Radiation therapy may vary somewhat among different doctors, hospitals, and treatment centers. Therefore, your treatment or the advice of your doctor (the radiation oncologist) may be different from what you read here. Be sure to ask questions and discuss your concerns with your doctor, nurse, or radiation therapist. Ask whether they have any additional written information that might help you.
The goal of radiation therapy is to kill the cancer cells with as little risk as possible to normal cells. Radiation therapy can be used to treat many kinds of cancer in almost any part of the body. In fact, more than half of all people with cancer are treated with some form of radiation. For many cancer patients, radiation is the only kind of treatment they need. Thousands of people who have had radiation therapy alone or in combination with other types of cancer treatment are free of cancer.
-Ask your doctor or nurse if you may use soaps, lotions, deodorants, sun blocks, medicines, perfumes, cosmetics, talcum powder, or other substances in the treated area.
-Wear loose, soft cotton clothing over the treated area.
-Do not wear starched or stiff clothing over the treated area.
-Do not scratch, rub, or scrub treated skin.
-Do not use adhesive tape on treated skin. If bandaging is necessary, use paper tape and apply it outside of the treatment area. Your nurse can help you place dressings so that you can avoid irritating the treated area.
-Do not apply heat or cold (heating pad, ice pack, etc.) to the treated area. Use only lukewarm water for bathing the area.
-Use an electric shaver if you must shave the treated area but only after checking with your doctor or nurse. Do not use a preshave lotion or hair removal products on the treated area.
-Protect the treatment area from the sun. Do not apply sunscreens just before a radiation treatment. If possible, cover treated skin (with light clothing) before going outside.
-Ask your doctor if you should use a sunscreen or a sunblocking product. If so, select one with a protection factor of at least 15 and reapply it often. Ask your doctor or nurse how long after your treatments are completed you should continue to protect the treated skin from sunlight.
INTERNAL RADIATION THERAPY: WHAT TO EXPECT
When Is Internal Radiation Therapy Used?
Your doctor may decide that a high dose of radiation given to a small area of your body is the best way to treat your cancer. Internal radiation therapy allows the doctor to give a higher total dose of radiation in a shorter time than is possible with external treatment.
Internal radiation therapy places the radiation source as close as possible to the cancer cells. Instead of using a large radiation machine, the radioactive material, sealed in a thin wire, catheter, or tube (implant), is placed directly into the affected tissue. This method of treatment concentrates the radiation on the cancer cells and lessens radiation damage to some of the normal tissue near the cancer. Some of the radioactive substances used for internal radiation treatment include cesium, iridium, iodine, phosphorus, and palladium.
Internal radiation therapy may be used for cancers of the head and neck, breast, uterus, thyroid, cervix, and prostate. Your doctor may suggest using both internal and external radiation therapy.
In this outline, 'internal radiation treatment' refers to implant radiation. Health professionals prefer to use the term "brachytherapy" for implant radiation therapy. You may hear your doctor or nurse use the terms, interstitial radiation or intracavitary radiation ; each is a form of internal radiation therapy. Sometimes radioactive implants are called "capsules" or "seeds."
How Is the Implant Placed in the Body?
The type of implant and the method of placing it depend on the size and location of the cancer. Implants may be put right into the tumor (interstitial radiation), in special applicators inside a body cavity (intracavitary radiation) or passage (intraluminal radiation), on the surface of a tumor, or in the area from which the tumor has been removed. Implants may be removed after a short time or left in place permanently. If they are to be left in place, the radioactive substance used will lose radiation quickly and become non-radioactive in a short time.
When interstitial radiation is given, the radiation source is placed in the tumor in catheters, seeds, or capsules. When intracavitary radiation is used, a container or applicator of radioactive material is placed in a body cavity such as the uterus. In surface brachytherapy the radioactive source is sealed in a small holder and placed in or against the tumor. In intraluminal brachytherapy the radioactive source is placed in a body lumen or tube, such as the bronchus or esophagus.
Internal radiation also may be given by injecting a solution of radioactive substance into the bloodstream or a body cavity. This form of radiation therapy may be called unsealed internal radiation therapy.
