Radiotherapy for ovarian cancer

Doctors don't often use radiotherapy to treat ovarian cancer. The main treatment is surgery, and most women will also have chemotherapy. But your doctor may suggest radiotherapy for

• Stage 1c or stage 2 cancers
• Advanced cancers that are causing symptoms

In Stage 1c and stage 2 ovarian cancer, you might have radiotherapy after surgery. This is to help kill off any cancer cells left behind and so lower the risk of the cancer coming back. Your doctor will only suggest this if there are very small deposits of cancer left in the area between your hips (your pelvis) and there is no sign of cancer in your tummy (abdomen).

For advanced ovarian cancer, your doctor may use radiotherapy to try to shrink tumours and reduce symptoms. This is called palliative radiotherapy.  You can have this treatment to any part of the body where the cancer is causing problems.

You have radiotherapy in the hospital radiotherapy department. If you have radiotherapy after surgery for early stage cancer, you usually have treatment once a day, from Monday to Friday, with a rest over the weekend. A course of treatment usually lasts for 3 or 4 weeks. For advanced ovarian cancer, you may have just a few radiotherapy treatments aimed at the area of the cancer.

Doctors plan radiotherapy very carefully. At your first visit you lie under a large machine called a simulator. The doctor uses this to work out where to aim your treatment so that it kills the most cancer cells and misses as much healthy body tissue as possible. You may have a small pinprick tattoo made on your skin.  The radiographers use this to line up the radiotherapy machine when you have your treatment. Sometimes more marks are made with felt pen. If so, you must be careful not to wash them off.

Each treatment only takes a few minutes. The radiographers will help position you on the couch and make sure you are comfortable. You will be left alone for the minute or two the machine is switched on. But the staff will be able to hear you through an intercom, so call if you need them.

The treatment does not hurt. You will not be able to feel it at all. You must lie very still for the few minutes it takes to treat you.

Having this type of radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

Radiotherapy to the tummy (abdomen) or area between the hips (the pelvis) usually causes a few side effects. These can be

• Short term side effects
• Long term side effects

Short term side effects

These can include

• Diarrhoea
• Irritable bladder (or radiation cystitis)
• Feeling sick

All these side effects usually disappear within a few weeks of finishing your treatment. Radiotherapy also causes tiredness for many people. The tiredness increases as you go through your treatment and continues for a few weeks after you have finished treatment.  If you have radiotherapy for symptoms (palliative radiotherapy) the side effects are likely to be very mild.

There is more about all these side effects in the section about the abdominal side effects of radiotherapy.

Long term side effects

These side effects can come on any time from a few months to several years after your treatment has finished. Normal tissues grow very slowly. So the effects of the radiation take a long time to show up. You may find you have

• Bowel changes
• To pass urine more often

Doctors can't usually tell who will be most at risk of side effects. Some people just seem to be more sensitive to radiation than others. Research work is going on to try to find a way of telling this in advance so that those people can have lower treament doses. Tell your doctor if you have had

• Bowel disease
• Previous surgery to the abdomen

as they may be able to take precautions to reduce your risk of side effects. If you are worried about long term side effects, you should certainly ask your doctor about the risks from your treatment.

Bowel changes

You may find you have diarrhoea or constipation. If you do, tell your radiotherapy doctor. Your problems will need to be investigated to make sure they are from your radiotherapy treatment. If they are, you may be able to take medicines to help regulate your bowels. You could also see a dietician to get some advice on how changes to your diet may help.

Passing urine more often

Radiotherapy can make your bladder less stretchy. So it won't hold as much urine as it used to and you will have to go to the toilet more often. Do tell your doctor who may be able to refer you to a nurse who specialises in continence problems. With help, you may be able to train your bladder so that you can pass urine a little less often.

The radiotherapy section gives more general information about this treatment including

• What it involves
• How your radiotherapy treatment is planned
• Possible side effects
• Radiotherapy for symptoms (palliative radiotherapy)