Navigating Cancer Radiation Therapy: Unveiling Side Effects
This article provides an overview of the role of radiation therapy in cancer treatment, the possible reactions to radiation treatment, the precautions before and after radiation treatment, the duration and hospitalization for radiation treatment, and the tips for caregivers and family members. It also answers some frequently asked questions and lists the references for further reading.
In this article, you will learn about:
Table of Contents
- The Role of Radiation in Cancer Treatment
- Possible Reactions to Radiation Treatment
- Precautions Before and After Radiation Treatment
- Duration and Hospitalization for Radiation Treatment
- Frequently Asked Questions
- References
The Role of Radiation in Cancer Treatment
Radiation therapy is a common and effective way to treat cancer by using high-energy particles or waves to destroy or damage cancer cells. Radiation therapy can be used alone or in combination with other treatments, such as surgery or chemotherapy. Radiation therapy can be delivered in two main ways: internally or externally.
Internal Radiation (Brachytherapy)
Internal radiation, also known as brachytherapy, involves placing a radioactive source inside or near the tumor. The radioactive source can be in the form of seeds, ribbons, capsules, or wires that emit radiation for a certain period of time. This method allows a high dose of radiation to be delivered to the tumor while sparing the surrounding normal tissues from unnecessary exposure. Internal radiation is often used for cancers of the prostate, cervix, uterus, breast, head and neck, and thyroid. Internal radiation may cause some discomfort, bleeding, infection, or swelling at the site of implantation, but these side effects are usually temporary and manageable.
External Radiation
External radiation, also known as external beam radiation therapy, involves using a machine that aims radiation beams at the tumor from outside the body. The machine can move around the patient and deliver radiation from different angles and directions. External radiation can use different types of radiation, such as x-rays, gamma rays, electron beams, protons, or neutrons, depending on the type, location, and depth of the tumor. External radiation is more commonly used than internal radiation and can treat a wide range of cancers, such as lung, breast, brain, bone, skin, and lymphoma. External radiation may cause some side effects, such as skin irritation, fatigue, nausea, hair loss, or changes in blood counts, but these side effects are usually mild and subside after the treatment is completed.
Possible Reactions to Radiation Treatment
Systemic Reactions
Systemic reactions are those that affect the whole body or multiple organs. They depend on the area and dose of radiation, as well as the sensitivity of the tissues involved. Some common systemic reactions are:
- Headache: Radiation can cause inflammation in the brain, leading to headache, dizziness, and fatigue. This is more common with radiation to the head and neck area.
- Nausea and vomiting: Radiation can irritate the stomach and intestines, causing nausea and vomiting. This is more common with radiation to the abdomen and pelvis area.
- Loss of appetite: Radiation can affect the taste buds and salivary glands, causing loss of appetite and weight loss. This is more common with radiation to the mouth and throat area.
- Mood swings: Radiation can affect the hormones and neurotransmitters, causing mood swings, anxiety, and depression. This is more common with radiation to the brain and pituitary gland.
These symptoms usually appear 6-12 hours after radiation treatment and last for a few days. They can be managed with supportive treatments, such as painkillers, anti-nausea drugs, and nutritional supplements. In some cases, the radiation dose may be reduced or the treatment schedule may be adjusted to minimize the side effects.
Reduced Red and White Blood Cell Counts
Red blood cells carry oxygen to the tissues, and white blood cells fight infections. Radiation can damage the bone marrow, where these cells are produced, leading to reduced red and white blood cell counts. This can cause:
- Anemia: Low red blood cell count can cause anemia, which is characterized by weakness, fatigue, shortness of breath, and pale skin.
- Leukopenia: Low white blood cell count can cause leukopenia, which is characterized by increased susceptibility to infections, fever, and chills.
- Thrombocytopenia: Low platelet count can cause thrombocytopenia, which is characterized by increased bleeding and bruising.
These conditions are more likely to occur with extensive bone irradiation, especially to the flat bones, such as the skull, ribs, and pelvis. The blood counts usually drop 2-4 weeks after radiation treatment and recover in 2-4 weeks after the treatment ends. The blood counts are monitored regularly during and after radiation treatment. If the white blood cell count drops below 2,500-3,000/cumm, the radiation treatment may be suspended until the count recovers. If the red blood cell count drops below 10 g/dL, a blood transfusion may be needed. If the platelet count drops below 50,000/cumm, a platelet transfusion may be needed. Medications, such as growth factors, may also be given to stimulate the bone marrow to produce more blood cells.
