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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. Or you may have more
serious side effects. The side effects that you have depend
mostly on the treatment 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, ask your doctor
and nurse about the side effects you might experience, how
long they might last, and how serious they might be.
There are two main types of side effects: acute and chronic.
Acute, or short-term, side effects occur close to the time
of the treatment and usually are gone completely within a
few weeks of finishing therapy. Chronic, or long-term, side
effects may take months or years to develop and usually are
permanent.
The most common side effects are fatigue, skin changes,
and loss of appetite. 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.
Fortunately, most side effects will go away in time. In
the meantime, there are ways to reduce the discomfort they
cause. If you have a side effect that is particularly severe,
the doctor may prescribe a break in your treatments or change
the kind of treatment you're receiving.
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. This information can
serve as a guide to handling some side effects, but it cannot
replace talking with your health care team.
Not necessarily. It will depend on what side effects you
have and how severe they are. Many patients are able to go
to work, keep house, and enjoy leisure activities while they
are receiving radiation therapy. Others find that they need
more rest than usual and therefore cannot do as much. You
should try to do 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. Your desire for physical intimacy
may be lower because radiation therapy may cause you to feel
more tired than usual. For most patients, these feelings
are temporary.
During radiation therapy, the body uses a lot of energy
healing itself. Stress related to your illness, daily trips
for treatment, and the effects of radiation on normal cells
all may contribute to fatigue. Most people begin to feel
tired after a few weeks of radiation therapy. Feelings of
weakness or weariness will go away gradually after your treatment
is finished.
You can help yourself during radiation therapy by not trying
to do too much. 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 normally do. Try to get
more sleep at night, and rest during the day if you can.
If you have been working a full-time job, you may want to
continue. Although treatment visits are time consuming, you
can ask the radiation department to help by trying to schedule
treatments with your workday in mind.
Some patients prefer to take a few weeks off from work while
they're receiving radiation therapy; others work a reduced
number of hours. You may want to 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 work at home.
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.
You may notice that your skin in the treatment area may
begin to look reddened, irritated, sunburned, or tanned.
After a few weeks you may have very dry skin from the therapy.
Ask your doctor or nurse for advice on relieving 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 some suggestions on how you can keep these
areas dry.
During radiation therapy you will need to be very gentle
with the skin in the treatment area. Avoid irritating treated
skin. When you wash, use only lukewarm water and mild soap.
Don't wear tight clothing over the area. It's important not
to scrub, or scratch any sensitive spots. Also avoid putting
anything that is very hot or very cold, such as heating pads
or ice packs, on your treated skin. Don't use any powders,
creams, perfumes, deodorants, body oils, ointments, lotions,
or home remedies in the treatment area while you're being
treated or for several weeks afterward (unless approved by
your doctor or nurse) Many skin products can leave a coating
on the skin that can interfere with radiation therapy or
healing.
Avoid exposing the area to the sun during treatment and
for at least 1 year after your treatment is completed. 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
sun blocking lotions.
The majority of skin reactions to radiation therapy should
go away a few weeks after treatment is finished. In some
cases, though, the treated skin will remain darker than it
was before.
Radiation therapy can cause hair loss, also known as alopecia,
but only in the area being treated. For example, if you are
receiving treatment to your hip, you will not lose the hair
from your head. However, radiation to your head may cause
you to lose some or all of the hair on your scalp. Many patients
find that their hair grows back again after the treatments
are finished, but accepting the loss of hair--whether from
scalp, face, or body--can be a hard adjustment. The amount
of hair that grows back will depend on how much radiation
you receive and the type of radiation treatment your doctor
recommends. Other types of treatment, such as chemotherapy,
also can affect how your hair grows back.
Although your scalp may be tender after the hair is lost,
you may want to cover your head with a hat, turban, or scarf
while you're in treatment. Also, you should wear a protective
cap or scarf when you're in the sun. If you prefer a wig
or toupee, be sure the lining does not irritate your scalp.
A hairpiece that you need because of cancer treatment is
a tax-deductible expense and may be covered in part by your
health insurance. If you plan to buy a wig, it's a good idea
to select it early in your treatment so that you can match
the color and style to your own hair.
Sometimes radiation therapy can cause low white blood cell
counts or low levels of platelets. These blood cells help
your body fight infection and prevent bleeding. If your blood
tests show this side effect, your treatment might be delayed
for about a week to allow your blood counts to increase.
