Common Side Effects
The following are some of the common side effects experienced as a result of radiotherapy treatment. Your radiation oncologist will discuss in further details all relevant short and long term side effects related to your individual diagnosis and treatment requirements.
The feeling of exhaustion, even when well-rested, is the most common side effect related to treatment, and at times can be the most severe. The tiredness happens because the body has to expend much more energy on a cellular level to heal itself after each day's treatment.
Many people have described this feeling as the entire body feeling too heavy to move. Mental exhaustion, stress and the extra travelling to and from treatment and other medical appointments, plus extra medications in the body can contribute to the problem.
During this time, it is important to get a good rest and nap during the day if desired. Managing time well, prioritising tasks and accepting the help of others can also reduce over-exertion. However we don't recommend complete bed rest or a sedentary lifestyle. Light exercise such as a 20- or 30-minute stroll can help combat fatigue. Good sleep routines and resting are also useful and relaxation techniques can be helpful. If you find it difficult to have uninterrupted sleep, please talk to your doctor.
Skin often reacts to radiation because of its constantly regenerating nature. The most common reaction is erythema--a drying and reddening of the skin which can appear in the treated area. Other reactions are inflammation and dry or moist skin peeling. Some permanent skin impacts could be a change in pigmentation, formation of scar tissue and dark red blotches caused by dilation of groups of capillaries. The likelihood of you experiencing these side effects is best discussed with your radiation oncologist as each person's case whilst often similar is unique.
Most skin reactions subside after treatment is complete; however it is very important that special skin care is taken once treatment begins:
- Sorbolene, Calendula or Vitamin E cream should be applied to the treated area three times a day to keep the skin nourished. This helps maintain good skin integrity and assist in reducing the early stage skin reddening intensity. A moisturising cream that is not heavily fragranced is recommended over other lotions as these are less likely to dry or irritate the skin. Ask your radiation oncologist, radiation therapist or nurse if unsure
- Soaps can dry the skin; therefore a moisturising soap such as Dove or Sorbolene cream should be used in the treated area when showering
- It is important the skin in the treatment area is not rubbed vigorously, scratched, or exposed to extremes of temperature. Talcum powder, Band Aids, and other sticky tapes should also be avoided
- Underarm deodorants are fine to use but are best avoided in the treated area once the area starts to become sensitive. Some women find that alcohol free and natural crystal deodorants such as DeoNat are a gentler alternative during this time
Temporary or permanent hair loss in the treated areas may occur. In the instance of radiotherapy hair will only fall out in the area of the body being treated. For example, if you are having radiotherapy to your head you will probably lose some hair from your scalp. If the area being treated includes an armpit or your chest, then it is only hair in these regions which is likely to fall out. This is a common side effect which can be discussed with you by your Radiation Oncologist.
When you finish radiotherapy your hair will usually grow back but it may not be as thick as before. The time it takes and the way it grows back depends on the dose of radiotherapy you have received and the duration of treatment. Your hair will usually have grown back within six to twelve months of completing your treatment. Occasionally after a large dose of radiotherapy the hair may not recover completely and new growth can be rather patchy.
Lymphoedema is the build-up of lymphatic fluid in tissues. Some patients have a higher tendency than others of developing troublesome lymphoedema; this is usually a genetic predisposition and is referred to as primary lymphoedema. Secondary Lymphoedema on the other hand often occurs after surgery, radiation therapy, burns or injury where the lymphatic vessels in tissue have been severed, or fibrosis (scar tissue) occurs and they can no longer perform their function of draining excess fluid from the body. This is often experienced by patients after breast surgery or patients who have had a neck dissection.
Lymphoedema when unmanaged can render arms and legs immobile, painful, and hugely swollen. Unfortunately, lymphedema cannot be cured so preventative management is preferable.
People at high risk of developing Lymphoedema should begin prevention and management exercises as soon as possible. Compression garments, medication, physical therapy and precautions can all be taken after surgery or after and during radiation therapy involving lymph nodes.
Your radiation oncologist or radiation oncology nurse can assist you in understanding better ways to manage Lymphoedema. Or alternatively a referral to a professional Lymphoedema management centre can be obtained from the radiation oncologist.
ORAL AND DENTAL CARE
Patients having treatment for a head and neck cancer will usually be recommended to see an oncology dentist before treatment. The importance of maintaining good oral hygiene and healthy teeth before during and after treatment is vital and is proved to assist in helping to reduce the severity of acute treatment side effects as well as the likelihood of long term chronic ongoing problems with your mouth and teeth.
A dental appointment will usually be arranged by the radiation oncologist at the time of your initial consultation. Our administration and reception staff will help to ensure you are fast tracked an appointment.
ANXIETY AND EMOTIONS
Many of our patients report difficulty with coping with a cancer diagnosis and treatment and being able to manage emotionally throughout. This is not unusual and we recognise that there may be periods of time where you will need to access cancer support services. The Cancer Council has information about a range of options. Alternatively you may also consider getting a referral to a private clinical psychologist.
Our administration staff can help you fast track an appointment at a time convenient to you. Alternatively it may help to discuss your feelings with your Radiation Oncologist or Radiation Oncology Nurse and they can help direct you to an alternate service that is able to best meet your immediate and personal needs.