Skin Redness, Swelling, Peeling
Skin reactions are common with external beam radiation therapy, which delivers radiation from a machine outside the body. The skin in the radiation field may become red, dry, itchy, swollen, and peeled. This is because radiation damages the skin cells and blood vessels, causing inflammation and reduced blood flow. The skin reactions may start 3-4 weeks into the treatment and last for several weeks after the treatment ends. They may vary in severity, depending on the radiation dose, the skin type, and the skin care. The skin reactions are classified into four grades:
| Grade | Description |
|---|---|
| 1 | Mild skin reaction, such as faint redness, dryness, and itching. |
| 2 | Moderate skin reaction, such as bright redness, swelling, and peeling of the outer layer of the skin. |
| 3 | Severe skin reaction, such as moist peeling of the deeper layer of the skin, bleeding, and infection. |
| 4 | Very severe skin reaction, such as ulceration, necrosis, and scarring of the skin. |
The skin reactions can be managed with proper skin care, such as:
- Cleansing: Gently wash the skin with mild soap and water, and pat it dry with a soft towel. Avoid rubbing, scratching, or shaving the skin.
- Moisturizing: Apply a thin layer of moisturizer, such as aloe vera gel or hydrocortisone cream, to the skin. Avoid products that contain alcohol, perfume, or additives.
- Protecting: Cover the skin with loose-fitting, soft, and breathable clothing. Avoid tight, rough, or synthetic fabrics. Avoid exposure to sun, heat, cold, and wind. Use sunscreen with SPF 30 or higher if the skin is exposed to the sun.
If the skin reaction is grade 3 or 4, the radiation treatment may be paused until the skin heals. The doctor may prescribe antibiotics, painkillers, or dressings to treat the skin. In rare cases, skin grafting may be needed to repair the skin.
Soft Tissue Reactions in the Mouth and Throat
The mouth and throat are lined with soft tissues, such as the mucous membranes, salivary glands, taste buds, and tongue. These tissues are sensitive to radiation and may develop reactions, such as:
- Taste alterations: Radiation can damage the taste buds, causing changes in the sense of taste. Some foods may taste bland, bitter, or metallic. This may affect the appetite and nutrition.
- Reduced saliva: Radiation can damage the salivary glands, causing reduced saliva production. This may cause dry mouth, difficulty swallowing, and increased risk of tooth decay and infection.
- Mucositis: Radiation can damage the mucous membranes, causing inflammation and ulceration. This may cause pain, burning, and bleeding in the mouth and throat.
- Xerostomia: Radiation can damage the salivary glands, causing reduced saliva production. This may cause dry mouth, difficulty swallowing, and increased risk of tooth decay and infection.
These reactions usually start 2-3 weeks into the treatment and last for several weeks after the treatment ends. They can be managed with oral care, such as:
- Brushing: Brush the teeth gently with a soft-bristled toothbrush and fluoride toothpaste after every meal and before bedtime. Avoid toothpastes that contain sodium lauryl sulfate, which can irritate the mouth.
- Flossing: Floss the teeth gently once a day. Avoid flossing areas that are sore or bleeding.
- Rinsing: Rinse the mouth with a saltwater or baking soda solution several times a day. Avoid mouthwashes that contain alcohol, hydrogen peroxide, or menthol, which can irritate the mouth.
- Moisturizing: Sip water or suck on ice chips, sugar-free candies, or gum to keep the mouth moist. Use artificial saliva or mouth spray to lubricate the mouth.
- Eating: Eat soft, moist, and bland foods, such as soups, yogurt, mashed potatoes, and scrambled eggs. Avoid spicy, acidic, salty, dry, or hard foods, such as citrus fruits, tomatoes, chips, and nuts. Avoid alcohol, tobacco, and caffeine, which can dry and irritate the mouth.
If the mouth and throat reactions are severe, the doctor may prescribe painkillers, anti-inflammatory drugs, or mouthwashes to relieve the symptoms. In some cases, the radiation dose may be reduced or the treatment schedule may be adjusted to minimize the side effects.
Precautions Before and After Radiation Treatment
Responses to radiation vary individually. Patients can self-care with simple methods when experiencing specific side effects. However, some precautions are necessary before and after radiation treatment to prevent complications and ensure optimal results. Here are some general guidelines:
- Consult your doctor. Before starting radiation therapy, discuss with your doctor about your medical history, current medications, allergies, and any concerns you may have. Your doctor will advise you on how to prepare for the treatment, such as whether you need to fast or avoid certain substances. After each session, report any symptoms or changes you notice to your doctor. Your doctor will monitor your progress and adjust your treatment plan accordingly.
