General Questions About Radiation Therapy
- What is Radiation Therapy?
- How is the radiation given?
- Does radiation affect more than just the cancer cells?
- What can I expect when I come for treatment?
- What are the side effects of radiation therapy?
- What do I need to do after my last treatment?
Important Health Issues in Radiation Therapy
Radiation treatment can be very effective but it is very important to be aware of recommendations for dealing with the following potential health issues that can accompany treatment:
- High risk for infection
- High risk of bleeding
- Fatigue caused by anemia
- Nutrition and medication
- Skin care
- Birth control
What is Radiation Therapy? (back to top)
Cancers are growths or collections of abnormal cells. Many of these cells are sensitive to radiation. Radiation therapy is the medical specialty that uses different forms of radiation to damage these cancer cells. There are many forms of radiation, and the choice for you depends on your type of cancer and its location. This is because various types of cancer react to radiation in different ways, so treatments vary for specific types.
How is the radiation given? (back to top)
Similar to an x-ray, radiation therapy does not hurt. Often, radiation is delivered using a machine that beams the radioactive material right at the cancer. This is called external radiation therapy.
In some cases, radiation is not beamed through a machine but instead comes from radioactive material placed in or near the tumor. Surgery is used to insert radiation implants in the tumor. Then cancer cells will be destroyed from inside the body. This is called low-dose-rate brachytherapy.
Radiation treatments take only a few minutes and often are given over a period of several weeks. You are not radioactive during or after external radiation therapy. However, if you are hospitalized for insertion of radioactive sources, you will be kept in a protected room until the sources are removed or no longer pose any hazard to loved ones.
Does radiation affect more than just the cancer cells? (back to top)
Radiation can affect normal cells surrounding the cancer cells. However, through careful treatment planning, we can direct radiation to the cancer while trying to spare most normal tissue near the cancer. To do this, we may have to treat the cancer from both sides of your body or from several different angles, and we may deliver treatments with more than one type of radiation. This may require the use of more than one machine.
In addition, we use special lead shields to cover the parts of the body not being treated. We also use dye or felt-tip markers to mark the target area on the skin. These marks are needed until treatment is complete.
For breast cancer patients, new advances in radiation therapy may make it possible to more closely contain the radiation to the targeted cells than ever before. (Learn more)
Finally, with careful scheduling of radiotherapy treatments, we may be able to kill the cancer cells while allowing normal cells to recover.
What can I expect when I come for treatment? (back to top)
On your first visit, plan to spend two to three hours. You usually will need to undress and get into a robe that we provide. You do not need to remove your jewelry or watch unless you wear it on the specific area being treated.
We may draw on your skin to indicate the area of radiation treatment. The marking fluid will stain clothing, so you should wear old clothing. We then will take x-ray pictures (called simulator films) to confirm the treatment area. Occasionally, the treatment area, and thus the lines, will be changed as the treatment progresses. These changes are made under the direction of the radiotherapist. Please do not wash off these markings.
The radiotherapy technician will help position you on the table for each treatment and then leave the treatment room. You should not move during the set up or the treatment. Actual treatment time takes only a few minutes, but you may spend 15 to 20 minutes in the treatment room being set up accurately.
Undergoing the treatments is very similar to having an x-ray examination; however you may breathe normally. The treatments cause no pain or discomfort, but the therapy machine may frighten you the first time. The treatment machines are large and make various noises when operated. Be assured, however, that we will be in continuous contact with you through closed-circuit television or mirrors and a two-way intercom system. If you should have any problems, we will turn off the machine immediately and help you. When the machine is turned off, the release of radiation stops immediately.
Your treatments usually will be given daily, Monday through Friday, with a rest on weekends. Your technician will notify you of any holidays on which you will not receive treatment. We will try to make your daily appointments convenient for you. If you find it necessary to change a treatment time, please call your radiotherapy station.
Your radiotherapy physician will examine you and review your progress once a week or more often if necessary. This review will require a longer than normal visit. Since radiotherapy may cause a drop in your blood count, periodic blood tests will be required.
