Pelvic Radiation Disease (PRD) is defined as one or more ongoing symptoms of variable complexity that may affect people who have previously had radiotherapy to the pelvic region to treat their cancer. This includes pelvic radiotherapy for cancers of the colon, rectum, anus, prostate, testes, bladder, cervix and womb, but also total body radiotherapy and radiotherapy in the pelvic area for other primary and secondary cancers.

Pelvic Radiation Disease can affect one or more of:

Bladder Bone
Bowel Nerves
Sexual Organs Blood supply
Stomach and digestion Lymphatic system
Skin Mental health

Symptoms arise as a result of damage to internal organs or skin. Symptoms often settle in the few weeks after radiotherapy finishes but Pelvic Radiation Disease can be defined as symptoms starting or continuing 3 months or more after the end of radiotherapy. Sometimes they start many years or decades after radiotherapy.

The following Pelvic Radiation Disease symptoms range from mild to severe, and some are more common than others, but all tend to be under-recognised:

  • bowel and stomach difficulties* (almost any bowel or stomach symptom can be caused by radiotherapy but the most common symptoms are accidents, leakage or an inability to control the bowel or hang on, diarrhoea, need to rush to the toilet, bleeding from the bowel, poor appetite and malnutrition)
  • bladder difficulties (such as leakage or lack of control, need to rush to pass urine, bleeding)
  • sexual difficulties (such as painful intercourse for women or achieving and maintaining a satisfactory erection and/ or problems with ejaculation for men)
  • pain
  • fatigue
  • swelling (e.g. lymphoedema)
  • poor mobility
  • blood circulation disorders
  • anaemia
  • sore skin
  • nerve damage
  • bone fractures
  • hormonal changes (such as hot flushes)
  • infertility
  • sleep disturbance
  • memory problems
  • psychological difficulties.

*A full list of gastrointestinal symptoms can be found in ‘The Practical Management of the Gastrointestinal Symptoms of Pelvic Radiation Disease‘.


Modified: 14th March 2024