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RADIOTHERAPY LATE EFFECTS
What are late effects of radiotherapy?
Radiotherapy late effects can occur many months or even years after completing radiotherapy for cancer . They may happen once, persist long-term, or come and go. While some side effects may not be curable, it might be possible to manage them.
Everyone is different, and you may experience a late effect that is not listed here. It is not possible to predict if or when you will experience them.
Types of side effects
Radiotherapy can cause side effects that are different for each person. These are:
- Early/short-term side effects – These happen during or soon after radiotherapy. They usually go away within 2 to 6 months
- Late/long-term side effects – These can appear many months or years later. They may be permanent
It is important to remember that the side effects of radiotherapy only affect the area that is being or has been treated.
The frequency or likelihood of experiencing late effects is approximate and can be explained in the following way:
- Definite (100%, this means 100 out of 100 people will experience this): This is a side effect that will affect everyone who has radiotherapy.
- Expected (50 - 100%, this means over 50 out of 100 people will experience this): It is anticipated that more than half of patients who have radiotherapy are expected to experience these side effects.
- Common (10 - 50%, this means up to 50 out of 100 people will experience this): It is anticipated that up to half of patients who have radiotherapy will experience these side effects.
- Less common (Less than 10%, this means less than 10 out of 100 people will experience this): It is anticipated that fewer than 10 in 100 patients who have radiotherapy will experience these side effects.
- Rare (Less than 1%, this means less than 1 person out of 100 people will experience this) It is anticipated that less than 1 out of 100 patients who have radiotherapy will experience these side effects.
The Royal College of Radiologists National Radiotherapy Consent Forms are used to help people understand the types of side effects and how common they are:
Sources of support for late effects of radiotherapy
This page gives information about support for people who have late effects (late or long-term side effects) from radiotherapy.
More people are living longer after cancer treatment. We now know more about how radiotherapy can affect the body over time. These late or long-term effects can appear months or years after treatment. While support is still limited, more services are becoming available as we learn more about late effects of radiotherapy.
How this information can help
This page gives a guide to support and information for late effects. Everyone's experience is different, but these services may help. This information includes:
- Videos about late effects
- Information by symptom and by the part of the body treated
- Links to support services
- Self-help tools
- Ways to talk to others with similar experiences
This is a guide to current support and information for radiotherapy late effects. While every patient’s experience is unique, the services mentioned should provide you with some general support. Always follow the specific instructions provided by your clinical team. This leaflet is for general information purposes only. If you are experiencing any symptoms that have not been discussed with your clinical team, please seek their advice.
Radiotherapy UK have produced a video on Frequently Asked Questions about late effects, you can access it here: VIDEO: Late effects - your questions answered Radiotherapy UK.
Webinar about late effects
This webinar produced by the East of England Cancer Alliance looks at possible late effects following completion of cancer treatment. It features The East of England Radiotherapy Late Effects Service Lead, Lara Anthony. You can watch it here.
Support by symptom (A-Z)
Chronic pain
- Live Well with Pain
- Pain Concern UK
- Pain UK
- SHOUT support - A free, confidential, 24/7 text support service for anyone in the UK who is struggling to cope
- The British Pain Society
- The Pain Toolkit - A self-management tool for people who live with lasting pain
Fatigue and tiredness
- Bath Centre for Fatigue - Follow the link to view the referral criteria and to make a self-referral
- Cancer Research UK - Useful Information about managing fatigue
Heart problems
Lung changes
Lymphoedema
Menopause
Nerve problems
Pelvic late effects (Radiotherapy for cancers of the: colon, rectum, anus, prostate, testes, bladder, cervix and womb, total body radiotherapy and radiotherapy in the pelvic area for other cancers).
