervical Cancer Trust (2017). Long term consequences of cervical cancer and its treatment. Web: https://www.jostrust.org.uk/sites/default/files/final_ltccc_2017_report.pdf. Accessed October 2020.
We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected].
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Date last updated:
29 Oct 2020
Date due for review:
29 Oct 2022