Radiotherapy for Bladder Cancer

Radiotherapy for Bladder Cancer

Introduction

This leaflet will explain possible side effects which may develop when receiving radiotherapy to your pelvic area.

These effects are individual and can vary from person to person. Most effects are temporary. Acute (early) side effects may start at varying times during treatment and disappear in the weeks after treatment finishes. Late side effects may not occur for a long time after the treatment has finished.

The radiographers will explain your possible side effects in more detail and answer any questions you may have before you start treatment.

You may also be having chemotherapy treatment at the same time as your radiotherapy. Chemotherapy is the treatment of cancer with drugs. You will be given specific written information and consented separately for this. You will have weekly blood counts while you are having chemo radiotherapy treatment.

For each treatment appointment we would like you to have an empty bladder. So we ask you not to drink one hour before your appointment and then you will be asked to empty your bladder immediately before you are called in for your daily radiotherapy treatment.

During treatment you are not radioactive. Once the treatment machine is switched off

there is no radiation present so you are safe to be around children and pregnant people.

Possible early/short-term side effects

These side effects typically begin during your radiotherapy treatment or shortly after its completion. In most cases, they are temporary and usually resolve within two to six months following the end of your radiotherapy. While the exact duration and intensity of side effects can vary, most people find that they gradually improve over time.

It is quite common to feel tired during radiotherapy treatment, and this may be more pronounced if you have also undergone chemotherapy. 

Research suggests that gentle exercise and staying active can help alleviate some of the tiredness and fatigue. Activities such as walking, stretching, or yoga can boost your energy levels and improve your overall well-being. It’s important to listen to your body and rest when needed, but staying moderately active can make a significant difference.

Effects on the bladder

You may experience an increase in frequency and urgency of urination and some people develop a burning or stinging sensation as well. There is also the possibility of feeling the urge to pass urine but then only passing small amounts. Some people also experience passing blood and debris.

You can help yourself by:

• Drinking plenty of fluids and keeping well hydrated. This will depend on weight and body size but the average amount is 1.5-2 litres (3-4 pints) per day.
• Avoid drinks that can irritate the bladder such as tea, coffee, green tea, alcohol, fizzy drinks such as cola and fresh juices. Herb/fruit or caffeine free drinks are fine.

Please tell the radiographers if you think you may be developing urinary symptoms. If at any time you feel you cannot pass urine at all you should seek urgent medical advice through your GP.

Effects on the bowel

You will probably find that your bowel motions become more frequent over time with looser stools and possibly diarrhoea. It is not uncommon to have increased wind and pass some mucous or blood in your stools. You may also experience a bloated and tender feeling in your stomach.

You can help yourself by

• Trying to eat your usual diet and avoid missing meals.

If necessary, we will advise you of a change of diet or medication. If you experience a loss of appetite or are struggling to eat, we will refer you to our dietitian. If you are having chemotherapy as well, these side effects may be more severe.

Hair loss

You may find that you will lose pubic hair in the area that is being treated. It will grow back but may be thinner.

Skin

Radiotherapy can cause a skin reaction similar to exposure to the sun. Most people have some redness around the area being treated. White skin tones may become redder or subtly darker; brown and black skin tones may appear yellow, purple or grey in appearance.

Nausea and weight loss

Some people may find they lose weight while having treatment. This can be due to the side effects such as diarrhoea, nausea, loss appetite and tiredness.

Let the radiographers know if you are experiencing any of these as they will be able to give you advice and get medication to help with the sickness and/or diarrhoea. It will also be possible to refer you to our dietitian.

Late side effects

These may occur months to years after you have completed your treatment. Modern machines and techniques have reduced some of these late effects.

Infertility – radiotherapy to the bladder can result in lowered sperm counts and early menopause. This is because the bladder is close to the reproductive organs. If you are concerned about infertility talk to your consultant before your treatment begins.

Radiotherapy can cause a narrowing and shortening of the vagina, which may make sexual intercourse uncomfortable or difficult. It may also cause some vaginal dryness but lubricants are available on prescription. To help prevent this happening you may be recommended to use a vaginal dilator with some lubricant jelly. These will be given to you during your radiotherapy. They are used to maintain the opening of the vagina, and can help to make future clinical examinations more comfortable for you.

Bladder changes – can include a need to pass urine more frequently and urgently, reduced bladder capacity and occasionally blood in the urine.  You may suffer from some urinary incontinence and may need to wear a pad.

Bowel changes – rarely there can be narrowing or bleeding from the bowel

Impotence – radiotherapy can cause impotence in 30-40% occurring up to 2-5 years after treatment.  Radiotherapy can cause changes to ejaculate and the inability to achieve adequate erections.

There is a very small risk of second cancers developing in adjacent areas in the years following your radiotherapy treatment.

Please discuss any new symptoms that you experience after your treatment, with your consultant in the follow up clinic.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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