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Managing Side Effects

ARE SIDE EFFECTS THE SAME FOR EVERYONE?

The extent of radiation therapy side effects varies from patient to patient. Some people have few or no side effects through their course of treatment. Very few have serious problems.

The side effects that you might have depend mostly on the treatment dose and what part of your body is treated. Your general health can also affect how your body reacts to radiotherapy. Some side effects can result from radiation to any treatment site; the most common ones are fatigue and skin reactions. Other side effects are related to treatment of specific areas, such as hair loss with treatment to the head.

Fortunately, most side effects will go away in time, and there are ways to reduce the discomfort they may cause. If you should have a side effect that is particularly severe, the Radiation Oncologist may prescribe a break in your treatments or change the kind of treatments you're having.

Tell your Radiation Oncologist of any side effects that you notice. He can help you with treatment measures and ways to prevent further occurrences. The information given here can serve as a guide to handling some side effects, but it cannot replace the discussion with the Radiation Oncologist.

WHAT CAUSES FATIGUE?

During radiation therapy, the body uses a lot of energy. Stress related to your illness, daily trips for treatment, the effects of radiation on normal cells - all may contribute to fatigue. Most people feel unusually tired after a few weeks of radiotherapy.

Feelings of weakness or weariness will gradually go away after your treatment is finished.

You can help yourself during radiation therapy by asking less of your body. If you feel tired, limit your activities and use your leisure time in a restful way. Do not feel that you have to do all the things you did before. Try to get more sleep at night and take naps during the day if you can.

If you have been working a full-time job and want to stay with it, by all means try to do so. Although treatment visits are time-consuming, you can ask your Therapist to try to schedule treatments with your workday in mind.

Some patients prefer to take a few weeks off from work while they're having radiation therapy. Others work a reduced number of hours. You should speak frankly with your employer about your needs and wishes during this time. You may be able to agree on a part-time schedule, or perhaps you can do some of your work at home.

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

HOW ARE SKIN PROBLEMS TREATED?

You are very likely to notice dry or itchy skin in any area getting radiation treatment. It is crucial that you do not rub, scrub or scratch sensitive spots. Don't try any powders, creams, salves, or other home remedies while you're being treated-or for several weeks afterward (unless approved by your Radiation Oncologist). Many over-the-counter products for the skin, such as lotions or petroleum jelly leave a coating that can interact with radiotherapy. Often Radiation Oncologists suggest using cornstarch if excess moisture is a problem.

You may develop a sunburned look-redness or tanning-and your skin may turn a shade darker than normal. You should avoid exposing treated areas to the sun both during and after treatment, and use sunblock.

The majority of skin reactions due to radiation therapy should go away a few weeks after treatment is finished. In some cases, though, darkened skin areas will remain. Tell your Radiation Oncologist if your skin cracks, blisters, or becomes too moist. Your Radiation Oncology team will also watch closely for symptoms that could mean a change in treatment is needed.

WHAT CAN BE DONE ABOUT HAIR LOSS?

If you have hair in the area being treated, you may lose some or all of it during radiotherapy. Most patients will find their hair growing back again after the treatments are finished, but the loss of hair-whether from scalp, face, or body-can be hard to adjust to.

You may want to cover your head with a hat, turban, or scarf while you're in treatment. Some people prefer a wig or toupee. A hairpiece that you need because of cancer treatment is a tax-deductible expense and may be covered by your health insurance. If you plan to buy a wig, it's a good idea to select it early in your therapy so that you have the option of matching the color and style to your own hair.

IS LOSS OF APPETITE A SERIOUS PROBLEM

You may lose interest in food during your course of radiation therapy. Depending on the part of the body treated, changes to normal cells may result in nausea, stomach pain, taste and swallowing difficulties, or other problems. Some people just don't feel like eating because of stress related to their illness and treatment.

Patients having external radiation therapy cannot afford weeks of poor nutrition. Even when your desire for food lags, it's important that you make every effort to keep your protein and calorie intake high. If you're not well nourished, you may not have all the strength you need for healing and rebuilding new tissues.

Try to keep in mind that your diet is one area in which you can control what's happening to your body. You might feel, at times, that your illness and its treatment are out of your hands, but you may improve the course of your therapy by feeding yourself well. Doctors have found that patients who eat well can better withstand both their cancer and the side effects of treatment.

WHAT EXTRA NUTRITION IS REQUIRED?

The importance of maintaining your weight during radiation therapy cannot be stressed enough. A number of side effects can cause problems with eating and digesting food, but you should always try to consume enough calories and protein to help damaged tissues rebuild themselves.

Some authorities say that during radiation therapy people may need extra protein and more calories. It is important to check your weight during treatment. Your Radiation Oncologist can tell you whether your specific treatment plan calls for special attention to diet.

If your appetite is poor, you may have to try new ways to spark it. When you do feel like eating, it's easy to pack in extra nutrients. A varied diet with ample portions is your best defense against the nutritional problems that can result during cancer treatment. A good multivitamin may be helpful.

WHAT IF EATING IS DIFFICULT?

Coping with short-term diet problems may be easier than you expect. There are a number of diet guides and recipe booklets available for patients who need help with nourishment.

If you're troubled by poor appetite or have pain when you chew and swallow, your Radiation Oncologist might advise you to use a powdered or liquid supplement. Many of these products, which you buy at drug stores without prescription, are made in a variety of flavors. They are tasty when used alone and can be chilled and combined with other foods, such as pureed fruit, or added to milk shakes.

WHAT IF PAIN IS A PROBLEM?

A small percentage of patients will need help to manage pain if it continues during or after radiation therapy. Some people need only a light medication. You should not use a heating pad or hot compresses to relieve pain in the area treated with radiation.

If you have severe pain, ask the Radiation Oncologist about prescribed drugs or other methods of relief. Be as specific as possible when telling the Radiation Oncologist about your pain so you can get the best treatment for it.