What are the side effects of radiation therapy? (back to top)
Although radiation therapy is not painful, it can cause unwanted side effects. You may be more tired than usual. The skin where radiation is aimed may feel like it has been sunburned and will need to be protected from the sun. Your hair may fall out but only in the area receiving radiation. If the radiation therapy aims at the stomach, you may experience nausea or vomiting, diarrhea or a loss of appetite. If you have radiation treatments to the head or neck, you may experience a sore throat, headaches, difficulty swallowing, loss of appetite, loss of taste or a changed sense of smell. Side effects present at the end of your treatment will generally begin to improve about a week after the last treatment.
What do I need to do after my last treatment? (back to top)
This information is designed to complement the specific discharge instructions found on the patient information card you will receive during your treatment:
- Your physician or nurse will tell you when you can bathe the treated area. If the treated area is tanned and dry, you generally will be able to begin bathing immediately. Bathe or shower in tepid water using mild soap and your hands on the treated skin. Do not use a washcloth. Do not soak in the tub for any period of time. After bathing, pat dry the skin in the treated areas with a soft towel and apply a thin layer of the prescribed ointment to the treated areas. Use the ointment three times a day or more often, as needed, until your skin appears normal.
- The treated area always will be sensitive to injury. Do not expose it to extreme changes in temperature (hot water bottle or ice bag).
- Avoid direct sun exposure to the treated area as much as possible. If you spend more than 20 minutes in the sun and your clothing or a hat does not cover the treated area, use a sunscreen with an SPF of 15 of higher.
- Even though your therapy treatments are complete, maintain good nutrition with an adequate diet and fluids to speed the healing process.
- We will send a report to your referring physician. You should have regular follow-up examinations by your referring physician and/or radiotherapist. We will schedule your follow-up visit for you at the completion of therapy.
- If you require any surgical procedures or biopsies in the future that will involve the areas that have been treated, make your physician aware of the radiation therapy you have received. If necessary, your physician can contact your radiotherapist for more information.
High risk for infection (back to top)
- Avoid using any type of container that has stagnant water such as humidifiers, flower vases, denture cups and soap dishes. These are places bacteria like to grow.
- Add 1 teaspoon of chlorine bleach to each quart of water used in flower vases.
- Add 1 teaspoon of vinegar to each quart of water or use saline for respiratory equipment; all equipment should be cleaned with 70 percent alcohol or chlorine bleach solution and vigorous scrubbing.
- Limit visitors to those without contagious illness that include colds, viruses, cold sores, influenzas or chicken pox; do not allow visitors who have recently received vaccinations with living or attenuated microbes, such as the polio vaccine.
- Avoid crowds such as in shopping malls or grocery stores.
- Avoid cleaning birdcages or cat litter boxes because bacteria or fungi could lurk in the excreta.
- Eat a high-protein and high-carbohydrate diet.
- Use a mild soap such as Dove or Dial to wash each day; rinse the skin thoroughly and pat dry.
- Cleanse the perianal area after each bowel movement and urination.
- Perform skin care daily with a water-soluble lubricant to prevent dryness of the skin.
- For personal hygiene, take a sponge bath, tub bath or shower every day.
- Keep nails clean and short.
- Four times a day, perform mouth care as prescribed by your nurse or physician.
- Promote healing of all skin wounds by changing dressings every 8 hours or as instructed by your physician or nurse.
- Avoid enemas, suppositories and rectal thermometers.
- If constipation is a problem, talk to your physician or nurse about putting you on a bowel regime.
- Drink at least eight 8-ounce glasses of fluid a day.
- If ordered to do so, take growth factors daily until told to stop by your physician or nurse.
- Dispose of needles in a thick container such as a coffee can or egg carton.
- Store in refrigerator at 36 to 45?F.
- Keep appointments for blood work.
- Take your temperature daily in the late afternoon or early evening. Call your physician immediately if you have a temperature over 101?F.
- Call your physician immediately if you get severe chills, mouth sores, pain with swallowing or fever.
High risk of bleeding (back to top)
- Avoid activities that have the potential for physical injury. Bleeding occurs more easily when the platelet count is low.
- Wear gloves while working in the garden.
- Wear shoes or slippers when out of bed.
- Avoid tight-fitting clothing.