For most types of implants, you will need to be in the hospital. You will be given general or local anesthesia so that you will not feel any pain when the doctor places the holder for the radioactive material in your body. In many hospitals, the radioactive material is placed in its holder or applicator after you return to your room so that other patients, staff, and visitors are not exposed to radiation.
How Are Other People Protected From Radiation While the Implant is in Place?
Sometimes the radiation source in your implant sends its high energy rays outside your body. To protect others while you are having implant therapy, the hospital will have you stay in a private room. Although the nurses and other people caring for you will not be able to spend a long time in your room, they will give you all of the care you need. You should call for a nurse when you need one, but keep in mind that the nurse will work quickly and speak to you from the doorway more often than from your bedside. In most cases, your urine and stool will contain no radioactivity unless you are having unsealed internal radiation therapy.
There also will be limits on visitors while your implant is in place. Children younger than 18 or pregnant women should not visit patients who are having internal radiation therapy. Be sure to tell your visitors to ask the hospital staff for any special instructions before they come into your room. Visitors should sit at least 6 feet from your bed and the radiation oncology staff will determine how long your visitors may stay. The time can vary from 30 minutes to several hours per day. In some hospitals a rolling lead shield is placed beside the bed and kept between the patient and visitors or staff members.
What Are the Side Effects of Internal Radiation Therapy?
The side effects of implant therapy depend on the area being treated. You are not likely to have severe pain or feel ill during implant therapy. However, if an applicator is holding your implant in place, it may be somewhat uncomfortable. If you need it, the doctor will order medicine to help you relax or to relieve pain. If general anesthesia was used while your implant was put in place, you may feel drowsy, weak, or nauseated but these effects do not last long. If necessary, medications can be ordered to relieve nausea.
Be sure to tell the nurse about any symptoms that concern you. In Section 4, "Managing Side Effects," you will find tips on how to deal with problems that might occur after implant therapy.
How Long Does the Implant Stay in Place?
Your doctor will decide the amount of time that an implant is to be left in place. It depends on the dose (amount) of radioactivity needed for effective treatment. Your treatment schedule will depend on the type of cancer, where it is located, your general health, and other cancer treatments you have had. Depending on where the implant is placed, you may have to keep it from shifting by staying in bed and lying fairly still.
Temporary implants may be either low dose-rate (LDR) or high dose-rate (HDR). Low dose-rate implants are left in place for several days; high dose-rate implants are removed after a few minutes.
For some cancer sites, the implant is left in place permanently. If your implant is permanent, you may need to stay in your hospital room away from other people for a few days while the radiation is most active. The implant becomes less radioactive each day; by the time you are ready to go home, the radiation in your body will be much weaker. Your doctor will advise you if there are any special precautions you need to use at home.
What Happens After the Implant Is Removed?
Usually, an anesthetic is not needed when the doctor removes a temporary implant. Most can be taken out right in the patient's hospital room. Once the implant is removed, there is no radioactivity in your body. The hospital staff and your visitors will no longer have to limit the time they stay with you.
Your doctor will tell you if you need to limit your activities after you leave the hospital. Most patients are allowed to do as much as they feel like doing. You may need some extra sleep or rest breaks during your days at home, but you should feel stronger quickly.
The area that has been treated with an implant may be sore or sensitive for some time. If any particular activity such as sports or sexual intercourse cause irritation in the treatment area, your doctor may suggest that you limit these activities for a while.
In remote brachytherapy, a computer sends the radioactive source through a tube to a catheter that has been placed near the tumor by the patient's doctor. The procedure is directed by the brachytherapy team who watch the patient on closed-circuit television and communicate with the patient using an intercom. The radioactivity remains at the tumor for only a few minutes. In some cases, several remote treatments may be required and the catheter may stay in place between treatments.
Remote brachytherapy may be used for low dose-rate (LDR) treatments in an inpatient setting. High dose-rate (HDR) remote brachytherapy allows a person to have internal radiation therapy in an outpatient setting. High dose-rate treatments take only a few minutes. Because no radioactive material is left in the body, the patient can return home after the treatment. Remote brachytherapy has been used to treat cancers of the cervix, breast, lung, pancreas, prostate, and esophagus.
