Radiation Side Effects

This information will help you to manage the side effects you might experience while receiving radiation therapy to the specific areas on the body. Your radiation oncologists and nurses will provide you with additional information as needed.

Radiation to the Upper Abdomen

1. You will experience a change in appetite during radiation therapy. Eat foods easily digested, especially those that are bland and low in fat. Small meals more frequently are usually best. A dietitian is available if you need help with your diet.

2. You may be given an anti-nausea pill to be taken prior to your treatment. If you develop vomiting, abdominal cramping and/or diarrhea, inform your doctor, therapist or nurse. These symptoms can be controlled with medication and diet.

3. Lack of energy and fatigue are frequently experienced by patients receiving radiotherapy to the upper abdomen. Do not over exert yourself, and get plenty of rest during your treatment.

4. It is important you do not wash off your marks. After your therapy is completed, you might wash the marks off.

5. It is important to drink plenty of fluids during the course of your radiation treatments.

6. Many people experience some minor skin irritation from the radiation treatments. The area being treated might appear red, which in turn could change to a brown or tan appearance. It is important not to put any lotion or cream on the area unless told to do so by your physician.

Radiation to the head and neck

1. Dental visits and good oral care are important before, during and after your treatment. Brush your teeth with fluoride containing and plaque preventing toothpaste (Crest, Dentaguard, etc.) at least twice daily with a soft brush. Use dental floss in early morning and at night. Gargle your mouth with a solution of one teaspoon salt and one teaspoon of baking soda in a quart of water every half hour during waking hours.

2. If your mouth is being treated, do not wear dentures or removable dentures while under therapy except for eating.

3. After two or three weeks of treatment, your mouth or throat might become temporarily sore and irritated. Your doctor will prescribe a solution to relieve this irritation. Do not use commercial mouth rinses.

4. You will be given special dietary instruction.

5. Your weight will be recorded weekly. It is especially important you maintain your weight while you are being treated. Eat five or six meals a day of foods high in protein, such as meat, milk shakes, eggs and cheese. A dietitian is available for consultation. If weight cannot be maintained in these ways, feedings through a nasogastric or gastrostomy tube might be needed.

6. Early in your treatment, you might temporarily lose your sense of taste. Your saliva may become thick because of the effect of radiation on your salivary glands. If you experience a dry mouth, add sauces, gravies or other liquids to your food to make swallowing easier. Frequent sips of water might also help.

7. Do not wash off your marks while you are on treatment. After your treatments are completed you may wash them off.

8. It is important to drink plenty of fluids during the course of your radiation treatments.

9. Many people experience some minor skin irritation from the radiation treatments. The area being treated may appear red, which in turn might change to a brown or tan appearance. It is important not to put any lotion or cream on the area unless told to do so by your physician.

10. Your skin may peel or weep in the treated area. Should this happen, report it to the nurse or doctor and they will instruct you.

Radiation to the Lung and Esophagus

1. After two or three weeks of treatment, your throat and/or esophagus might become temporarily sore and irritated. You might notice foods or beverages are not as easy to swallow. Should this occur, notify your nurse or doctor and they will prescribe a solution you will take before meals and give you dietary instructions.

2. We will record your weight weekly. It is especially important you maintain your weight while being treated. Eat five or six meals a day of foods high in protein, such as meat, milkshakes, eggs and cheese. It is important you drink at least two quarts of liquid daily. A special high-protein, high-calorie drink is available. For addition information, a dietitian is available to help you with any problems.

3. Do not wash off your marks. After treatment is completed you may wash them off.

4. Many people experience some minor skin irritation from the radiation treatments. The area being treated might appear red, which in turn might change to a brown or tan appearance. It is important not to put any lotion or cream on the area unless told to do so by your physician.

Radiation to the breast
1. Simulation of your treatment portal might take an extended period of time. Plan on the simulation taking from one to two hours. It might be helpful to take a mild analgesic, such as Tylenol, aspirin or ibuprofen just prior to your appointment time.