Many side effects can cause problems with eating and digesting
food, but you always should try to eat enough to help damaged
tissues rebuild themselves. It's very important not to lose
weight during radiation therapy. Try to eat small meals often
and eat a variety of different foods. Your doctor or nurse
can tell you whether your treatment calls for a special diet,
and a dietitian will have a lot of ideas to help you maintain
your weight.
Coping with short-term diet problems may be easier than
you expect. There are a number of diet guides and recipe
booklets for patients who need help with eating problems.
See link Eating Hints, for information on how to get more calories and
protein without eating more food and provides further tips
to help you enjoy eating. The recipes it contains can be
used for the whole family and are marked for people with
special concerns, such as low-salt diets.
If you have pain when you chew and swallow, your doctor
may advise you to use a powdered or liquid diet supplement.
Many of these products, available at the drugstore without
prescription, are made in a variety of flavors. They are
tasty when used alone, or they can be combined with other
foods, such as pureed fruit, or added to milkshakes. Some
of the companies that make diet supplements have produced
recipe booklets to help you increase your nutrient intake.
Ask your dietitian or pharmacist for further information.
You may lose interest in food during your treatment. Loss
of appetite can happen when changes occur in normal cells.
Some people just don't feel like eating because of stress
from their illness and treatment or because the treatment
changes the way foods taste. Even if you're not very hungry,
it's important that you make every effort to keep your protein
and calorie intake high. Doctors have found that patients
who eat well can better handle both their cancer and the
side effects of treatment.
The list below suggests ways to perk up
your appetite when it's poor and to make the most of it
when you do feel like eating.
- Eat
when you are hungry, even if it is not mealtime.
- Eat
several small meals during the day rather than three large
ones.
- Use
soft lighting, quiet music, brightly colored table settings,
or whatever helps you feel good while eating.
- Vary
your diet and try new recipes.
- If
you enjoy company while eating, try to have meals with
family or friends, or turn on the radio or television.
- Ask
your doctor or nurse whether you can have a glass of wine
or beer with your meal to increase your appetite. Keep
in mind that in some cases, alcohol may not be allowed
because of the chance that it will worsen the side effects
of treatment. This may be especially true if you are receiving
radiation therapy for cancer of the head or neck.
- When
you feel up to it, make some simple meals in batches and
freeze them to use later.
- Keep
healthy snacks close by for nibbling when you get the urge.
- If
other people offer to cook for you, let them. And don’t
be shy about telling them what you'd like to eat.
- If
you live alone, you might want to arrange for "Meals
on Wheels" to bring food to you. Ask your doctor,
nurse, local American Cancer Society office, or Cancer
Information Service about "Meals on Wheels." This
service is active in most large communities.
If
you are able to eat only small amounts of food, you can
increase the calories per serving by trying the following
ideas:
- Add
butter or margarine if you like the flavor.
- Mix
canned cream soups with milk or half-and-half rather than
water.
- Drink
eggnogs, milkshakes, or prepared liquid supplements between
meals.
- Add
cream sauce or melted cheese to your favorite vegetables.
Some people find they can handle large amounts
of liquids even when they don't feel like eating solid
foods. If this is the case for you, try to get the most
from each glassful by having drinks enriched with powdered
milk, yogurt honey, or prepared liquid supplements.
Nearly all patients who receive treatment
for cancer feel some degree of emotional upset. It's not
unusual to feel depressed, afraid, angry, frustrated, alone,
or helpless. Radiation therapy may affect the emotions
indirectly through fatigue or changes in hormone balance,
but the treatment itself is not a direct cause of mental
distress.
Many patients help themselves by talking
about their feelings with a close friend, family member,
chaplain, nurse, social worker, or psychologist with whom
they feel at ease. You may want to ask your doctor or nurse
about meditation or relaxation exercises that could help
you unwind and feel better.
American Cancer Society nationwide programs
can provide support. Groups such as the United Ostomy Association
and the Lost Chord Club offer opportunities to meet with
others who share the same problems and concerns. Some medical
centers have formed peer support groups so that patients
can meet to discuss their feelings and inspire each other.
There are several helpful books and other
materials on this subject. The Cancer Information Service
can direct you to reading matter and other resources in
your area.
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