MANAGING SIDE EFFECTS
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 in this booklet 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. (See "Sexual Relations" later in this section.)
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:
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.
What Can Be Done About Hair Loss?
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. Radiation of 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. The amount of hair that grows back will depend on how much and what kind of radiation you receive. You may notice that your hair has a slightly different texture or color when it grows back. Other types of cancer treatment, such as chemotherapy, also can affect how your hair grows back.
Although your scalp may be tender after the hair is lost, it's a good idea to cover your head with a hat, turban, or scarf. You should wear a protective cap or scarf when you're in the sun or outdoors in cold weather. If you prefer a wig or toupee, be sure the lining does not irritate your scalp. The cost of 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 if you want to match the color and style to your own hair.
How are Side Effects on the Blood Managed?
Radiation therapy can cause low levels of white blood cells and platelets. These blood cells normally help your body fight infection and prevent bleeding. If large areas of active bone marrow are treated, your red blood cell count may be low as well. If your blood tests show these side effects, your doctor may wait until your blood counts increase to continue treatments. Your doctor will check your blood counts regularly and change your treatment schedule if it is necessary.
Will Eating Be a Problem?
Sometimes radiation treatment causes loss of appetite and interferes with eating, digesting, and absorbing food. Try to eat enough to help damaged tissues rebuild themselves. It is not unusual to lose 1 or 2 pounds a week during radiation therapy. You will be weighed weekly to monitor your weight.
It is very important to eat a balanced diet. You may find it helpful to eat small meals often and to try to eat a variety of different foods. Your doctor or nurse can tell you whether you should eat a special diet, and a dietitian will have some ideas that will 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.
If it's painful to chew and swallow, your doctor may advise you to use a powdered or liquid diet supplement. Many of these products are available at drugstores and supermarkets and come in a variety of flavors. They are tasty when used alone or combined with other foods such as pureed fruit, or added to milkshakes. Some of the companies that make these diet supplements have recipe booklets to help you increase your nutrient intake. Ask your nurse, dietitian, or pharmacist for further information.
You may lose interest in food during your treatment. Fatigue from your treatments can cause loss of appetite. Some people just don't feel like eating because of stress from their illness and treatment or because the treatment changes the way food tastes. Even if you're not very hungry, it's important to keep your protein and calorie intake high. Doctors have found that patients who eat well can better cope with having cancer and with the side effects of treatment. Medications for appetite enhancement are now available; ask your doctor or nurse about them.
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.
If you are able to eat only small amounts of food, you can increase the calories per serving by:
Some people find they can drink 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 making drinks enriched with powdered milk, yogurt, honey, or prepared liquid supplements.
Will Radiation Therapy Affect Me Emotionally?
Nearly all patients being treated for cancer report feeling emotionally upset at different times during their therapy. It's not unusual to feel anxious, depressed, afraid, angry, frustrated, alone, or helpless. Radiation therapy may affect your emotions indirectly through fatigue or changes in hormone balance, but the treatment itself is not a direct cause of mental distress.
You may find that it's helpful to talk about your feelings with a close friend, family member, chaplain, nurse, social worker, or psychologist with whom you feel at ease. You may want to ask your doctor or nurse about meditation or relaxation exercises that might help you unwind and feel calmer.
Nationwide support programs can help cancer patients to meet others who share common problems and concerns. Some medical centers have formed peer support groups so that patients can meet to discuss their feelings and inspire each other.
What Side Effects Occur With Radiation Therapy to the Head and Neck?
Some people who receive radiation to the head and neck experience redness, irritation, and sores in the mouth; a dry mouth or thickened saliva; difficulty in swallowing; changes in taste; or nausea. Try not to let these symptoms keep you from eating.
