Pelvis

Radiotherapy to the pelvis is a common treatment approach for cancers involving pelvic organs.

Radiotherapy To The Pelvis

Is often used to treat cancers in areas such as the bladder, rectum, anus, prostate, cervix, uterus (womb) and vagina. It can also be used to treat lymph nodes in the pelvis region.

Some radiotherapy treatments are also given together with chemotherapy and/or brachytherapy (internal radiation). Please see the individual sections below.

Meeting your Doctor

Before treatment starts, you’ll have a chat with your doctor. They will explain the treatment, possible side effects, and ask you to sign a consent form. This meeting can be in person or over the phone.

Planning Scan

Before treatment starts, you’ll have a planning scan, usually a few weeks before. During this visit, you’ll meet with a radiographer to discuss things like the use of micro-enemas for your treatment. You will also be asked to follow a drinking protocol for your scan and treatment.

To ensure that your bladder and bowels resemble the planning scan, it’s important to follow to the proper bladder and bowel guidelines. This prevents delays from getting on and off the bed to manage your bowels or bladder and helps ensure that your radiotherapy is accurate.

During this planning CT session, you will be laid down in the treatment position and will have a CT scan to precisely locate the tumour and the area to be treated.

Small tattoos will be placed on the skin around the area that will receive radiation. These markings help ensure that radiation is delivered to the same spot each time.

Please note: Depending on the dose and schedule that the consultant has prescribed, some prostate patients may have a planning scan on an MRI scanner instead of a CT scanner.

If you have been referred for internal radiation therapy (brachytherapy) to the gynaecological region, please see the Brachytherapy section for more information.

Radiotherapy

Radiotherapy for prostate cancer is usually given 5 days a week (Monday to Friday). The number of treatments will depend on the doctor’s recommendation. You must follow the same bowel and bladder preparation which you were given at your planning scan. Once you are ready for treatment, the therapeutic radiographers will accurately position you on the treatment couch. This will be the same position which you laid down in for your planning CT scan.

The linear accelerator will rotate around you and deliver the radiotherapy treatment. You won’t feel the radiation, but you might hear some noises as the machine operates. Each session typically takes around 10 to 15 minutes. However, the actual radiation exposure lasts only a few minutes. You’ll need to stay still during the treatment, but you won’t feel pain or discomfort during the process.

Links to Useful Resources:

Meeting your Doctor

Before treatment starts, you’ll have a chat with your doctor. They will explain the treatment, possible side effects, and ask you to sign a consent form. This meeting can be in person or over the phone.

Planning Scan

Before treatment starts, you’ll have a planning scan, usually a few weeks before. During this visit, you’ll meet with a radiographer to discuss things like the use of micro-enemas for your treatment. For your planning scan and treatments, your bladder will need to be empty. During the planning scan, you’ll be positioned for treatment, and the scan will help the doctors find the tumour and the area that needs treatment.

During this planning CT session, you will be laid down in the treatment position and will have a CT scan to precisely locate the tumour and the area to be treated.

Small tattoos will be placed on the skin around the area that will receive radiation. These markings help ensure that radiation is delivered to the same spot each time.

Radiotherapy

Radiotherapy for bladder cancer is usually given 5 days a week (Monday to Friday). The number of treatments will depend on the doctor’s recommendation. You must follow the same bowel and bladder preparation which you were given at your planning scan. Once you are ready for treatment, the therapeutic radiographers will accurately position you on the treatment couch. This will be the same position which you laid down in for your planning CT scan. The linear accelerator will rotate around you and deliver the radiotherapy treatment. You won’t feel the radiation, but you might hear some noises as the machine operates. Each session typically takes around 10 to 15 minutes. However, the actual radiation exposure lasts only a few minutes. You’ll need to stay still during the treatment, but you won’t feel pain or discomfort during the process.

Links to Useful Resources:

Meeting your Doctor

Before treatment starts, you’ll have a chat with your doctor. They will explain the treatment, possible side effects, and ask you to sign a consent form. This meeting can be in person or over the phone.