2. Wear loose-fitting cotton clothing over the treatment area. You might, after a few weeks of treatment, need to stop wearing a bra. A man's cotton T-shirt is excellent if you need to wear something under your blouse.

3. Your skin might become very sensitive. At least a portion of your axilla will be in the treated area, therefore do not shave or use your normal deodorant under that arm. Do not apply any lotions, creams or powders unless instructed to do so by your physician or nurse. A special deodorant made for patients receiving treatment is available in the OMP pharmacy at BMH.

4. It is important you exercise your arm to prevent movement difficulties of the arm and shoulder.

5. It is essential you do not wash off your marks. Specific skin care instructions will be given to you.

6. The area being treated might become irritated and pink. The pink coloring of the skin (erythema) might then change to a brown or tan color. This is an expected side effect of treatment. Again, do not apply any creams, lotions or powders unless told to do so by your physician or nurse. It is important to avoid sun exposure in the area being treated. You should also avoid chlorinated water  found in swimming pools, hot tubs or whirlpools during your treatments. Saunas should also be avoided.

7. Occasionally, your skin may peel and weep, especially under the breast or in your axilla. This occurs more frequently in large-breasted women or during summer months. Should this happen, tell the doctor or nurse and they will instruct you.

Radiation to the Brain

1. Wash your hair only once a week with baby shampoo. Rinse hair well using lukewarm water.

2. You can get your hair wet between washings.

3. Do not use oils, lotions, sprays or other hair products.

4. Do not wear wigs or turbans while at home. You need to let your scalp breathe by exposing it to the air.

5. Protect your head from direct sunlight by wearing a hat or scarf.

6. Do not drive.

7. You will lose your hair in the area being treated. Your hair loss may be permanent.

8. Your scalp might become reddened, dry, itchy and scaly. If this happens, the nurse will give you gel to use on your scalp.

9. You might be started on medication (steroids) to decrease the swelling in your brain. If you are taking steroids during treatment, you will gradually be tapered off them after treatments are completed.

10. During your simulation appointment, a special soft breathable "mask" will be formed to help maintain the same treatment position each day. This is important so the exact treatment field will be maintained. It also eliminates the need for any skin markings on your head or face.

Radiation to the testis

1. To prevent irritation to the treated skin, wear loose-fitting cotton boxer shorts.

2. If you develop nausea, vomiting, diarrhea or urinary frequency, inform your doctor or nurse. These symptoms can be controlled with diet and medication.

3. Sexual activity can be continued throughout your radiation therapy, however you should take precautions to prevent impregnating your spouse/significant other during treatment and for at least one year after completion of treatment. It is possible these treatments could lead to sterility, depending on the area treated. Please discuss this with your doctor or nurse.

4. It is important you do not wash off your marks. After you have finished your series of treatments , you can wash them off. You will be given specific skin care instructions.

5. It is important to drink plenty of fluids during the course of your radiation treatments.

6. Many people experience some minor skin irritation from the radiation treatments. The area being treated might appear red, which in turn might change to a brown or tan appearance. It is important not to put any lotion or cream on the area unless told to do so by your physician.

Radiation to the prostate

1. Do not wash off your marks while you are on treatment. After you have completed treatment, you can wash them off. You will be given specific skin care instructions.

2. Periodic blood tests will be taken during your course of treatment, which will monitor your CBC (hemoglobin and white blood cell counts) and platelets. This does not include a PSA level. The PSA level will be obtained by your urologist after treatment has been completed.

3. After about two weeks of radiation therapy, you might develop diarrhea. Let the doctor or nurse know should you develop loose watery stools. You will be given diet instructions and medication at that time.

4. After approximately three to four weeks of radiation therapy, you might notice lower rectal discomfort, anal discomfort and/or hemorrhoidal irritation. Let us know if any of these symptoms develop so we can help relieve them.

