What to Expect When Undergoing Radiation Treatment:
What is Radiation Treatment?
Radiation Therapy - also known as radiotherapy - is a treatment for cancer that uses very high doses of radiation to kill cancer cells and cease the spread of these malignant cells. Lower doses of radiation - like X-Rays - allow for the visualization of the bones of the body, but radiation that's used to treat cancer is given in higher doses.
Radiation therapy can be used as external beam radiation or internal radiation. External beam radiation means that a machine located outside of the body aims the radiation beams at the cancerous cells or tumor. Internal radiation is a type of radiation treatment in which the radiation is placed inside the body, either near or inside the cancer cells.
Some cancer patients receive both types - external beam and internal radiation - therapy. In fact, 60% of those who have cancer go through radiation treatments; often as the only type of cancer treatment needed.
How Does Radiation Treatment Work?
Radiation treatment, or radiation therapy, is a therapy consisting of ionizing radiation used primarily in cancer treatment to kill off malignant cells and control possible regrowth.
Typically, radiation treatment is used as the first attack on cancerous cells, and then followed by chemotherapy to prevent the cancerous cells from returning or relapsing. This page will focus specifically on radiation treatment for cancer.
Radiation therapy is often localized to the area of the body infected with cancerous cells, but can have an impact on the whole body via side effects.
Radiation beams are aimed at the tumor from various angles in an effort to reduce the amount of additional exposure to the skin and organs between the machine and the tumor, and to increase the exposure on the tumor itself.
In high doses, radiation therapy kills or slows the growth of malignant cancer cells or tumors. Radiation therapy is used to treat cancer and, if treatment of cancer is not possible, radiation therapy can be used to shrink tumors and alleviate the symptoms, which is called palliative care, or care designed to make a person more comfortable.
What to Expect Before Your Radiation Treatment:
Prior to your first radiation appointment it is important to follow any steps your doctor has asked of you.
Be prepared to have several appointments set up with your specialist, such as an oncologist, prior to the start of radiation treatment.
The medical staff will first take a detailed medical and family history to ensure radiation treatment is the best option for your recovery.
A full treatment plan will be laid out prior to the first radiation session.
Don't be afraid to speak up and ask questions about your treatment during any and all meetings. Dialogue is vital, if only to make yourself feel more in control of your own care.
Simulation appointments will be conducted after the initial history appointment.
You can expect to receive a CAT scan, where you will lie still on a table while the machine take photographs of the area in order to pinpoint the specific treatment area.
CAT scans do not require dye so no IV or needle is used, nor are you required to drink any dyes. You will have to lie perfectly still during the scan to ensure accurate photographs.
Molds will be formed of the parts of the body being treated.
Tattoos and marks will be put on your body to direct the daily treatment and ensure the same area is treated each day.
If it is a part of your treatment plan, be sure to meet with a dietician before you begin radiation treatments - your body will need a lot of extra energy to heal while you're undergoing radiation treatments - to see what sort of diet you should be following during radiation treatments.
Radiation treatments are expensive. Before beginning radiation treatments, talk to your insurance company to see the benefits they offer so you have a good idea what you will be paying for your treatments.
You may be able to work full-time during your radiation treatments, while others are unable to. It all depends upon how you react to radiation. Be sure to discuss employment with your oncologist, and his or her predictions for your ability to continue working, who may have insight into how you may be feeling.
What to Expect During Your Radiation Treatment:
While frightening, radiation therapy does not hurt during treatments, although many of the side effects can cause discomfort.
Be certain to arrive on time for all of your sessions - perhaps a bit early in case there are issues with scheduling.
Don't hesitate to ask questions of your doctor, nurse, or radiation team. This is your body - ask questions until you understand what is going on.
Make sure you're getting enough calories. Radiation treatments require a lot of energy, and if you're unable to keep your weight up, talk to your doctor or dietician for ideas for high calorie and high protein foods.
You may experience a variety of feelings during radiation treatment. Anything from anxiety to depression to fear to frustration to hopelessness to loneliness is normal. Living with cancer and the treatments is extremely stressful.
Cope with these feelings by practicing mediation and breathing exercises. Allow your mind to drift and daydream.
Talk about your feelings with others around you - a friend, a loved one, or someone else who you trust with your feelings.
Discuss your fears with your doctor and cancer treatment teams. They may be able to provide you answers to your questions as well as assuage your fears.
Find a support group in your area for people going through cancer treatments. Knowing that you're not alone is one of the most important parts of cancer and cancer treatments.
If you become overwhelmed with your feelings during radiation therapy, don't hesitate to talk to a therapist about these feelings.
Accept that fatigue during radiation is normal and expected. Break big tasks into smaller tasks. Don't hesitate to ask for help when you need it.
When you ask for help, ask for specific things - a friend to watch your children, someone to help cook meals for you - things that are tangible and something others can do for you.
Allow others to help you. Don't be afraid to need some help - cancer is very hard to deal with alone.
Complications That Can Arise During Radiation Treatment:
Radiation treatments can be cancelled for various reasons that are out of your control. This means you need to remain flexible and understanding. For example, if the equipment needs servicing you wonʼt be able to receive your treatment that day.