- Use an electric razor or safety razor when shaving.
- Use an emery board or fine-mesh file for nail care.
- Eat soft, bland foods such as soup, yogurt, ice cream and peanut butter. Avoid foods that are irritating such as hot, spicy or rough dishes.
- Use a soft-bristly toothbrush or toothette for oral care, and avoid using dental floss when the platelet level is less than 50,000. Seek approval from the physician before having dental work.
- Avoid constipation. If you have difficulty, ask your nurse for a bowel regimen.
- Avoid blowing your nose forcefully. Only blow gently through both nostrils simultaneously, if necessary.
- If nose bleeding occurs, sit straight up and apply firm pressure to the nostrils below the bridge of the nose.
- If the bleeding does not stop, place an ice bag to the bridge of the nose and at the back of the neck.
- If bleeding continues, call your doctor.
- Do not take medications such as aspirin that have the potential to start or prolong bleeding. Ask your physician, nurse, or pharmacist if you are not sure of the contents of any of your medicines.
- Call your physician or nurse for signs of bleeding such as nose bleeds, blood in your urine, black bowel movements, tiny purplish spots on your skin or bruises that happen easily.
Fatigue caused by anemia (back to top)
- Eat a well-balanced nutritious diet.
- Eat foods high in iron such as potatoes, red meats, dark green leafy vegetables and carrots.
- Eat high-protein and high-carbohydrate foods such as peanut butter, milk products (cottage cheese, cheese, milk, ice cream, yogurt, cream cheese), rice, pudding, custard, macaroni, pasta and potatoes.
- Try nutritional supplements such as Nutra Shake, Ensure or Carnation Instant Breakfast.
- Add a tablespoon of powdered skim milk to fluids to provide more protein.
- Take naps or rest periods of 30 minutes to an hour, perhaps one in the morning and one in the afternoon.
- Sleep later in the morning or go to bed earlier at night.
- Resting all day, however, will increase feelings of fatigue.
- Plan consistent exercise periods, such as walking to a specific designation once a day.
- For extreme fatigue, prevent tissue breakdown by walking short distances three times a day, sitting on the side of the bed three times a day, or turning in bed.
- Provide skin care with water-based skin lotion.
- Don’t be afraid to ask for help. Seek assistance with activities such as housework, childcare or meal preparation when experiencing fatigue.
- Tell your physician or nurse if you have pain, trouble sleeping or difficulty catching your breath.
Nutrition and Medication Guidelines (back to top)
- We will record your weight weekly and more often if necessary. It is very important that you maintain an adequate diet and get sufficient rest. We encourage you to continue some physical activity. We will discuss any specific restrictions and requirements with you.
- Your physician will review your current medications, which can usually be continued throughout the course of radiation. Any additional medications will be prescribed, as needed.
- A registered dietitian from the Radiation Oncology Department will help you with your individual nutritional problems. If you are on a special diet, such as a diabetic or sodium-restricted diet, the dietitian can help you change the diet plan, as needed.
- Radiation destroys cancer cells, which then need to be eliminated from the body. Therefore it is important that you drink at least two quarts of liquid daily.
Skin Care Guidelines (back to top)
- It is very important that you do not wash off the colored lines. You should not wash the treatment areas with soap, and you should not apply lotions, creams or powders, unless directed by the radiotherapist.
- We encourage good personal hygiene, and you may use soap and water on any area not being treated.
- Wear only loose-fitting clothing over treatment areas usually covered with clothing.
- Do not apply heat in any form to the treatment areas. Also, avoid any exposure of the areas to intense direct sunlight or ultraviolet rays. Ice packs should not be applied to the treated skin.
- Toward the end of your treatments, skin in the location that has been receiving radiation may become pink and itchy. In some cases it will tan and flake like a moderate suntan. Avoid scratching the skin in the treated area and any clothing that rubs it. The skin reactions heal quickly after you complete treatment, and you will be given ointment to soothe the irritation.
Birth Control (back to top)
It is important that you do not get pregnant while you are receiving radiotherapy. Please discuss birth control methods with your radiotherapy physician.
Other special instructions relevant to your particular treatment will be given to you on a separate card during your first visit.