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Pelvis: Care of Radiation Therapy Side Effects

Information for people having radiation to their pelvis or pelvic area.
Side Effects

Some organs in the pelvic area are the anus, bladder, cervix, endometrium, ovary, penis, prostate, rectum, testes. uterus vagina and vulva.

Side Effects

Radiation treatment damages cancer cells but can also affect normal tissues in the treatment area. Damage to normal tissues may cause side effects.

These side effects will vary depending on:

  • The amount of radiation prescribed.
  • The area of your body being treated.
  • The size of the treatment area.
  • Whether or not you are having chemotherapy.

Your BC Cancer health care team will explain which side effects you may have during or after your treatment. You will see a nurse or a doctor regularly during your treatment to talk about your radiation side effects. The doctor you see may not be your radiation oncologist.

If you have a problem or concern between visits with the nurse or doctor, please talk to your radiation therapists who can help you right away.


Fatigue is a feeling of extreme tiredness. If you are fatigued, you may want to rest and sleep more than is normal for you.

There are many causes of fatigue:

  • Radiation therapy
  • Previous treatments
  • Emotional stress
  • Changes in lifestyle

You may be able to continue your normal lifestyle or you may need to adjust your routine according to your energy level. For more information, go to our Managing Fatigue page.

Bowel and Rectal Reaction

If your bowel is included in the treatment area, you may experience:

  • Cramping
  • Bloating
  • Frequent, loose bowel movements or diarrhea
  • Passing of watery mucus or even some blood with your stool ("poop")

Here are some things you can do that may help with your bowel reactions:

  • Try to drink at least 8 - 10 cups (2 - 2.5 litres) of fluid each day (unless you are on a fluid- restricted diet)
  • Do not take laxatives (medications that help you poop) unless your BC Cancer health care team tells you to
  • Try to maintain a healthy diet
  • Try not to eat foods and drinks that will bother your bowel, such as:
    • Fibrous fruits and vegetables
    • Fried foods
    • Spices and pepper
    • Coffee and tea
    • Cocoa
    • Alcohol

    If are unsure about what to eat or you are having bowel issues, please ask to speak with a BC Cancer dietitian.

    You can also go to:

    You may also find sitz baths soothing. A sitz bath cleanses and soothes irritated sore skin. Read the Sitz Baths handout or ask your BC Cancer health care team for a copy.

    Bladder Reaction

    You may have some or all of these urinary symptoms:

    • Increased urinary frequency (you have to pee more often).
    • Urgency (you have a sudden need to pee)
    • Burning when you urinate (pee)
    • Dribbling

    You may also have blood in your urine.

    Try to drink at least 8 – 10 cups (2 – 2.5 litres) of fluids every day. Examples of fluids include water, juice, broth, sports drinks, and herbal tea.

    Your doctor may send you for a urine sample to test for infection. They may prescribe medication if needed.

    Endometrium, Cervix, Uterus or Vaginal Reaction

    If the endometrium, cervix, uterus or vagina is included in the treatment area, you may have cramping or bloating. You may also have bleeding, or increased or odorous (smelly) vaginal discharge.

    Please tell BC Cancer health care team if you have an unusually large amount of bleeding, even if it is during a menstrual cycle. Your doctor may send you for a blood test to check your blood counts.

    You can wear sanitary pads or napkins, if needed. You may not be able to use tampons. If you want to use tampons, please check with your radiation therapy team.

    Do not douche unless your oncologist tells you to.

    You can participate in sexual activity as long as you are not having discomfort, pain or too much bleeding. If you are unsure, please talk to your BC Cancer health care team.


    Radiation treatment may cause hemorrhoids to flare up. You may find sitz baths soothing. Ask your BC Cancer health care team about which hemorrhoid cream is right for you.


    If you have pain from your cancer or its treatment, please tell your BC Cancer health care team. Also, go to our Pain from Cancer page.

    Skin Care

    If you are having external radiation therapy, a skin reaction in the treated area is possible. Talk to your BC Cancer health care team about whether this might happen to you.

    The skin in the treated area may become warm, dry or itchy. It may change colour (become pink, red, darker or tanned looking) and you may have hair loss in the treated area.

    Most skin reactions begin within the first week or so of starting treatment, but timing can be different for each person.  Some people do not have a skin reaction until after their radiation treatment is finished.

    Skin reactions usually go away a few weeks after your last treatment. Some skin changes, like skin darkening or scarring, can be permanent (they will never go away).

    Here are some tips to protect your skin and help it feel better:

    Lifestyle and well-being

    • Be very gentle with the skin in the treated area.
    • Wear loose, comfortable clothing.
    • Protect the treated skin from wind and direct sunlight. If you cannot cover the area, use sunscreen with an SPF of 30 or higher.
    • It is okay to swim as long as your skin is not broken or irritated. It is best to shower right away after swimming: gently wash off the chlorine, pat dry and apply moisturizer

    Hygiene and moisturizing

    • Keep your skin moisturized to prevent dryness. There is no evidence that any cream or product is better for this. If you like a certain product or brand, please continue to use it.
    • If you do not have a moisturizer, use one that is water-based (water or aqua is the first ingredient on the list).
    • Once you start your radiation treatment, use the moisturizer many times each day.
    • You can use deodorants and anti-perspirants.
    • When you bathe or shower, use warm water (not hot) and pat dry with a soft towel.
    • Use an electric razor if you want to shave.
    • If you have a skin reaction, your BC Cancer health care team may ask you to use a steroid-based cream or antibiotic on the treated area.

    'Do Nots' for the treatment area

    • Do not use perfume, alcohol, astringents, and adhesives on the treated skin.
    • Avoid extremes of hot or cold (heating pads, ice packs, saunas, etc).
    • Do not use hot tubs or Jacuzzis®.
    • Do not rub, scratch, or massage the treated skin.
    Support Services

    BC Cancer helps those living with or affected by cancer to cope with the physical, practical, emotional, and psychological aspects of their care.

    If you have any questions or concerns, please talk to your BC Cancer health care team.

    Alcohol and Smoking

    Alcohol and Smoking

    Please try not to smoke during your treatment. Smoking may cause more irritation and increase the side effects you experience.

    Stopping smoking has major and immediate benefits for people of all ages. It:

    • Helps improve your body's ability to heal.
    • Improves your body's response to cancer treatment.
    • Lowers the risk of your cancer returning or another cancer developing.
    • Lowers your risk of pneumonia and respiratory failure (when your lungs cannot work properly).

    If you use tobacco or have recently quit, ask your BC Cancer health care team for more information. You can also go to our Smoking Cessation Program page.

    Depending on the area of your body being treated, alcohol may worsen your side effects. Small amounts of alcohol may be fine for some people. Please check with your BC Cancer health care team.

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