5. To relieve the amount of pressure to the rectal area, do not sit for periods of longer than one hour without getting up and walking for at least two minutes.

6. After approximately three to four weeks of radiation therapy, you might find you need to urinate more frequently than normal. If this occurs, please let us know. You might even develop burning and discomfort while passing urine.

7. Sexual activity can be continued throughout your radiation therapy. You will not be radioactive , and there are no hazards to your partner from radioactivity or cancer.

8. Many people experience some minor skin irritation from the radiation treatments. The area being treated may appear red, which in turn might change to a brown or tan appearance. It is important not to put any lotion or cream on the area unless told to do so by your physician.

WHAT HAPPENS AFTER MY COURSE OF RADIATION IS OVER?

On the last day of treatment, you will meet with the radiation oncologist and registered nurse to review post-treatment care instructions. You will also be given an appointment for a follow-up visit (usually one month after completion). It is important you continue regular follow-up visits. If you have problems or questions after completion of treatment, call the numbers listed in your radiation therapy pamphlet.

Radiation to the breast

The skin reaction might increase for about one week after your final treatment, and then subside. You might want to wait one to two weeks after the completion of treatments before wearing your bra regularly.

Continue with the exercise routine you have been following during the course of treatments.

Continue to perform monthly breast self-exam. Instructions are available in the department.

Radiation to the prostate

You may gradually return to your normal diet over the next two to three weeks. If diarrhea continues to be a problem, stay on a low-residue diet and continue taking the medications the physician prescribed for treatment of diarrhea.

It is important in the future to avoid becoming constipated, as a constipated stool might damage the previously irradiated bowel. A mild stool softener can be taken orally. It is important not to take suppositories. A diet high in bulk, as well as adequate fluid intake, will be helpful.

Radiation to the testis

If needed, continue the medication prescribed for nausea or vomiting, and/or diarrhea. If these symptoms continue for more than one week from completion of treatment, notify your physician.

Perform self-examination of the scrotum and other testis at least once a month. Self-examination instructions will be provided.

Radiation to the lung or esophagus

Avoid tobacco use.

Maintain good nutrition, and avoid losing weight.

Avoid foods or beverages that irritate your throat or esophagus for about two weeks after the completion of treatment. If neccessary, blend your food and moisten it with sauces, creams and other liquids.

Radiation to the upper abdomen

1. You can gradually return to your normal diet over the next two to three weeks after treatment. If nausea and vomiting or diarrhea continue, stay on the bland diet and continue taking the medication the physician prescribed. These symptoms should stop in two to three weeks. Notify your physician if they persist.

2. Report to your physician or nurse any severe nausea and/or vomiting, abdominal pain or distention, tarry bowel movements or any other unusual problems you experience.

Radiation to the brain

1. Avoid injury to the treated area, such as cuts or bruises and protect against direct sun exposure. Wear a hat, or use a sunscreen of at least 30 SPF.

Radiation to the head or neck

1. Stop smoking permanently, and minimize alcohol consumption. Both are irritating to the mucous membranes.

2. Avoid wearing dentures (except for eating) until your physician informs you otherwise. About six months after treatment, have your dentures checked to see they fit properly. New dentures might be necessary. It is preferable to have a soft lining on the inside of the dentures. Please consult your dentist.

3. It is important you keep your mouth clean. Continue gargling with a salt and soda solution until healing has occurred (usually about two weeks). Report to your physician any ulcerations in your mouth in the area affected by your radiation treatments.

4. Men should continue to shave with an electric shaver and avoid pre-shave and after-shave lotions until the treated area has healed.

5. Avoid sharp, spicy, acidic foods and very hot or cold drinks for at least two weeks. If you need tooth extractions or other major dental work, consult your physician before work is done.

6. Routinely exercise your neck as instructed by the radiation oncologist to maintain flexibility and prevent stiffening of the muscles.