We say that there are “pros and cons” to any kind of treatment. Radiation therapy for cervical cancer can also have complications. There are many considerations before and after radiation therapy. Today, we will focus on the related issues. Did you know that prevention, observation and management of radiotherapy complications are a “constant battle”? The target area of radiotherapy for cervical cancer includes the uterus (the vaginal stump after surgery), a part of the vagina and the regional lymphatic drainage area. Therefore, radiotherapy complications mainly occur in the pelvic cavity, including damage to the bladder, rectum, small intestine and other tissues. The most common ones are gastrointestinal reactions, such as prolonged diarrhea, a feeling of urgency in the anus, wanting to poop but not being able to do so, constipation in individual patients, and, in the most severe cases, intestinal obstruction and intestinal fistula. Some post-radical surgery radiotherapy patients may develop leg swelling. The complications of radiotherapy for cervical cancer are also distant, some of them are irreversible and permanent damage, which are troublesome to deal with and can be prevented, and most of them appear six months or a year after the end of radiotherapy. Patients find it difficult to understand and consider it as medical malpractice. Doctors are also helpless and inevitably take the risk of complications in order to save lives. Since the medical community has not yet found a very effective method of prevention, we put more emphasis on follow-up after radiotherapy and on early response. Once an intestinal fistula develops, an artificial anus is needed for intestinal diversion. In addition, physicians should instruct patients to follow up regularly after treatment is completed and emphasize which symptoms predict recurrence and which are signs of complications. For example, rectal reactions after radiation therapy may appear six months to a year later and manifest as blood in the stool. Patients who run to the anorectal or surgical department for a colonoscopy can suffer a direct result of an intestinal fistula and have to have an artificial anus. That’s a shame. Did you know: drink more water and hold urine before radiotherapy First, we should advise patients to ensure that the positioning line of radiotherapy is clear, otherwise repeatedly drawing lines will lead to errors. Secondly, patients with external radiation should fill their bladders before radiotherapy, that is, drink more water and hold urine. This can lift up the small intestine and reduce the amount of its irradiation. Again, vaginal irrigation should be insisted upon after radiation is finished. Vaginal irrigation is not only for cleaning but also to ensure the vagina is open. If vaginal occlusion occurs, it is difficult to detect early once recurrence occurs; and with no lumen to implant the radiation source, the patient loses the opportunity for internal radiation therapy. Finally, I will do some individualized pretreatment for patients, which is what I have gained after summing up years of clinical experience. For example, radiotherapy for cervical cancer will cause some patients to vomit and have gastrointestinal discomfort. I encountered many such patients in the clinic, so I would give them some preventive medications to prevent vomiting to make them more comfortable during radiotherapy. In addition, radiation therapy will have a lasting effect. I will advise my patients to continue with some gastrointestinal protective medications after the radiotherapy is over. Patients are reminded to keep their skin and vagina dry, as well as to pay attention to hygiene and cleanliness to avoid or deal with inflammation as early as possible.