About 2 weeks after your first radiation treatment:

• Your skin over the treated area may turn red, start to peel, get dark, or itch.
• Your body hair will fall out, but only in the area being treated. Your hair loss may be permanent. Sometimes if your hair does regrow, it may be different than before.
• You may have bladder discomfort.
• You may have to urinate often.
• It may burn when you urinate.
• You may have diarrhea and cramping in your belly.
• You may experience gas and bloating.
• You may have trouble controlling your bladder or bowels.

Women may have:

• Itching, burning, or dryness in the vaginal area
• Menstrual periods that stop or change
• Infertility (unable to have children), make sure you discuss this with your provider before starting treatment
• Hot flashes or changes in hot flashes you already have
• Pain with intercourse

Both men and women may lose interest in sex.

When you have radiation treatment, color markings are drawn on your skin. Do not remove them. These show where to aim the radiation. If they come off, do not redraw them. Tell your provider instead.

Take care of the treatment area.

• Wash gently with lukewarm water only. Don't scrub.
• Use a mild soap that doesn't dry out your skin.
• Pat yourself dry instead of rubbing.
• Don't use lotions, ointments, perfumed powders, or perfumed products on this area. Ask your provider what is OK to use.
• Keep the area that is being treated out of direct sunlight.
• Don't scratch or rub your skin.
• Don't put heating pads or ice bags on the treatment area.

Your provider may recommend soaking in room temperature water.

Tell your provider if you have any breaks or openings in your skin.

Your provider may prescribe medicines to help soothe the skin and prevent infection.

Wear loose-fitting clothing around your stomach and pelvis.

• Women should not wear girdles or pantyhose.
• Cotton underwear are best.

Keep the buttocks and pelvic area clean and dry.

Ask your provider how much and what types of liquids you should drink each day.

Your provider may place you on a low-residue diet that limits the amount of roughage you eat. You need to eat enough protein and calories to keep your weight up. Ask your provider about liquid food supplements. These can help you get enough calories.

Do not take a laxative. Ask your provider about medicines to help with diarrhea or the need to urinate often.

You may feel tired after a few days. If so:

• Do not try to do too much in a day. You probably will not be able to do everything you are used to doing.
• Get more sleep at night. Rest during the day when you can.
• Take a few weeks off work, or work less.

Watch out for early signs of lymphedema (fluid buildup). Tell your provider if you have:

• Feelings of tightness in your leg, or your shoes or socks feel tight
• Weakness in your leg
• Pain, aching, or heaviness in your arm or leg
• Redness, swelling, or signs of infection

It is normal to have less interest in sex during and right after radiation treatments end. Your interest in sex will probably come back after your treatment is over and your life returns to normal.

Women who get radiation treatment in their pelvic areas may have shrinking or tightening of the vagina. Your provider will advise you about using a dilator, which can help gently stretch vaginal walls. You may also want to discuss hormone replacement therapy if you have menstrual changes from radiation or chemotherapy.

Your provider may check your blood counts regularly, especially if the radiation treatment area on your body is large.

Radiation of the pelvis - discharge; Cancer treatment - pelvic radiation; Prostate cancer - pelvic radiation; Ovarian cancer - pelvic radiation; Cervical cancer - pelvic radiation; Uterine cancer - pelvic radiation; Rectal cancer - pelvic radiation; Anal cancer - pelvic radiation; Vulvar cancer - pelvic radiation; Vaginal cancer - pelvic radiation

Doroshow JH. Approach to the patient with cancer. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 164.

Mitsis D, Beaupin LK, O'Connor T. Reproductive complications. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 43.

National Cancer Institute website. Radiation therapy and you: support for people with cancer. www.cancer.gov/publications/patient-education/radiation-therapy-and-you.pdf. Updated April 2021. Accessed June 3, 2024.

Updated by: David Herold, MD, Radiation Oncologist in Jupiter, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.