The list of side effects from radiation treatment can be downright terrifying. But, as with many treatments, just because there are a dozen possible side effects listed it does not mean that you will experience any or all of them. You simply should be aware and be on the look out for them so as not to be surprised.
Here is a list of possible side effects of radiation treatment and ways to reduce these side effects:
Bladder Issues: the urinary and bladder issues associated with radiation therapy tend to begin 3-5 weeks after the start of therapy and cease 2-8 weeks after the end of treatment. Bladder side effects sometimes occur when a person has radiation therapy on the bladder or prostate, and occur when the radiation beams harm the healthy cells of the walls of the bladder. This can lead to ulcers, infection, and inflammation.
Treatment of Bladder Issues can include the following:
- Talking to your doctor about all symptoms experienced.
- Drinking 6-8 cups of fluids each day.
- Avoiding tobacco, tea, coffee, spices, and alcohol.
- Medications to treat infections, reduce urinary frequency, and ease spasms of the bladder.
Diarrhea: radiation treatments of the stomach, abdomen, or pelvis can cause diarrhea as the radiation can hurt the healthy cells in the GI tract.
Management Of Diarrhea:
- Inform your doctor of all symptoms experienced.
- Drink 8-12 cups of clear liquid.
- Avoid dairy and milk products.
- Eat many smaller meals each day.
- Avoid spicy foods, greasy or fatty foods, high fiber foods, and fast food.
- Eat easy-to-digest foods.
Exhaustion: the degree of exhaustion experienced by those undergoing radiation therapy can range from non-existent to extreme fatigue. Fatigue may occur for a number of reasons: anxiety, anemia, depression, infections, inactivity, medications, stress, or simply the effort of cancer treatment, and can depend upon a number of personal factors. Exhaustion may last up to twelve months after the last radiation session.
Management of Exhaustion:
- Discuss fatigue and discussion with your care team so that they are aware of the degree of your fatigue and offer solutions to manage it.
- Make time each day to rest - plan each day so that you have periods allotted for rest throughout the day.
- Don't overdo anything.
- Try light exercise, a slow walk or some yoga can help tremendously.
- Attempt eight hours of sleep a night.
- Make sure your work schedule works for YOU!
- Ask for help from friends, family and loved ones.
- Learn how other people with cancer manage their exhaustion.
Hair Loss: radiation treatment may cause some or all of your hair to fall out as the treatment damages the cells - like hair - that grow quickly. Alopecia - or hair loss - only occurs in the area of your body undergoing treatment. Hair loss may begin 2-3 weeks following the first radiation session and may grow back within six months following the last radiation treatment. It's important to note that not all people experience hair regrowth.
Managing Hair Loss:
- Be gentle while washing and brushing your hair.
- Use a baby shampoo while washing your hair.
- Don't use blow dryers, curling irons, hair bands, clips, or sprays, which can damage the scalp.
- Avoid harsh hair products like dye, gels, grease, pomade, mousse, or oil.
- If you do decide to use a wig, choose one while you have hair so that the wig color, texture, and style matches your own. Wigs are wildly expensive, especially those made of human hair. Synthetic wigs are far cheaper, so be sure to discuss purchase of a wig with your doctor and insurance company to see if they can cover the cost.
- Decide whether or not to cut your hair off or shave it yourself.
- Talk to your insurance company to see if they'll cover the cost of a wig.
- Stay warm - hair loss can make you feel much colder. Use a hat, wig, or scarf to keep yourself warm.
- Protect your tender scalp - avoid harsh sunlight and very cold air.
- Never go out into the sun without a hat covering your head.
Nausea and Vomiting: these side effects are common when you have radiation therapy to the brain or GI tract and can be directly proportionate to the amount of radiation you are receiving.
Managing Nausea and Vomiting:
- Talk to your doctor about the nausea and vomiting you are experiencing.
- Eat and drink small, bland, easy digest meals and drinks.
- Plan out these meals according to the times that you feel best.
- Make sure your meals are warm or cool - not hot or cold.
- Go into each radiation treatment as relaxed as possible.
Oral Changes: Head and neck radiation can cause sores in the mouth, dry mouth, loss of (or changes in) taste, tooth decay, oral infections, bone changes, jaw stiffness. Some of these problems may disappear after radiation treatment ends, while others may last forever.
Managing Oral Changes:
- See a dentist at least two weeks before beginning radiation treatment to ensure your mouth is healthy before beginning radiation of the head or neck.
- Report any oral changes to your treatment team.
- Make checking your mouth a normal part of the day to prevent sores, infections or white patches.
- Keep your mouth moist by sucking ice chips, sipping water, chewing sugar-free gum or candy.
- Ask your doctor about medications to increase production of saliva.
- Take care to brush teeth, gums, and tongue after meals and before bedtime.
- Use an extra-soft toothbrush.
- Ensure your toothpaste has fluoride and talk to your dentist about special fluoride-containing toothpaste.
- Avoid any mouthwashes that use alcohol.
- Floss your teeth gently every day.
- Rinse your mouth a couple times a day with a solution of 1-cup warm water 1/4 teaspoon baking soda, and 1/8 teaspoon salt.