- Guts Charity, Helpline team: 03001024887
- Macmillan: Pelvic insufficiency fractures
- Macmillan: Pelvic late effects
- Menopause and Cancer
- Pelvic Radiation Disease Association
Sex and intimacy
- Cancer Research UK: Sexuality and sex life
- Information specifically for LGBTQI+ people
- Macmillan: Sex life and relationships
- Fruitfly Collective: Pleasure & Intimacy: A Guide for people living with cancer
- Prostate Cancer UK: Sex and relationships
- Life after Cancer: Sex lives and intimacy after cancer (video)
Skin changes
- Changing faces - A support and information line, and support with skin camouflage. Available to everyone with a scar, mark or condition on their face or body. Tel: 0300 012 0275
Skeletal problems
Support by part of the body treated
Bladder
Bowel ·
Brain ·
Breast ·
- Breast Cancer Now: Life after treatment - Nurse helpline: 0808 800 6000
- Radiotherapy UK: Understanding late effects of radiotherapy for breast cancer
Head and neck·
- Changing faces - A support and information line and support with skin camouflage, available to everyone with a scar, mark or condition on their face or body. Tel: 0300 012 0275
- Radiotherapy UK: Understanding late effects of radiotherapy for head and neck cancer
- Salivary Gland Cancer UK: Radiotherapy treatment and late effects
- The Mouth Cancer Foundation – Support includes an online support group and Facebook group
Liver·
- British Liver Trust
- Radiotherapy UK: Understanding the late effects of radiotherapy for liver cancer
Lung·
Oesophagus (food pipe)
Pancreas·
Prostate ·
- Prostate Cancer Research: Late effects of radiotherapy treatment·
- Radiotherapy UK: Understanding the late effects of radiotherapy for prostate cancer
Stomach
General help
- Macmillan: Cancer information and support - Call: 0808 808 0000
- Maggie’s: Information and support – Call: 0300 123 1801
- Life after Cancer
- NHS talking therapies for anxiety and depression – Free treatments delivered by fully trained and accredited NHS practitioners. They can help if you're struggling with things like feelings of depression, excessive worry, social anxiety or post-traumatic stress disorder (PTSD).
- SHOUT - A free, confidential, 24/7 text support service for anyone in the UK who is struggling to cope. Text the word ‘Shout’ to 85258.
We love feedback!
This page is part of our commitment to improving the support available to people living with the late effects of radiotherapy. If you’ve found this information helpful, or if you think something could be improved, we’d really appreciate your feedback.
Please fill out our feedback form by clicking on the link below.
Remember
This page offers general information only. If you have any symptoms that have not been discussed with your clinical team, or if you are unsure about any aspect of your care, please speak to your clinical team.
This information was correct as of September 2025 and will be reviewed in September 2026
LATE EFFECTS OF RADIOTHERAPY FOR BREAST CANCER
Expected (50-100%)
Breastfeeding: After breast radiotherapy (and/ or surgery), you may not produce milk in that breast, but the other breast will not be affected.
Common (10-50%)
Skin colour change in the treatment area: Lighter or darker for any skin tone.
Subtle changes to breast appearance: Change to breast size, shape, and texture.
Breast/ chest wall/ axilla discomfort: Aching and shooting pains.
Worsened cosmetic outcome after reconstruction surgery: Which may require the implant to be replaced.
Less common (less than 10%)
Marked change to breast appearance: Change to breast size, shape, and texture. Breast/chest wall swelling.
Shoulder stiffness.
Swelling (lymphoedema) of the arm fluid collecting in the arm which may cause swelling, pain, and/ or movement difficulties.
Rare (less than 1%)
Skin changes (telangiectasia) in the treatment area: Small visible blood vessels which look like spidery marks.
Rib fracture.
Fibrosis (scarring) of the underlying lung: Which can cause breathlessness, cough, or changes on X-ray.
Increased risk of heart disease in later life.
Brachial plexopathy: Nerve damage which may cause pain, numbness, or tingling affecting the arm and shoulder.
A different cancer in the treatment area.
LATE EFFECTS OF RADIOTHERAPY FOR GYNAECOLOGICAL CANCER
Definite (100%)
Early menopause: Symptoms of this may start during or shortly after radiotherapy.
Egg and hormone production will stop.
Infertility: You will be unable to carry a pregnancy in the uterus (womb) after radiotherapy.
Expected (50-100%)
Vaginal narrowing, shortening or dryness: This may impact vaginal intercourse and the comfort and quality of a vaginal examination.
Common (10-50%)
Urinary frequency (passing urine more often than normal) and urgency (a sudden urge to pass urine).
Urinary incontinence including urine leaking when coughing or straining.
Bowel frequency (opening your bowels more often than normal) and urgency (a sudden urge to open your bowels).
Looser stools compared to normal.
Asymptomatic pelvic bone fractures, particularly when post-menopausal.
If you received radiotherapy to the lower pelvis/ vulva, there may also be the following late effects:
* Hair loss in treatment area.
* Lymphoedema (fluid build-up) in your legs or pubic area.
* Skin thickening or discoloration: Lighter or darker for any skin tone, or visible blood vessels.
* Skin thinning.
