Defining the mechanisms underlying Pelvic Radiotherapy Related Insufficiency Fractures

Radiotherapy is a type of cancer treatment using radiation. Every year, over 30,000 patients in the UK get this treatment for cancers in the pelvis, such as prostate, womb, bowel cancer. The good news is more people are surviving cancer because we are finding it early and treating it better.
But there is a problem. Cancer treatments, including radiotherapy, cause long-term health problems, which can be tough on patients and the NHS. Sometimes radiotherapy damages people's bones making them crack or break. This condition is called Radiotherapy-Related Insufficiency Fractures (RRIFs) and usually happens between 3 months and 3 years after radiotherapy. RRIFs can be very painful, make it hard for people to move around and reduce the quality of life.
We are not sure why RRIFs happen. We thought that radiotherapy causes osteoporosis (thinning of the bone) in the pelvis, making them easily breakable. However, I found that even people without bone thinning can get these fractures. Therefore, we need to dig deeper.
To understand why bones break after radiation, we have to study bones that have been treated with radiotherapy. But taking samples from people is risky because their bones are fragile. So, we use mice for our studies. Mouse bones work a lot like human bones, so they are a good model for our tests. Previous studies have tested radiotherapy on long bones, like the thigh bone. However, the structure of the pelvis is very different, and I believe that radiotherapy may have different effects there. My early research showed this might be true.
For this reason, I will study the impact of radiotherapy on the pelvis of mice in more detail. I will use a special machine that gives radiotherapy to mice in a similar way to that in humans. I will study the mouse bones at different times after treatment to see how they change and what makes them more fragile and prone to breaks. I will also check the effect of chemotherapy in addition to radiotherapy on bone, for the first...