At the consultation visit before treatment begins, Dr. Wooten will talk to you about the side effects you may experience, how long they last and the severity. Please ask any questions you have about what to expect. Radiation therapy is highly targeted, so side effects are limited mostly limited to the area being treated. For example, your hair will not fall out unless the cancer is next to hair. The only exception is that most people experience some fatigue from treatments so it is important to maintain a healthy diet.
Side effects typically do not begin until after the first two weeks of treatments. You should notice gradual changes from week to week. It is not common to have big changes in symptoms day to day from radiation therapy. It is for this reason Dr. Wooten performs weekly treatment visits. It is possible to treat most symptoms when detected early in treatment. Side effects can occur because the cancer being treated is next to healthy organs, putting them at risk of receiving the radiation.
Make sure you tell your physician as soon as you experience symptoms. If you experience a side effect, the vast majority are manageable and go away soon after treatment. Until they resolve, make sure to discuss with Dr. Wooten and our team about any changes you notice so they can be treated. It is rare, but if a side effect is particularly severe, treatment may be stopped or delayed until you recover. Here are some common side effects to radiation:
This is the most common side effect during radiation. It is caused by the extra energy used by your body as it heals from therapy and cancer. Stress, weight loss and travel to and from radiation can also contribute. Like most symptoms fatigue begins typically around the third week of treatment and gets gradually worse week to week. Most people can continue to function normally. This tiredness typically resolves by the first follow up visit within 4 weeks of completing treatment. The best thing to do is to limit activities, rest often and get adequate sleep.
Skin irritation occurs when we are treating cancers that involve or are directly beneath the skin. If this happens, be careful not to irritate your skin. Do not apply anything that can irritate your skin. This includes alcohol based products, fragrant creams and most deodorants. Check with Dr. Wooten before applying anything into the treated areas. These reactions are worse in areas where the skin folds on itself. For example, during breast radiation the axilla (armpit) and under the breast have a worse reaction. These skin reactions occur gradually and will be managed and treated weekly. Typically you will notice an itching and/or redness/darkening of the skin during the third week of treatment. Some reactions are worse and require more aggressive therapy such as when we treat anal cancer, head and neck cancer and certain gynecologic cancers. Here are some additional basic tips to care for irritated skin during radiation:
- When you wash, use only lukewarm water and mild soap.
- Wear loose, soft cotton clothing over the treated area.
- Do not wear tight clothing over the treated skin (such as girdles, close fitting collars or wired bras).
- Do not rub, scrub or scratch any sensitive spots.
- Avoid putting anything very hot (like heating pads) or very cold (like ice packs) on the area we are treating.
- Your doctor or nurse will tell you if you can shave the treated skin. If approved, use only an electric shaver and do not use a pre-shave lotion, shaving cream, hair removal product, or aftershave.
- Do not use any soaps, medicines, cosmetics, powders, creams, perfumes, deodorants, body oils, ointments, lotions or home remedies on the treated area of skin during and for several weeks after your treatment unless your doctor or nurse approves. Many skin products can leave a coating on the skin that can interfere with radiation therapy or healing.
- Avoid using commercial mouthwash if you are being treated in the mouth and neck area.
- Avoid exposing the skin in the treatment area to the sun during radiation treatments and for at least one year after treatments are complete.
- Most skin reactions to radiation therapy should go away a few weeks after treatment has stopped. Occasionally, the treated skin will stay darker than it was before.
It is sometimes possible to have a decreased appetite and weight loss during therapy. This is especially true if treated for a cancer involving the bowels or if you are receiving chemotherapy with radiation therapy. It is important to maintain weight despite a loss in appetite to maintain energy and help with the healing process. This is done through proper nutrition. You may have to begin dietary supplements to increase fluid, carbohydrate and protein intake. If needed, you can consult with a nutritionist. Here are some tips for maintaining weight:
- Always follow any special diet that your doctor or dietician gives you.
- Eat whenever you are hungry — even if it is not mealtime.
- Eat 5-6 small meals during the day rather than three large ones.
- Moisten food with gravies or sauces to make eating easier.
- Eat and drink slowly.
- Avoid foods that are fried.
- Keep healthy snacks close by for nibbling when you get the urge.
- Vary your diet and try new recipes.
- Use soft lighting, quiet music, brightly colored table settings, or whatever helps you feel good while you eat.
- If you enjoy company while you eat, try to have meals with family or friends.
- Ask your doctor or nurse whether you can have a glass of wine or beer with you meal to increase your appetite.
Bowel symptoms, or gastrointestinal symptoms, vary depending on the type of cancer treated. For example, if being treated for prostate cancer men can experience loose and/or frequent stools several weeks into treatment. These can get gradually worse week-to-week and sometimes require diet modifications or over-the-counter medications. This is the reason we offer hydrogel spacers to our men being treated for prostate cancer. If being treated to the abdomen or pelvis, nausea can also be a problem. Nausea happens early in the course of treatment and is managed with medications prescribed by the physician. Worse side effects can occur but are rare.