Information currently under review
Coping with side effects
Face, mouth, neck and upper chest problems
Radiotherapy is an effective treatment for many cancers; however it can cause unwanted side effects. Fortunately, most go away in time and there are ways to reduce the discomfort they may cause. Other, less common, side effects may be permanent.
Side effects vary greatly. Most are very specific to the area of your body being treated but vary in intensity from person to person. Two people on the same treatment may react quite differently to the treatment, while some people will have no side effects. Reactions can also vary from one period of radiotherapy to the next.
It is important to remember that the type and severity of your side effects relate to the area of your body being treated and whether treatment is being given to cure the cancer or to relieve symptoms. (Side effects are usually more severe with curative treatment.) Before your treatments begin, talk to your radiation oncologist about the possible side effects from your particular treatment. These will be discussed with you when you are asked to give your consent to having treatment.
During your course of treatment, tell your radiation oncologist, radiation therapist or nurse of any side effects you notice. These can usually be controlled with the right care and medication. Occasionally, if you have side effects that are particularly severe, the doctor may prescribe a break in your treatments or change the kind of treatments you are having.
If you are having side effects during a potentially curative course of radiotherapy treatment, the radiation oncologist will usually not interrupt the treatment to allow the side effects to settle down. This is because it could lessen the effectiveness of the treatment.
Do not use any medicines, home remedies or creams without your doctor's approval. Always ask your radiation oncologist first.
Most side effects are short-term but some can be long-term or permanent. It is impossible to predict who will get a long-term side effect of treatment. Your doctor will explain the risks and the benefits.
The most common side effects of radiotherapy are related to the area of the body being treated. The commonest general side effects are fatigue and loss of appetite, although not everyone will have these.
During radiotherapy, your body uses a lot of energy dealing with the effects of radiation on normal cells. Some people are able to carry on as usual, but many people find that they cannot do as much and feel tired during and after treatment. Your weariness may build up slowly during the course of treatment but goes away gradually after your treatments are finished.
Over the weeks you are having radiotherapy, help your body by not overdoing things and doing restful things in your leisure time. Try to get more sleep at night. If you are feeling able, maintain your normal activity level, but if you are tired, don't feel that you must do everything you normally do. Ask family or friends to help with shopping, childcare, housework and driving. On the other hand, there is no need to avoid physical activity if you feel up to it.
If you have a job, you may feel well enough to continue to work full time if your treatment appointments can be organised to suit. You may, however, need to take a few weeks off work during or after your radiotherapy, or work fewer hours. Maybe you can do some of your work at home.
Eating a healthy, balanced diet is important when you are receiving any treatment for cancer, so that you remain as well as possible and get the most from your treatment.
Depending on the site of your radiation treatment, you may lose interest in food during your course of radiotherapy. Even when you know that eating properly is important, there may be days when you cannot eat much. Try to catch up on days when you do feel like eating.
You may find you can drink a lot, even if you don't feel like eating solid foods. If so, try enriching your drinks with powdered milk, yoghurt, honey or commercially prepared weight gain supplements.
The hospital dietitian will be able to help if you have problems with food. If your treatment is to an area where problems with swallowing, nausea, vomiting or diarrhoea are expected, a dietitian will see you. If you have radiotherapy in the head and neck area, chewing or swallowing might be difficult or painful.
Depending on the length of your treatment course, and the treated site, radiotherapy may cause your skin to become dry and itchy in the treatment area. In some cases, the skin may become bright red or even peel. If this occurs, you'll be given special dressings. Some of the radiation passes through your body and out the other side, so that the skin may also be affected in an unexpected location, though probably less severely. You should keep all treated areas out of the sun during treatment.
After treatment, you may be left with a sunburnt look in the treated area, such as redness or tanning. This fades with time. Your skin may also be more sensitive than normal to the sun long term. After treatment, be sure to protect skin that has had radiotherapy.
Tips for personal care during radiotherapy
If you have hair in the area being treated (scalp, face or body), you may lose some or all of it during radiotherapy. Depending on the dose, it may or may not grow back after the treatments are finished. If it does grow back, it may sometimes be different in colour or curliness from the original. In general, you will not lose hair outside the treated area. However, temporary hair loss on the back of the head can sometimes occur when tumours in the facial area are treated, as a result of radiation that passes through the head and out the other side.
If you are having radiotherapy to your stomach or some part of your lower abdomen, you may have to cope with an upset stomach, soreness or diarrhoea. Your radiation oncologist can prescribe medicines to relieve these problems. Do not take any home remedies during your radiotherapy treatment unless you first check with your radiation oncologist, or nurse. If you do feel ill, try to keep eating or drinking as well as you can so that your body gets the calories and nutrients it needs.
Remember that these problems will fade when your treatment is over. Some people feel queasy for a few hours after external radiotherapy. If you have this problem, you may find you can handle the treatment better on an empty stomach. Try not to eat anything for a few hours beforehand, or only a bland snack such as toast, dry biscuits or apple juice. Do, however, discuss this with your doctor as very effective medication is available to prevent nausea.
If it occurs, diarrhoea most often begins in the third or fourth week of treatment. Your doctor can give you medicine to help, but you can also help to control diarrhoea by eating carefully. You may see a dietitian, or ask your doctor or nurse to suggest food that will not make your diarrhoea worse.
After the diarrhoea has cleared up, it is important for you to return to a nourishing and balanced diet.
Radiotherapy is often used to treat cancers in the mouth, throat, neck and upper chest and can give excellent results. However, radiation side effects may make eating and swallowing difficult.
If you have a course of treatment that goes on for several weeks, your mouth or throat may become dry and sore and your voice may become hoarse after two to three weeks of treatment. This will gradually recover after treatment is completed, but may take several weeks or even months to resolve depending on the treatment intensity. You might also have thick phlegm in your throat, or a lump-like feeling that makes it hard to swallow. Your doctor can help you with these problems.
If you have a dry mouth, it might help to suck ice chips and sip cool drinks often. Your nurse or doctor might give you some mouthwash to use. Avoid tobacco and alcohol (including mouthwashes containing alcohol), as they will dry your mouth even more. Depending on the treatment required, loss of saliva and therefore dry mouth can be permanent. There are various ways to treat this side effect: ask your doctor or nurse for information.
If eating is uncomfortable or difficult, ask your doctor for something to relieve the pain. Good pain relief will help you to eat well and feel better. If chewing and swallowing are painful, try to have more liquids or soft meals. If you lose too much weight during therapy, you may need a tube inserted into your stomach for extra feeding.
A dietitian will review you regularly during the radiotherapy and may advise a diet supplement. You can buy these at the pharmacy without a prescription and many are available in a range of flavours. You can use them alone or with other foods such as pureed fruit.
Sometimes your sense of taste can change during radiotherapy. If this happens, try different ways of preparing food. Recovery of normal taste can take several months after treatment is completed.
Radiotherapy to your mouth will make your teeth more likely to decay and can make future dental work more hazardous. If you have your own teeth, your doctor will arrange a dental consultation before your radiotherapy begins so that any dental work you need can be done.
Your dentist will give you detailed instructions about caring for your mouth and teeth, to help prevent tooth decay and to deal with problems such as mouth sores. It is very important that you follow this advice. You will need ongoing dental care after treatment is completed.