- Choose what you eat carefully - try soft foods that are easily chewed and swallowed, sip water between bites, soften harder food with sauce, yogurt, gravy, or other liquids.
- Make sure foods are warm or room temperature - not hot.
- Avoid foods that can hurt, burn, or scrape the mouth, like chips, spicy foods, alcoholic beverages, tobacco products, or foods with a high acid content (such as fruit juices).
- Avoid foods that are high in sugar.
- Exercise your jaw muscles several times a day.
Sexual/Fertility Changes: radiation treatments to the pelvic area can cause sexual side effects, such as hormonal changes or the desire to have sex. Radiation therapy may also affect fertility.
Managing Sexual and Fertility Changes:
- If you are pregnant, tell your treatment team immediately.
- Discuss the possibility of pregnancy in the future after radiation treatments in order to preserve fertility.
- Discuss sexual side effects and ways to manage them with your treatment team.
- Pregnancy during radiation treatment can cause much damage to the fetus - it's important to discuss birth control with your treatment team.
- Use lubricants during sex to combat vaginal dryness.
Skin Changes: redness, dry skin, itchy, peeling skin, swollen skin, and moist reaction are all side effects of the area in which the radiation beams are aimed. These skin changes can begin days or weeks after radiation therapy begins and may persist until after treatment is over.
Managing Skin Changes:
- Talk to your doctor about any skin changes you may be experiencing.
- Do not rub, scratch, or itch your skin.
- Use creams and lotions that are prescribed by your doctor to help with skin changes. Do not use other lotions until they've been approved by the doctor.
- Do not use hot or cold items on your skin - this includes not taking hot showers.
- Don't wash off any ink markings needed for the radiation therapy.
- Be very gentle with your skin while taking a lukewarm shower or bath.
- Buy a cool mist humidifier or put a bowl of water over a heating vent to add moisture to any room.
- Use soft, cotton sheets to sleep on.
- Wear clothes that are soft and gentle to the skin.
- Do NOT use tanning beds.
- Ask before shaving the treated areas and what type of razor to use.
- Don't use adhesive tapes on the area being treated.
What to Expect After Your Radiation Treatment:
As is the case with many treatments for cancer, there are a number of things you can expect after six or more months after radiation treatments are over. While late-term effects are rare, they can happen and depend upon the part of the body treated, dosage and length of time radiation treatment occurred, and whether or not chemotherapy was used in conjunction with radiation therapy.
It is vital that you have follow-up care with your cancer treatment team for the rest of your life.
Report any suspicious symptoms to your doctor or team immediately.
Ask about late-term side effects of radiation, learn if you can prevent them, symptoms you may want to look for and treatments for the late-term effects.
Managing Late-Term Side Effects:
Brain Changes - months or years after radiation therapy, memory loss, difficulties with thinking and math, personality changes, incontinence, or personality changes may occur.
Managing Brain Changes:
- Medication or surgical management of symptoms.
- Therapy - speech, occupational, or physical therapy can help.
Infertility - the inability to become pregnant.
Management of Infertility:
- Usage of donor eggs or sperm, depending upon whether you are male or female.
- Surrogacy - usage of a gestation surrogate - a woman who carries a child for a couple - can be a way for a couple to realize their dream of becoming parents.
Joint Changes - tissues and scar tissue may build up in the area of the body treated by radiation, which can reduce range of motion.
Management of Joint Changes:
- Medication management.
- Physical therapy for pain management, to increase strength and range of motion.
Lymphedema - swelling in the leg or arm as a result of excess lymphatic fluids, especially if lymph nodes were removed via surgery. Make sure to talk to your doctor and treatment team about early signs of lymphedema so that they can be properly treated.
Early signs of Lymphedema include:
- Difficulty putting on shoes or rings.
- Pain or feeling of heaviness in the affected limb.
- Tightness in your limb.
- Weakness in your arm or leg.
- Swelling, redness or other symptoms of infection.
Management of Lymphedema:
- Talk to your treatment team.
- Keep active, which can help prevent and decrease lymphedema.
- Use lotion once a day.
- Wear gloves while cooking or gardening.
- Do not allow yourself to get a sunburn.
- File down your fingernails and cut your cuticles.
- Clip toenails straight across.
- Avoid extreme temperatures - no ice packs or heating pads.
- Use antibacterial ointment on cuts.
- Don't put pressure on affected limb.
- Wear loose clothing without tight wrist cuffs or waistbands.
Oral Changes - Radiation therapy - especially radiation therapy of the head and neck - can cause late side effects in the mouth, which include, dry mouth, cavities, or bone loss.
Management of Mouth Changes:
- Ensure your dentist is a part of your cancer treatment team.
- Visit the dentist at least every other month to inspect for changes in the mouth, teeth and jaw.
- Do jaw exercises as instructed by a physical therapist.
- Ensure proper dental hygiene by brushing, flossing, and using fluoride treatments after meals and before bedtime.
Secondary Cancer: Rarely, radiation therapy can cause another form of cancer to develop. This is why regular check-ups with your cancer treatment team are of the highest importance.
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