Planning Scan

A few weeks before treatment starts, you will have CT and MRI planning scans. These scans help the consultant and the Planning team to outline the area that needs to be treated. A radiographer will explain to you how to prepare your bladder for the scans and treatment.

During these planning scans, you will be laid down in the treatment position. Small tattoo dots will be placed on the skin around the treatment area. These markings help the radiographers to set you up to the same spot every day.

Radiotherapy

Radiotherapy for rectum and anus cancer is usually given 5 days a week (Monday to Friday). The number of treatments will depend on the doctor’s recommendation. You must follow the same bladder preparation which you were given at your planning scan. Once you are ready for treatment, the therapeutic radiographers will accurately position you on the treatment couch. This will be the same position which you laid down in for your planning CT scan.

The linear accelerator will rotate around you and deliver the radiotherapy treatment. You won’t feel the radiation, but you might hear some noises as the machine operates. Each session typically takes around 10 to 15 minutes. However, the actual radiation exposure lasts only a few minutes. You’ll need to stay still during the treatment, but you won’t feel pain or discomfort during the process.

Links to Useful Resources:

Meeting your Doctor

Before treatment starts, you’ll have a chat with your doctor. They will explain the treatment, possible side effects, and ask you to sign a consent form. This meeting can be in person or over the phone.

Planning Scan

A few weeks before treatment starts, you will have CT and MRI planning scans. These scans help the consultant and the Planning team to outline the area that needs to be treated. A radiographer will explain to you how to prepare your bowels and bladder for the scans and treatment. This involves drinking a certain amount before each scan and treatment, and the use of micro-enemas to prepare your bowels.

During these planning scans, you will be laid down in the treatment position. Small tattoo dots will be placed on the skin around the treatment area. These markings help the radiographers to set you up to the same spot every day.

Radiotherapy

Radiotherapy for gynaecological cancer is usually given 5 days a week (Monday to Friday). The number of treatments will depend on the doctor’s recommendation. You must follow the same bowel and bladder preparation which you were given at your planning scan. Once you are ready for treatment, the therapeutic radiographers will accurately position you on the treatment couch. This will be the same position which you laid down in for your planning CT scan.

The linear accelerator will rotate around you and deliver the radiotherapy treatment. You won’t feel the radiation, but you might hear some noises as the machine operates. Each session typically takes around 10 to 15 minutes. However, the actual radiation exposure lasts only a few minutes. You’ll need to stay still during the treatment, but you won’t feel pain or discomfort during the process.

If you have been referred for internal radiation therapy (brachytherapy) to the prostate, please see the Brachytherapy section for more information.

Links to Useful Resources:

Side Effects

Even though radiation targets the tumour, it can also affect healthy tissue nearby. Side effects usually start after a few treatments and can be different depending on the area being treated.

Common side effects of pelvis radiotherapy include:

  • Tiredness (Fatigue): Tiredness is one of the most common side effects, and it tends to build up over time during treatment.
  • Skin Changes: The skin in the treated area may become red, dry, or irritated, like sunburn. You might also experience itching or peeling. See the link below advising you on how to look after your skin during and after radiotherapy treatment.
Skin care during and after your radiotherapy treatment leaflet
  • Nausea: Some patients may feel nauseous, especially if the radiation is directed near the stomach or bowels.
  • Pelvic Discomfort: Some patients experience pelvic pain and cramping.

Radiotherapy to the pelvis can irritate the bowel or bladder, leading to symptoms like:

  • Diarrhoea or more frequent bowel movements.
  • A feeling of urgency to urinate or burning sensation when urinating.
  • Blood in the stool or urine, though this is less common.
Important:

Please Note

Most side effects improve 10-14 days after treatment ends. Your healthcare team will be there to manage any side effects and provide support during and after your treatment.

Please inform your radiotherapist if you are experiencing any side effects.

Useful Resources:

Radiotherapy to your whole pelvis – For prostate, bladder and penile cancers leaflet
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