- Follow the instructions. Your radiation therapist will give you specific instructions on how to position yourself during the treatment, how to care for your skin and oral hygiene, what to eat and drink, and what activities to avoid. Follow these instructions carefully and ask questions if you are unsure. Do not apply any creams, lotions, perfumes, or deodorants to the treatment area unless prescribed by your doctor. Do not expose the treatment area to sunlight, heat, or cold. Do not smoke, drink alcohol, or use recreational drugs.
- Take care of yourself. Radiation therapy can affect your physical and emotional well-being. To cope with the side effects and stress, you need to take good care of yourself. Eat a balanced diet, drink plenty of fluids, get enough rest, and exercise moderately. Avoid strenuous activities that may cause fatigue or injury. Seek support from your family, friends, or professional counselors. Join a support group or online community of people who have gone through or are going through radiation therapy.
Duration and Hospitalization for Radiation Treatment
The treatment duration depends on cancer type, severity, and prescribed dosage. Typically, radiation therapy occurs daily, Monday to Friday, lasting 5-10 minutes per session. The total dose and treatment frequency vary based on cancer size, location, type, patient health, and concurrent treatments. High-dose radiation might take longer, but daily visits, not hospitalization, are common. The ability to work during treatment depends on the patient’s condition, allowing work if physically and mentally capable. However, some factors may affect the work schedule, such as travel time, side effects, and doctor appointments. Therefore, it is advisable to consult with your employer and arrange for flexible or reduced hours, if possible.
Frequently Asked Questions
What are the benefits and risks of radiation therapy?
Radiation therapy is a type of cancer treatment that uses high-energy rays or particles to kill cancer cells or slow their growth. The benefits of radiation therapy are:
- It can shrink tumors and relieve symptoms, such as pain, bleeding, or pressure.
- It can cure some cancers or prevent them from coming back.
- It can be used alone or in combination with other treatments, such as surgery, chemotherapy, or immunotherapy.
- It can be delivered externally or internally, depending on the type and location of the cancer.
- It can be customized to target the cancer cells and spare the normal tissues as much as possible.
The risks of radiation therapy are:
- It can damage healthy cells and cause side effects, such as fatigue, skin changes, nausea, diarrhea, hair loss, mouth sores, or sexual problems. These side effects are usually temporary and can be managed with medications, creams, or dietary changes.
- It can increase the risk of developing a second cancer later in life, especially if high doses of radiation are used or if radiation is given to children or young adults. However, this risk is low and the benefits of radiation therapy usually outweigh the risks.
- It can interact with some drugs or supplements, such as blood thinners, anticoagulants, or antioxidants. Therefore, it is important to tell your doctor about all the medications and supplements you are taking before starting radiation therapy.
Before you decide to have radiation therapy, talk to your doctor about the benefits and risks of this treatment for your specific situation. You can also ask for a second opinion from another radiation oncologist if you have any doubts or concerns.
What should I do if I experience pain or discomfort during or after radiation treatment?
Pain or discomfort during or after radiation treatment can be caused by various factors, such as the type and dose of radiation, the location and size of the tumor, the sensitivity of the skin or tissues, or the presence of inflammation or infection. Here are some steps you can take to relieve pain or discomfort:
- Tell your doctor or nurse about the pain or discomfort you are feeling. They can prescribe painkillers, anti-inflammatory drugs, or antibiotics to help you. They can also adjust the radiation dose or schedule if needed.
- Apply cold or warm compresses to the affected area, unless your doctor advises otherwise. Cold compresses can reduce swelling and inflammation, while warm compresses can improve blood circulation and relax muscles.
- Use mild, unscented, and hypoallergenic products to clean and moisturize your skin. Avoid rubbing, scratching, or shaving the skin in the treatment area. Wear loose, soft, and cotton clothing to avoid irritation.
- Avoid exposure to sunlight, heat, or cold in the treatment area. Use sunscreen, hats, scarves, or clothing to protect your skin from sunburn. Avoid hot baths, showers, or saunas. Use a fan, air conditioner, or humidifier to keep the temperature and humidity comfortable.
- Eat a balanced and nutritious diet that is rich in protein, calories, fluids, and fiber. Avoid foods that are spicy, acidic, salty, or hard to chew or swallow. Drink plenty of water or other fluids to stay hydrated and prevent constipation.
- Do gentle exercises, such as walking, stretching, or yoga, to improve your mood, energy, and flexibility. Avoid strenuous or vigorous activities that may cause injury or fatigue. Rest when you feel tired and get enough sleep at night.
Pain or discomfort from radiation therapy usually improves over time as the healthy cells heal and the side effects subside. However, if the pain or discomfort persists, worsens, or interferes with your daily activities, contact your doctor or nurse for further evaluation and treatment.
References
- National Cancer Institute. Radiation Therapy Side Effects.
- American Cancer Society. Radiation Therapy Side Effects.
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