Other problems that may occur during treatment to the head and neck are a loss of taste, which may diminish appetite and affect nutrition, and earaches (caused by hardening of ear wax). You may notice some swelling or drooping of the skin under your chin as well as changes in the skin texture. Your jaw may also feel stiff and you may be unable to open your mouth as wide as before treatment. Jaw exercises may help ease this problem. Report all side effects to your doctor or nurse and ask what you should do about them.
If you are receiving radiation therapy to the head or neck, you need to take especially good care of your teeth, gums, mouth, and throat. Side effects from treatment to these areas commonly involve the mouth, which may be sore and dry. Here are a few tips that may help you manage mouth problems:
Radiation treatment for head and neck cancer can increase your chances of getting cavities in your teeth. Mouth care designed to prevent problems will be a very important part of your treatment. Before starting radiation therapy, make an appointment for a complete dental/oral checkup. Ask your dentist and radiation oncologist to consult before your radiation treatments begin.
Your dentist probably will want to see you often during your radiation therapy to help you care for your mouth and teeth. This is a good way to reduce the risk of tooth decay and help you deal with possible problems such as soreness of the tissues in your mouth. It's important that you follow the dentist's advice while you're receiving radiation therapy. Most likely, your dentist will suggest that you:
Your dentist can explain how to mix the salt and baking soda mouthwash and how to use the fluoride treatment method that best suits your needs. You can probably get printed instructions for proper dental care at the dentist's office. If dry mouth continues after your treatment is complete, you will need to continue the mouth care recommended during treatment. Always share your dentist's instructions with your radiation nurse.
Dealing with Mouth or Throat Problems:
Soreness in your mouth or throat may appear in the second or third week of external radiation therapy and it will most likely have disappeared within a month or so after your treatments have ended. You may have trouble swallowing during this time because your mouth feels dry. Your doctor or dentist can prescribe medicine for mouth discomfort and tell you about methods to relieve other mouth problems during and following your radiation therapy. If you wear dentures you may notice that they no longer fit well. This occurs if the radiation causes your gums to swell. You may need to stop wearing your dentures until your radiation therapy is over. It's important not to risk denture-induced gum sores because they may become infected and heal slowly.
Your salivary glands may produce less saliva than usual, making your mouth feel dry. Unfortunately dry mouth may continue to be a problem even after treatment is over. You may be given medication to help lessen this side effect. It's helpful to sip cool drinks throughout the day. Although many radiation therapy patients have said that drinking carbonated beverages helps relieve dry mouth, water probably is your best choice. In the morning, fill a large container with ice, add water, and carry it with you during the day so that you can take frequent sips. Keep a glass of cool water at your bedside at night, too. Sugar-free candy or gum also may help; be careful about overuse of these products as they can cause diarrhea in some people. Avoid tobacco and alcoholic drinks because they tend to dry and irritate your mouth tissues. Moisten food with gravies and sauces to make eating easier. If these measures are not enough, ask your dentist, radiation oncologist, or nurse about products that either replace or stimulate your own saliva. Artificial saliva and medication to increase saliva production are available.
TIPS ON EATING
You may find that it's difficult or painful to swallow. Some patients say that they feel as if something is stuck in their throat. Soreness or dryness in your mouth or throat can also make it hard to eat. The earlier section on eating problems in this booklet may be helpful. In addition, some of the following tips may help to make eating more comfortable:
What Side Effects Occur With Radiation Therapy to the Chest?
Radiation treatment to the chest may cause several changes. For example, you may find that it is hard to swallow or that swallowing hurts. You may develop a cough or a fever. You may notice that when you cough the amount and color of the mucus is different. Shortness of breath is also common. Be sure to let your treatment team know right away if you have any of these symptoms. Remember that your doctor and nurse have seen these changes in many radiation patients and they know how to help you deal with them.
Are There Side Effects With Radiation Therapy for Breast Cancer?
The most common side effects with radiation therapy for breast cancer are fatigue and skin changes. However there may be other side effects as well. If you notice that your shoulder feels stiff, ask your doctor or nurse about exercises to keep your arm moving freely. Other side effects include breast or nipple soreness, swelling from fluid buildup in the treated area, and skin reddening or tanning. Except for tanning which may take up to 6 months to fade, these side effects will most likely disappear in 4 to 6 weeks.
