Radiation Therapy : Managing Side Effects

by National Cancer Institute

(Page 5 of 9)

Are Side Effects the Same for Everyone?

The side effects of radiation treatment vary from patient to patient. You may have no side effects or only a few mild ones through your course of treatment. Some people do experience serious side effects, however. The side effects that you have depend mostly on the radiation dose and the part of your body that is treated. Your general health also can affect how your body reacts to radiation therapy and whether you have side effects. Before beginning your treatment, your doctor and nurse will discuss the side effects you might experience, how long they might last, and how serious they might be.

Side effects may be acute or chronic. Acute side effects are sometimes referred to as "early side effects." They occur soon after the treatment begins and usually are gone within a few weeks of finishing therapy. Chronic side effects, sometimes called "late side effects," may take months or years to develop and usually are permanent.

The most common early side effects of radiation therapy are fatigue and skin changes. They can result from radiation to any treatment site. Other side effects are related to treatment of specific areas. For example, temporary or permanent hair loss may be a side effect of radiation treatment to the head. Appetite can be altered if treatment affects the mouth, stomach, or intestine. This chapter discusses common side effects first. Then the side effects that involve specific areas of the body are described.

Fortunately, most side effects will go away in time. In the meantime, there are ways to reduce discomfort. If you have a side effect that is especially severe, the doctor may prescribe a break in your treatments or change your treatment in some way.

Be sure to tell your doctor, nurse, or radiation therapist about any side effects that you notice. They can help you treat the problems and tell you how to lessen the chances that the side effects will come back. The information discussed here can serve as a guide to handling some side effects, but it cannot take the place of talking with the members of your health care team.

Will Side Effects Limit My Activity?

Not necessarily. It will depend on which side effects you have and how severe they are. Many patients are able to work, prepare meals, and enjoy their usual leisure activities while they are having radiation therapy. Others find that they need more rest than usual and therefore cannot do as much. Try to continue doing the things you enjoy as long as you don't become too tired.

Your doctor may suggest that you limit activities that might irritate the area being treated. In most cases, you can have sexual relations if you wish. You may find that your desire for physical intimacy is lower because radiation therapy may cause you to feel more tired than usual. For most patients, these feelings are temporary.

What Causes Fatigue?

Fatigue, feeling tired and lacking energy, is the most common symptom reported by cancer patients. The exact cause is not always known. It may be due to the disease itself or to treatment. It may also result from lowered blood counts, lack of sleep, pain, and poor appetite.

Most people begin to feel tired after a few weeks of radiation therapy. During radiation therapy, the body uses a lot of energy for healing. You also may be tired because of stress related to your illness, daily trips for treatment, and the effects of radiation on normal cells. Feelings of weakness or weariness will go away gradually after your treatment has been completed.

You can help yourself during radiation therapy by not trying to do too much. If you do feel tired, limit your activities and use your leisure time in a restful way. Save your energy for doing the things that you feel are most important. Do not feel that you have to do everything you normally do. Try to get more sleep at night, and plan your day so that you have time to rest if you need it. Several short naps or breaks may be more helpful than a long rest period.

Sometimes, light exercise such as walking may combat fatigue. Talk with your doctor or nurse about how much exercise you may do while you are having therapy. Talking with other cancer patients in a support group may also help you learn how to deal with fatigue.

If you have a full-time job, you may want to try to continue to work your normal schedule. However, some patients prefer to take time off while they're receiving radiation therapy; others work a reduced number of hours. Speak frankly with your employer about your needs and wishes during this time. A part-time schedule may be possible or perhaps you can do some work at home. Ask your doctor's office or the radiation therapy department to help by trying to schedule treatments with your workday in mind.

Whether you're going to work or not, it's a good idea to ask family members or friends to help with daily chores, shopping, child care, housework, or driving. Neighbors may be able to help by picking up groceries for you when they do their own shopping. You also could ask someone to drive you to and from your treatment visits to help conserve your energy.

How Are Skin Problems Treated?

You may notice that your skin in the treatment area is red or irritated. It may look as if it is sunburned, or tanned. After a few weeks your skin may be very dry from the therapy. Ask your doctor or nurse for advice on how to relieve itching or discomfort.

With some kinds of radiation therapy, treated skin may develop a "moist reaction," especially in areas where there are skin folds. When this happens, the skin is wet and it may become very sore. It's important to notify your doctor or nurse if your skin develops a moist reaction. They can give you suggestions on how to care for these areas and prevent them from becoming infected. Other tips on skin care can be found in the section on external radiation therapy.

During radiation therapy you will need to be very gentle with the skin in the treatment area. The following suggestions may be helpful:

• Avoid irritating treated skin.
• When you wash, use only lukewarm water and mild soap; pat dry.
• Do not wear tight clothing over the area.
• Do not rub, scrub, or scratch the skin in the treatment area.
• Avoid putting anything that is hot or cold, such as heating pads or ice packs, on your treated skin.
• Ask your doctor or nurse to recommend skin care products that will not cause skin irritation. Do not use any powders, creams, perfumes, deodorants, body oils, ointments, lotions, or home remedies in the treatment area while you're being treated and for several weeks afterward unless approved by your doctor or nurse.
• Do not apply any skin lotions within 2 hours of a treatment.
• Avoid exposing the radiated area to the sun during treatment. If you expect to be in the sun for more than a few minutes you will need to be very careful. Wear protective clothing (such as a hat with a broad brim and a shirt with long sleeves) and use a sunscreen. Ask your doctor or nurse about using sunblocking lotions. After your treatment is over, ask your doctor or nurse how long you should continue to take extra precautions in the sun.

The majority of skin reactions to radiation therapy go away a few weeks after treatment is completed. In some cases, though, the treated skin will remain slightly darker than it was before and it may continue to be more sensitive to sun exposure.

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