Side effects of radiotherapy

Radiotherapy for vaginal cancer can cause short-term and long-term side effects. The most common effects happen during or soon after treatment. The side effects happen because radiotherapy can cause damage to healthy cells as well as cancer cells.

Most of these side effects can be treated and your doctor or nurse will be able to help you. Most side effects should gradually disappear once your treatment is over.

You may experience some of the following side effects:

  • Lethargy and loss of appetite: The radiotherapy will make you feel tired and you may lose your appetite.
  • Diarrhoea: Radiotherapy may irritate the bowel and cause diarrhoea. This occurs when your stools are loose and watery and you have frequent bowel movements.
  • Hair loss: Radiotherapy can cause hair loss in the area being treated, such as your pubic hair, and this may be permanent.
  • Menopause: Radiotherapy to the pelvic region may cause menopause.
  • Shortening and narrowing of the vagina: Radiotherapy to the pelvic area can affect the vagina, which will become tender during the course of radiotherapy and for a few weeks after it ends. In the long term this irritation can make the vagina drier and can leave scarring that makes the vagina shorter, narrower and less flexible. This may make sex uncomfortable or difficult. To keep your vagina open and supple, use a dilator, which is a tube-shaped device made of plastic or rubber, to keep the vagina open. Your health care team can show you how to use a dilator. A water-based vaginal lubricant can help relieve painful irritation. Avoid Vaseline or other oil-based lubricants as they may cause irritation. If you are ready and able, have regular gentle sex to help widen the vagina.
  • Cystitis: Radiotherapy to the pelvic area can also cause a burning sensation when passing urine (cystitis). These side effects can be mild or troublesome depending on the strength of the radiotherapy dose and the length of your treatment.
  • Skin changes. Your skin may get red, itchy, dry or swollen in the area being treated. Use lukewarm water to shower or bathe, and a mild soap that does not have fragrance or deodorant in it. Ask your radiographer or nurse for advice on any skin problems.

When you’re having radiotherapy, you should allow yourself plenty of time to rest. You should also try to drink lots of water and have small, frequent meals. Ask your doctor or nurse about ways to manage side effects.

The Cancer Council booklet, Understanding Radiotherapy, has more information about managing the side effects of radiotherapy. It is available free online or by calling the Cancer Council Helpline (13 11 20).

Long-term side effects of radiotherapy

Radiotherapy to the pelvic area can sometimes lead to long-term side effects. However, improvements in treatment planning and the way in which the radiotherapy is given have made these long-term effects much less likely. Long-term side effects include:

  • Menopause: Radiotherapy for cancer of the vagina affects the uterus and the ovaries. This means that if you have not already been through menopause, you will experience an early menopause.
    During menopause, your periods will stop and you may have symptoms such as hot flushes, dry or itchy skin, mood swings, or loss of libido (interest in sex). An early menopause also means that you will no longer be able to become pregnant. If this is a concern for you, talk to your doctor about your fertility and any options available to you before you start treatment.
    Hormone replacement treatment (HRT) may help to control or minimise menopausal symptoms. Your gynaecologist can start HRT during the radiotherapy treatment or shortly after it has ended.
  • Bowel and bladder problems: In a small number of people, radiotherapy may permanently affect the bowel or bladder. If this happens, increased bowel motions and diarrhoea may continue, or you may need to pass urine more often than before.
    The blood vessels in the bowel and bladder can become more fragile and this can cause blood to appear in the urine or bowel movements. This can take many months or years to occur. If you notice any bleeding, it is important to let your doctor know so that tests can be done and appropriate treatment given.
  • Lymphoedema: Some people find that radiotherapy affects the lymph glands in their pelvic area and can cause swelling of the legs. This is known as lymphoedema and is more likely if you have had surgery as well as radiotherapy.

The Cancer Council booklet Understanding Radiotherapy has more information about radiotherapy. It is available free from the Cancer Council Helpline (13 11 20).