If you are being treated for breast cancer and you are having radiation therapy after a lumpectomy or mastectomy, it's a good idea to go without your bra whenever possible or, if this makes you more uncomfortable, wear a soft cotton bra without underwires. This will help reduce skin irritation in the treatment area.
Radiation therapy after a lumpectomy may cause additional changes in the treated breast after therapy is complete. These long-term side effects may continue for a year or longer after treatment. The skin redness will fade, leaving your skin slightly darker, just as when a sunburn fades to a sun tan. The pores in the skin of your breast may be enlarged and more noticeable. Some women report increased sensitivity of the skin on the breast; others have decreased feeling. The skin and the fatty tissue of the breast may feel thicker and firmer than it was before your radiation treatment. Sometimes the size of your breast changes--it may become larger because of fluid buildup or smaller because of the development of scar tissue. Many women have little or no change in size.
Your radiation therapy plan may include temporary implants of radioactive material in the area around your lumpectomy. A week or two after external treatment is completed, these implants are inserted during a short hospitalization. The implants may cause breast tenderness or a feeling of tightness. After they are removed, you are likely to notice some of the same effects that occur with external treatment. If so, let your doctor or nurse know about any problems that persist.
Most changes resulting from radiation therapy for breast cancer are seen within 10 to 12 months after completing therapy. Occasionally small red areas called telangiectasias appear. These are areas of dilated blood vessels and the color may fade with time. If you see new changes in breast size, shape, appearance, or texture after this time, report them to your doctor at once.
What Side Effects Occur With Radiation Therapy to the Stomach and Abdomen?
If you are having radiation treatment to the stomach or some portion of the abdomen, you may have an upset stomach, nausea, or diarrhea. Your doctor can prescribe medicines to relieve these problems. Do not take any medications for these symptoms unless you first check with your doctor or nurse.
It's not unusual to feel queasy for a few hours right after radiation treatment to the stomach or abdomen. Some patients find that they have less nausea if they have their treatment with an empty stomach. Others report that eating a light meal 1 to 2 hours before treatment lessens queasiness. You may find that nausea is less of a problem if you wait 1 to 2 hours after your treatment before you eat. If this problem persists, ask your doctor to prescribe a medicine (an antiemetic to prevent nausea. If antiemetics are prescribed, take them within the hour before treatment or when your doctor or nurse suggests, even if you sometimes feel that they are not needed.
If your stomach feels upset just before every treatment, the queasiness or nausea may be caused by anxiety and concerns about cancer treatment. Try having a bland snack such as toast or crackers and apple juice before your appointment. It may also help to try to unwind before your treatment. Reading a book, writing a letter, or working a crossword puzzle may help you relax.
Here are some other tips to help an unsettled stomach:
For severe nausea and vomiting, try a clear liquid diet (broth and clear juices) or bland foods that are easy to digest, such as dry toast and gelatin.
What to Do About Diarrhea:
Diarrhea may begin in the third or fourth week of radiation therapy to the abdomen or pelvis. You may be able to prevent diarrhea by eating a low fiber diet when you
What Does "Followup" Mean?
Once you have completed your radiation treatments, it is important for your doctor to monitor the results of your therapy at regularly scheduled visits. These checkups are necessary to deal with radiation side effects and to detect any signs of recurrent disease. During these checkups your doctor will examine you and may order some lab tests and x-rays. The radiation oncologist also will want to see you for followup after your treatment ends and will coordinate followup care with your doctor.
Followup care might include more cancer treatment, rehabilitation, and counseling. Taking good care of yourself is also an important part of following through after radiation treatments.
Who Provides Care After Therapy?
Most patients return to the radiation oncologist for regular follow-up visits. Others are referred to their original doctor, to a surgeon, or to a medical oncologist. Your followup care will depend on the kind of cancer that was treated and on other treatments that you had or may need.
What Other Care Might Be Needed?