Less common (less than 10%)
Cystitis/ pain when you urinate.
Reduced bladder capacity.
Rectal pain/ discomfort which may worsen on opening your bowels. This may also affect your sex life if you receive anal sex.
Faecal discharge/ soiling.
Bleeding from your bladder, bowel, or vagina
Bowel/ bladder damage which may require surgery due to stricture (narrowing), fistula (abnormal connection between two parts of your body), and may require stoma formation.
Duodenal ulceration.
Symptomatic pelvic bone fractures, particularly when post-menopausal
Kidney impairment.
Malabsorption problems with nutrient absorption.
Hair loss in treatment area.
Lymphoedema (fluid build-up) in your legs or pubic area.
Rare (less than 1%)
Skin thickening or discoloration: Lighter, darker, or visible blood vessels.
Ureteric strictures narrowing of tubes running from kidneys and bladder.
A different cancer in the treatment area.
Radiation induced nerve damage in the lower back area.
LATE EFFECTS OF RADIOTHERAPY FOR HEAD AND NECK CANCER
Expected (50-100%)
Skin colour change in the treatment area: Usually lighter or darker for any skin tone. Lymphoedema: Skin, chin, and soft tissue swelling.
Dry mouth.
Altered taste or loss of taste with possibility of some recovery over 18 months.
Hair loss in the treatment area or patchy re-growth.
Common (10-50%)
Permanent skin texture changes in treatment area: Thicker or thinner skin.
Telangiectasia in the treatment area: Small visible blood vessels which look like spidery marks.
Dental problems.
Trismus jaw stiffness.
Voice changes.
Hypothyroidism: Under-active thyroid gland, which may require you to take medication. Hair loss in the treatment area or patchy re-growth.
Permanent dryness of nose.
Nasal crusting.
Dry mouth.
Altered taste or loss of taste with possibility of some recovery over 18 months.
Cataract clouding in the lens of the eye: Which may require surgery to correct.
Less common (less than 10%)
Dry eye.
Visual changes and damage to the eye.
Nasal regurgitation/reflux.
Loss of smell Hearing loss or hearing changes.
Dental problems.
Trismus jaw stiffness.
Voice changes.
Osteoradionecrosis of the jaw: Damage to the jawbone.
Swallowing problems with risk of long-term/permanent feeding tube requirement. Laryngeal chondronecrosis: Irreversible damage to the voice box.
Increased risk of stroke.
Pituitary dysfunction: Your pituitary gland not producing enough hormones, this may require you to take medication to replace the hormones.
Osteoradionecrosis of the jaw: Damage to the jawbone.
Rare (less than 1%)
Permanent changes to brainstem, spinal cord and nerves to the face, arm or hand. Radionecrosis of the brain: Damage to a small area of the brain which is not repairable
A different cancer in the treatment area.
Risk to life.
LATE-EFFECTS OF RADIOTHERAPY FOR PROSTATE CANCER
Expected (50-100%)
Infertility: Radiotherapy will affect your fertility. At consent, plans for having children and management options will be discussed.
Common (10-50%)
Urinary daytime/night-time frequency - passing urine more often than normal.
Urinary urgency a sudden urge to pass urine.
Bowel urgency a sudden urge to open your bowels.
Looser stools with more mucous or wind compared to normal.
Changes in ejaculate such as reduced amount, dry, altered consistency or blood stained. Loss of orgasm.
Change to penile length/appearance Inability to achieve an erection.
Less common (less than 10%)
Cystitis/ pain when you urinate due to bladder inflammation.
Incomplete emptying of your bladder or reduced bladder capacity.
Urinary stricture a narrowing in your water pipe which may require surgery.
Bowel frequency opening your bowels more often than normal.
Inflammation of the rectum which may cause pain when opening your bowels. This may also affect your sex life if you receive anal sex.
Bleeding from your bladder or bowel Intermittent abdominal discomfort.
Rare (less than 1%)
Urinary incontinence including urine leaking.
Pelvis/hip bone thinning and/or fractures.
Bowel/bladder damage which may require surgery due to perforation (hole), fistula (abnormal connection between two parts of your body), bowel obstruction (blockage), or severe bleeding.
An increased risk of a different cancer in the treatment area.
If you received radiotherapy to your pelvic lymph nodes:
* Lymphoedema: fluid build-up in your legs and potentially your scrotum.
* Malabsorption: problems with nutrient absorption.
* Neuropathy: damage to nerves which could cause pain, numbness or weakness in your legs.
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