What is Pelvic Radiation Disease? (PRD)
Pelvic radiation disease is defined as any, brief or longlasting problems, which can be anything from very mild to very severe, arising in normal, non cancerous tissues and which start as a result of radiotherapy to a tumour in the pelvis.
How common is PRD?
In the UK 17,000 patients are treated with radiotherapy to the abdomen and pelvis for cancer. 90% develop some bowel upset during treatment but this often settles or remains minor when treatment finishes. 50% develop gastro-intestinal symptoms which affect quality of life and range from minor inconvenience to being house-bound. Approximately one quarter will develop sexual or urinary problems. Some people might go on to have long term damage to their bones, skin or lymph drainage from the legs.
How do I know if I have pelvic radiation disease?
People who develop new symptoms affecting the bowel, urinary tract, sex organs, bones, or skin, during or after radiotherapy may have pelvic radiation disease. Other diseases can start after radiotherapy, so people need to be properly assessed to establish the causes of symptoms.
How long after radiotherapy treatment does PRD occur?
Any time following radiotherapy but sometimes side effects aren’t evident for months or years.
Are there other names for PRD?
Yes, the late effects of pelvic radiotherapy or the side effects of pelvic radiotherapy
My medical team has never heard of pelvic radiation disease - What do you suggest I do?
Take the information from this website to your GP to discuss the possibility of PRD. Ask to be referred to a gastroenterologist. See our documents section in About Us for recent clinical guidelines on how to treat PRD.
Can PRD be treated?
Symptoms of constipation, diarrhoea, frequency of stool, increased gas, erratic bowel, greasy stool, abdominal pain, bloating, rectal pain, faecal incontinence, and often rectal bleeding can usually be improved or cured by using a combination of life style changes and medication depending on the exact causes. Specific conditions caused by damaged tissues such as bile acid malabsorption, lactose intolerance or functions of the bowel such as small intestinal bacterial overgrowth respond to specific treatments.
Some doctors increasingly believe that some of the changes in tissues which lead to the symptoms of pelvic radiation disease may be reversible. As yet, the available treatments are experimental but the most promising ones include hyperbaric oxygen, vitamin E with pentoxyfilline and possibly statins and a group of drugs called ACE inhibitors. However, much more research needs to be done before these can be recommended for widespread use.
What is hyperbaric oxygen therapy?
Hyperbaric oxygen therapy is oxygen delivered under high pressure and works by increasing the oxygen levels in the blood and tissues helping damaged tissues to heal. It is a treatment which needs to be repeated daily for 6-8 weeks and can only be given in a hyperbaric chamber, of which there are only about a dozen in the UK. A clinical trial, the HOT11 study, is testing if high pressure oxygen has beneficial effects in patients with PRD. This is an important trial because a course of treatment with hyperbaric oxygen is time consuming and expensive, so we need to be sure whether it is helpful and which symptoms it really does help.
Information provided by Dr Jervoise Andreyev, Consultant Gastroenterologist, Royal Marsden Hospital and Barbara Benton research nurse, Royal Marsden Hospital. May 2012.
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