Just as every patient is different, followup care varies. Your doctor will prescribe and schedule the followup care that you need. Don't hesitate to ask about the tests or treatments that your doctor orders. Try to learn all the things you need to do to take good care of yourself.
Following are some questions that you may want to ask your doctor after you have finished your radiation therapy:
It's a good idea to write down the questions you want to ask your doctor. Some patients find that it's helpful to take a family member with them to help remember what the doctor says.
What if Pain Is a Problem?
Radiation therapy is not painful. However, some radiation side effects may cause discomfort. In addition, when radiation is used for palliation (see section above), some discomfort or pain may remain. Sometimes patients need help to manage cancer pain. Over-the-counter pain medicine may be enough for mild pain. Remember that you should not use a heating pad or a warm compress to relieve pain in any area treated with radiation.
If your pain is severe, ask the doctor about prescription drugs or other methods of relief. Try to be specific about your pain (how severe is it on a scale of 0-10 where 0 is no pain and 10 is the worst pain you can imagine? where is your pain? is the pain throbbing, stabbing, searing? is it continuous or intermittent? what makes it better or worse?) when you tell the doctor about it so you can get the best pain management. If you are unable to get pain relief, you may want to ask your doctor for a referral to a pain specialist.
Because fear and worry can make pain worse, you may find that relaxation exercises are helpful. Other methods such as hypnosis, biofeedback, and acupuncture may be useful for some cancer pain. Be sure to discuss these complementary or alternative treatments with your doctor or nurse. Sometimes complementary therapies can interfere with other treatment you are having. They can also be harmful when combined with other treatment.
How Can I Help Myself After Radiation Therapy?
Patients who have had radiation therapy need to continue some of the special care they used during treatment, at least for a short while. For instance, you may have skin problems for several weeks after your treatments end. Continue to be gentle with skin in the treatment area until all signs of irritation are gone. Don't try to scrub off the marks in your treatment area. If tattoos were used to mark the treatment area, they are permanent and will not wash off. Your nurse can answer questions about skin care and help you with other concerns you may have after your treatment has been completed.
You may find that you still need extra rest after your therapy is over while your healthy tissues are recovering and rebuilding. Keep taking naps as needed and try to get more sleep at night. It may take some time to get your strength back, so resume your normal schedule of activities gradually. If you feel that you need emotional or social support, ask your doctor, nurse, or a social worker for information about support groups or other ways to express your feelings and concerns.
When Should I Call the Doctor?
After treatment for cancer, you're likely to be more aware of your body and to notice even slight changes in how you feel from day to day. The doctor will want to know if you are having any unusual symptoms. Promptly tell your doctor about:
What About Returning to Work?
Many people find that they can continue to work during radiation therapy because treatment appointments are short. If you have stopped working, you can return to your job as soon as you feel up to it. If your job requires lifting or heavy physical activity, you may need a change in your work responsibilities until you have regained your strength. Check with your employer to see if a 'return to work' release from your doctor is required.
When you are ready to return to work, it is important to learn about your rights regarding your job and health insurance. If you have any questions about employment issues, contact the Cancer Information Service (CIS). CIS staff can help you find local agencies that can help you deal with problems regarding employment and insurance rights that are sometimes faced by cancer survivors.
We hope this information will help you understand how radiation therapy is used to treat cancer. If you know what to expect when you go for your treatments, you may not feel as anxious. Remember to talk with your nurse, doctor, or other members of your health care team whenever you have questions or feel that you need more information.
The information on this page was obtained from the National Cancer Institute. The National Cancer Institute provides accurate, up-to-date information on many types of cancer, information on clinical trials, resources for people dealing with cancer, and information for researchers and health professionals.
The National Cancer Institute is in no way affiliated with the Mary Stolfa Cancer Foundation.
The information on this web site is provided for general information only. It is not intended as medical advice, and should not be relied upon as a substitute for consultations with qualified health professionals who are familiar with your individual medical needs. The MSCF disclaims all obligations and liabilities for damages arising from the use or attempted use of the information, including but not limited to direct, indirect, special, and consequential damages, attorneys' and experts' fees and court costs. Any use of the information will be at the risk of the user.
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