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Radiation Oncology | What to expect

Radiation therapy side effects
You may experience a sunburn effect

After a couple of weeks of treatment, you may start to notice a sunburn effect in the affected area.  The skin can get quite red, itchy and sore. You will have regular contact with the nursing staff, who will be able to provide some cream which you can use during the treatment. Using it from the beginning of treatment is beneficial, as it tends to prevent some degree of reaction.  Hair loss will occur only in the area being treated by radiation therapy.  Any hair lost from parts of the body in the treatment area will start to grow back a few months after the treatment has finished.

Throughout treatment, you will see the Radiation Oncologist once a week. This is a routine procedure and is to ensure that treatment is going smoothly and to address any issues you may have.  Some areas of the body experience worse side effect than others.  It is important to remember that upon completion of treatment, reactions have a tendency to get worse before they get better.  This is because the radiation has a cumulative effect, and actually continues to work for 10-14 days after treatment is finished.   The following list indicates some of the side effects that may occur in a particular area.

Side effects

The severity of side effects from radiation therapy varies from individual to individual. The following information is only a guide.Remember that side effects are related to the area being treated. For example having radiation therapy to your abdomen will not make the hair on your head fall out, or having treatment to your leg will not make you feel sick. The side effects discussed below are possible short term side effects .Long term side effects/concerns should be discussed with the Radiation Oncologist (RO) at the time of initial consultation.


Radiation therapy to this region may cause a dry cough and shortness of breath due to irritation to the normal lung tissue and air passages. Mild skin dryness and redness may also occur. Temporary chest pain may occur occasionally after the first treatment if a single dose is used.  Towards the end of treatment course you may notice some difficulty in swallowing and find it easier to take a soft or liquid diet. Care must be taken to avoid alcohol and spicy foods. Ensure fluid intake is maintained. Medical/nursing staff can prescribe medications to alleviate side-effect symptoms as necessary.

Radiation therapy to the breast is generally well tolerated.  There are some side effects, which are short term and easily managed.  Most women develop a skin reaction on the breast similar to mild sunburn.  This may progress to flaking or breakdown of the skin, particularly in the folds of skin such as under the breast.  The skin usually heals within two or three weeks of treatment being completed, though may appear tanned or discoloured for several months.  Many women feel tired during treatment.  This usually begins around the third week of treatment and may last for several months after treatment.   In the longer term, the breast may feel heavier and firmer especially in the first two years.  Your breast or chest may feel tender and a little swollen and you may experience some aches and pains.  This will eventually ease.

Radiation therapy may also be given to the lymph glands in the armpit as well as the breast.  Dose given to the lymph glands may increase your risk of developing arm swelling (lymphoedema) on the side being treated.   Your doctor will discuss this with you if your lymph glands need treatment.  The physiotherapist or occupational therapist can assist with the management of lymphoedema if it occurs.

Generally symptoms do not develop within the first two to three weeks of treatment. Because the prostate and the area of treatment is near the bladder some irritation of the bladder does occur. Symptoms that can develop are: needing to urinate more frequently; a burning sensation when passing urine. Diarrhoea can also occur with an increase in wind and stomach cramps. Severe and prolonged diarrhoea can lead to weight loss so please inform the nursing staff if these symptoms do occur so that appropriate medications can be given. The skin in the treatment area can become sore and irritated towards the end of the treatment course. We recommend you wear loose cotton underpants. Symptoms can be minimised by the taking of frequent salt baths. A bath full of warm water, with a cup of salt may be used.  Alternatively, a litre spray bottle with a teaspoon of salt is very handy.

Tiredness may be experienced by patients having treatment in this area.  Nausea and vomiting may be common, but can be relieved with medication taken 30 to 60 minutes prior to treatment.  A decreased appetite may occur, but it is important to maintain good nutrition during your treatment.  If you don't feel like eating, you may be able to replace meals with nutritious, high calorie drinks.  Speak with the oncology nursing staff if this is the case, and they will advise you on products available, and how to go about obtaining them. An appointment with the departmental dietitian can also be arranged.

This heading covers many different areas including eyes, nose, mouth, throat, and ears. To cover the treatment reactions for each specific cancer type under this category is an enormous task. So below we shall discuss the reactions for some of the most commonly occurring tumours in this area.

Larynx: Usually this treatment area is relatively small and confined to the neck/larynx area only. Generally symptoms do not develop within the first 2-3 weeks of treatment. It is common for your throat to start feeling rough/sore and you may feel like there is a "lump" there. This is normal. As the treatment course progresses you may have increased difficulty in swallowing food and liquids. This is to be expected at this stage and the symptoms can be alleviated with regular gargling. If you find that your throat is too sore to swallow food, please inform the nursing staff who can organise various remedies to allowing you to eat. Liquid painkillers can be given prior to eating so as to anaesthetise the throat to enable food/liquid intake. Remember to avoid hot and spicy foods, alcohol and smoking cigarettes, as all these factors can increase the severity of reactions. You may also notice a well defined red area developing on your neck. This again is normal. Specific creams can be administered to help with itching /soreness. Remember to avoid the area being exposed to the sun as this can worsen the reaction. Shaving should be limited to a "dry" electric shave .Avoid the use of aftershaves, colognes etc as these will increase the skin reactions.

Tongue: Development of a reaction is not expected within the first 2-3 weeks of treatment. Symptoms can start with dryness of the mouth, food tasting "strange" followed by loss of taste. It is important to pay attention to oral hygiene at this point ensuring gargling and brushing of teeth are done regularly (nursing staff will advise before treatment starts). As treatment continues the lining of the mouth may become very sore as the effects of the treatment build up. You may find it difficult to maintain your food intake as loss of taste and pain make the task of eating very difficult. Stick to bland, soft, mushy foods. If you find that your throat is too sore to swallow food, please inform the nursing staff who can organise various remedies to allowing you to eat. Liquid painkillers can be given prior to eating so as to anaesthetise the throat to enable food/liquid intake. Avoid hot and spicy food as well as alcohol and cigarettes. Decrease in eating can lead to weight loss. Appointments with our dietitians can be made. The dietitian can give advice on menu suggestions, food supplements and minimising weight loss.

All patients having radiotherapy to the head and neck area are routinely bookde in to see the Speech Pathologist and Dietitian on a weekly basis during their treatment.  If you have trouble swallowing, please advise your nurse who can refer you to the Speech Pathologist for specific advice on eating and drinking during your treatment.

 
 

After treatment

When you have finished your treatment, you will be given a discharge summary by the oncology nurses (to be given to your GP).  This will highlight the treatment that has been given, and the specific care requirements necessary for a full recovery.   Your Radiation Oncologist will issue a medical discharge report directly to your GP.   You will also be given a follow up appointment to see your Radiation Oncologist within four to six weeks.  The Oncology nurses will make a follow up phone call to you at home to ensure the recovery process is going smoothly.  Any questions at this point of the process should be directed to your GP, unless otherwise specified by the Radiation Oncology team.

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Last Updated: 01 January 2013
Last Reviewed: 01 January 2013