Pelvic Radiation Disease (PRD) is a term used for ongoing or late symptoms that can affect some people after radiotherapy to the pelvic area, including radiotherapy for prostate cancer. Many short-term side effects improve after treatment, but some symptoms can continue or develop months or even years later.
Not everyone who has pelvic radiotherapy develops PRD, and symptoms vary considerably between individuals.
What can pelvic radiation disease affect?
Pelvic radiotherapy can affect tissues and organs close to the area being treated. Longer-term problems can involve the bowel, bladder, sexual function, bones, nerves, lymphatic system and other pelvic tissues.
Possible symptoms can include:
- diarrhoea, bowel urgency or difficulty controlling the bowel
- rectal bleeding or other changes in bowel habits
- urinary urgency, leakage or bleeding
- erectile or other sexual difficulties
- pelvic pain
- fatigue
- swelling or lymphoedema
- changes in mobility or physical function
These symptoms can have causes other than previous radiotherapy, so new or persistent symptoms should be assessed rather than assumed to be caused by radiation.
When can symptoms occur?
Some radiotherapy side effects occur during treatment or shortly afterwards and then improve. Late effects can persist beyond the first few months or appear much later after treatment.
The Pelvic Radiation Disease Association describes PRD as symptoms starting or continuing three months or more after pelvic radiotherapy, although symptoms may sometimes appear years later.
When to seek medical advice
Tell your GP, clinical nurse specialist, oncology team or other healthcare professional about persistent or troublesome bowel, bladder, sexual or pelvic symptoms after radiotherapy. Do not assume that a new symptom is simply an unavoidable consequence of previous treatment.
Seek prompt medical advice for symptoms such as significant or persistent bleeding, severe or worsening pain, inability to pass urine, severe diarrhoea, unexplained weight loss or a marked deterioration in your health.
Assessment and management
Management depends on the symptoms and their cause. Assessment may involve different specialists because pelvic radiotherapy can affect several organs and tissues.
Depending on your symptoms, your healthcare team may consider investigations, medicines, dietary or specialist dietitian advice, physiotherapy, continence support or referral to a service experienced in managing late effects of radiotherapy.
Do not make major restrictive dietary changes or start supplements specifically for PRD without discussing them with an appropriate healthcare professional, particularly if you are losing weight or having significant bowel problems.
Further information and support
Pelvic Radiation Disease Association: What is PRD?
For information about prostate cancer radiotherapy itself, see our Radiotherapy page.
This page provides general information about possible late effects of pelvic radiotherapy. New, persistent or worsening symptoms should be discussed with your healthcare team so that their cause can be properly assessed.