Pancreatic cancer: Understanding late effects of radiotherapy
Late side effects may happen a few months or years after treatment. They might happen once, carry on over the long term or come and go. Sometimes they cannot be cured, but there are often ways to make them easier to manage.
You might have late effects not listed here, because everyone is different. They may also be caused by a different part of your cancer treatment. It is not possible to predict if you will get them and when they might happen, which can be difficult to come to terms with. Research and support for late effects of radiotherapy is growing.
Joining a support group can be a positive way to share your experiences, feel less alone, and come to terms with the physical and emotional impact of treatment. Ask your clinical team if you need more support or have any late effects at all.
This page looks at late side effects.
How likely am I to get late side effects?
Before treatment you will discuss and sign a consent form with your clinical oncologist or therapeutic radiographer. They will tell you what to expect, and you can ask questions and discuss any concerns you have about late effects. It’s important to know what you are consenting to and can help to take someone with you.
You can read different radiotherapy consent forms (HERE) based on the specific area being treated. These consent forms are packed with useful information about early and late side effects.(1)
When you consent to treatment, you are saying you understand that you have a chance of getting late side effects. Your team will use words like Expected, Common, Less Common and Rare.
This table shows what these words mean.
| Wording on the consent form | % chance of side or late effect | How many patients will get this? |
|---|---|---|
| Expected | 50 to 100% | Between half and all patients |
| Common | 10 to 50% | Up to half of all patients |
| Less common | Less than 10% | Fewer than one in ten patients |
| Rare | Less than 1% | Fewer than one in 100 patients |
Possible late side effects
- High blood sugar or diabetes: If your pancreas (an organ that helps control blood sugar) doesn’t work well after treatment, it can cause high sugar levels, which might lead to diabetes.
- Digestive problems: If your pancreas isn’t working well, it can also cause loose bowel movements (diarrhea or watery poo) and problems digesting food.
- Malabsorption: You might have difficulty digesting or absorbing nutrients from food after treatment.
Less common and rare late effects
- Stomach or bowel issues: The stomach or intestines might get narrower causing a blockage, you may develop ulcers, which can sometimes bleed.
- Bowel perforation: This is less common and means a hole in your bowel. This is serious and will need to be treated, so if you have pain or notice any changes, contact your doctor or healthcare team.
- Reduced spleen function: This can lead to an increased risk of infection. The spleen can be affected by the radiation which can lower your immunity (ability to fight infection). If you have this late effect you may need vaccinations and long-term antibiotics to help.
- Cancer-related fatigue: You might find you still have fatigue after your treatment has finished. For some people this can go on for months or years.
- Skin changes: Sometimes, after radiation treatment, your skin might look different and even change colour. The skin in the treated area could look and feel different, and blood vessels might become more visible.
- Liver problems: Your liver might become inflamed or not work as well.
- Reduced kidney function: Radiotherapy may reduce kidney function over time if your kidneys are in, or near, the treatment area.
- Second Cancer: There is a very small chance that you could develop another type of cancer. This is rare, and depends on lots of different factors like age, area treated and radiation dose.
What can help with these late effects?
- Bowel health: Professional advice on what food and drink to have can help. So can medication. Speak to your treatment team about any bowel changes and watch for any signs of blockage.
- Keeping active: Gentle movement can help you feel better, both during and after treatment. Your treatment team can tell you what is safe for you to do.
- Monitoring rare side effects: Talk to your treatment team as soon as you notice any changes, this can help catch and treat any serious problems early.
- Managing cancer-related fatigue: Food and drink, keeping active, keeping a fatigue diary, medicine like steroids and physiotherapy may all be options for managing fatigue. Speak to your doctor or medical team for advice; and learn more about managing cancer-related fatigue.
- Drinking fluids: Drinking plenty of fluids such as water and squash can help with fatigue and tiredness caused by your treatment. You can try diluted juice if you don’t like water.
- Skin care: The skin in the treatment area will always be more sensitive to the sun. Always protect it by covering up and use a high factor sunblock.
- Alcohol use: Please follow the NHS guidelines on safe drinking levels and any instructions you get from your team on what is right for you, your diagnosis and your treatment. If in doubt, please ask your team.
- Stop smoking: If you are looking to stop or reduce smoking, there are services available to help you.
Always talk to your doctor or treatment team about any late effects you have. Even if they are not mentioned here. Everyone is different and experiences treatment differently. There may be ways they can help you reduce or manage symptoms.
Further information
Living with Pancreatic Cancer | Pancreatic Cancer Awareness | PCA
Support for you – Pancreatic Cancer UK
Support for patients and families • Radiotherapy UK
