Are there any specific steps I can take to help prevent or manage the side effects, like dietary changes, activity...

Based on the provided guidelines, here are several evidence-based approaches to help manage side effects, with specific citations:

According to the NCCN Guidelines for Patients: Cervical Cancer (2024):

For Physical Side Effects:

• Pelvic floor physical therapy is specifically recommended to help with: • Bowel and bladder control issues • Sexual function • The guidelines note you can start this "2 to 4 weeks after radiation therapy" and continue as long as needed

For Vaginal Health:

• The guidelines specifically recommend: • Using water-based vaginal moisturizers daily • Vaginal dilator therapy after radiation (with doctor's guidance) • Vaginal estrogen cream or tablets may help with tissue thinning

For Bone Health:

• The guidelines note that radiation can weaken pelvic bones and recommend: • Bone density monitoring • Discussing bone strengthening strategies with your doctor

For Overall Health: The guidelines recommend:

• "Exercising at a moderate intensity for at least 150 minutes per week"
• "Eating a healthy diet that includes lots of plant-based foods"
• "Maintaining a healthy body weight"
• "Drinking little to no alcohol"
• Quitting smoking if applicable

Important Note: The guidelines emphasize that you should "talk to your doctor before starting a new exercise regimen" and that side effect management should be personalized to your specific situation.

For mental health and emotional impacts, the guidelines recommend:

• Being proactive in discussing mental health with your care team
• Seeking support from social workers at your treatment center who can connect you with mental health resources
• Considering professional counseling or support groups

Sources: NCCN Guidelines for Patients: Cervical Cancer (2024), pages 59-64, "Survivorship" section.