What are the reactions after radiotherapy for cervical cancer?

  Radiation therapy is applicable to all stages of cervical cancer, including vaginal retrofit therapy and pelvic external irradiation. Since the site of the cervix is in front of the bladder and near the rectum at the back, while radiation kills cancer cells, it also damages normal tissues to a certain extent. Tissue congestion, edema and ulceration may occur, and in serious cases, necrosis and detachment may occur. Fibrous tissue proliferation occurs in the late stage, causing organ stenosis. These reactions may occur during or after radiation therapy. Generally common radiation reactions are such as weakness, loss of appetite, bowel movements, and frequent urination. Some patients may experience increased stool frequency, which can be relieved with symptomatic treatment. A small number of patients may experience anal drop during stool, mucus and blood stool, urinary frequency, urinary urgency, and blood picture such as decreased portal cells or decreased platelets. The treatment is firstly preventive, with proper control of the radiotherapy plan, such as avoiding improper placement of the uterine cavity tube or dislodgement into the vagina resulting in excessive local radiation and tissue burned and causing fistulae. If symptoms such as hematuria and blood in the stool have already appeared. (1) Recent cystitis or proctitis is mainly treated symptomatically by drinking a lot of water, giving antiemetics, antidiarrheal agents and antibiotics, which usually heal on their own.  (2) Late urological complications are most common with radiation cystitis, with an incidence of 2% to 10%, vesicovaginal fistula with an incidence of 1% to 3%, and ureteral obstruction due to pelvic fibrosis in some patients with varying degrees of renal dysfunction. Late radiation cystitis is most common with blood in the urine, often manifesting as sudden hematuria, often with exertion. If the bladder is filled with blood vessels of the bladder mucosa, which is not elastic after radiation therapy, it can be improved by symptomatic treatment, such as drinking a lot of water, eating more vegetables, taking antispasmodic drugs and antibiotics, etc. A few severe cases can be treated with intravenous antibiotics and hemostatic drugs. Or use bladder irrigation, often can play a better role in stopping bleeding.  (3) Late intestinal complications include radiation proctitis, sigmoid colitis, rectovaginal fistula, intestinal adhesions, intestinal obstruction, intestinal perforation and so on. They are classified as mild, moderate and severe according to the degree. The mild degree is mainly a small amount of blood in the stool; the moderate degree is repeatedly a large amount of blood and mucus stool with urgency; the severe degree is more serious until the development of intestinal ulcers, strictures, intestinal fistula and so on. In mild cases, no special treatment is needed; in moderate cases, anti-inflammatory, hemostatic and antispasmodic drugs are used, such as oral antibiotics; in severe cases, 10% epinephrine can be added to the enema solution to quickly stop the bleeding. Transverse colostomy is feasible for vaginal rectal fistula or severe intestinal ulceration, stricture, resulting in intestinal obstruction and severe bleeding.