Side Effects & Care

Radiation treatment to the chest may cause swallowing problems, cough, or shortness of breath. Be sure to tell your doctor or nurse if you notice any of these side effects. If you get radiation therapy after surgery (such as a lumpectomy or mastectomy) for breast cancer, try to go without wearing a bra whenever you can. If this is not possible, wear a soft cotton bra without underwire so that your skin is not irritated. If your shoulders feel stiff, ask your doctor or nurse about exercises to keep your arms moving freely.

Other Potential Side Effects May Include:

• Skin may become tan or slightly red. Itching and tenderness may occur over time.
• Soreness of breast, nipple, under arm and possibly the shoulder on the side being treated.
• Swelling from fluid build-up in the treated area.
• Irritation of the skin fold beneath breast and axilla.
• Dryness or scaliness of treated skin area.
• Skin may have orange peel appearance over time or (tiny dimples).
• Blistering and/or skin breakdown toward the end of treatment.
• Pain and heaviness of breast. Sensation of warmth of the breast.
• Possibly dry cough towards the latter part of treatment.
• Fatigue.

These side effects most likely will go away a month or two after you finish radiation therapy. If fluid build-up continues to be a problem (a condition called lymphedema), ask your doctor what steps you can take. Skin discoloration will most likely fade one or two months after you finish radiation.

Radiation therapy after breast surgery may cause other long-term changes in the breast. Your skin may be slightly darker, and pores may be enlarged and more noticeable. The skin may be more or less sensitive and feel thicker and firmer than it was before your treatment. Sometimes the size of your breast changes — it may become larger because of fluid build-up or smaller because of the development of fibrous tissue. Many women have little or no change in breast size. These side effects may continue for a year or longer after treatment.

If your treatment includes internal radiation implants, you might notice breast tenderness or tightness. After the implants are removed, you are likely to have some of the same side effects that happen with external radiation treatment. If so, follow the advice given above and let your doctor know about any problems that persist.

After 12 months, you should not have any new changes. If you do see changes in breast size, shape, appearance, or texture after this time, report them to your doctor right away.

If you are having radiation treatment to some part of the abdomen (belly area), such as for colorectal, gastric, kidney and stomach cancers, you may have vomiting, nausea, or diarrhea. Your doctor can give you medicines to help relieve these problems. Check with your doctor or nurse about any home remedies you are thinking about taking during your treatment.

Managing Nausea

Some patients report feeling queasy for a few hours right after radiation therapy. If you have this problem, do not eat for several hours before your treatment. You may be able to handle the treatment better on an empty stomach. After treatment, you may want to wait one to two hours before eating. If the problem persists, ask your doctor about medicines to prevent and treat nausea. Be sure to take the medicine as prescribed. If you notice nausea before your treatment, eat a bland snack, such as toast or crackers, and try to relax as much as possible.

To prevent or ease an upset stomach

• Stick to any special diet your doctor or dietitian gives you.
• Eat small meals.
• Eat often and try to eat and drink slowly.
• Avoid foods that are fried or high in fat.
• Drink cool liquids between meals.
• Eat foods that don’t have strong smells and can be served cool or at room temperature.
• For a severe upset stomach, try a clear liquid diet (broth and juices) or bland foods that are easy to digest, such as dry toast and gelatin.
• Learn deep breathing and relaxation techniques, and try them when you feel nauseated.

How to address diarrhea

Diarrhea most often begins a few weeks after starting radiation therapy. Your doctor may prescribe medicine or give you special instructions to help with the problem. He or she may also recommend changes in your diet, such as:

• Try a clear liquid diet (water, weak tea, apple juice, peach nectar, clear broth, popsicles, and plain gelatin) as soon as diarrhea starts or when you feel it is going to start.
• Avoid foods that are high in fiber or can cause gas or cramps, such as raw fruits and vegetables, coffee, beans, cabbage, whole grain breads and cereals, sweets, and spicy foods.
• Eat frequent small meals.
• Avoid milk and milk products if they irritate your bowels.
• When the diarrhea starts to improve, try eating small amounts of low-fiber foods such as rice, bananas, applesauce, yogurt, mashed potatoes, low-fat cottage cheese, and dry toast.
• Be sure you take in enough potassium (bananas, potatoes, apricots, peaches), an important mineral you may lose through diarrhea.

Diet planning is an important part of radiation treatment of the stomach and abdomen. Keep in mind these problems will get better when treatment is over. In the meantime, try to pack the highest possible food value into even small meals so you get enough calories, vitamins, and minerals.

When radiation treatments include the chest area, the lungs can be affected. One early change is a decrease in the levels of surfactant, the substance that helps keep the air passages open. This keeps the lungs from fully expanding, and may cause shortness of breath or cough. These symptoms are sometimes treated with steroids. A possible late effect of radiation to the lungs is fibrosis (stiffening or scarring). When this happens, the lungs can no longer fully inflate and take in air. If a large area of the lungs is treated with radiation, these changes can cause shortness of breath and less tolerance for physical activity.

If you get radiation therapy to any part of the pelvis, you might have one or more digestive problems, such as, diarrhea. You may have some irritation of the bladder, too, which can be uncomfortable and cause you to urinate often. You may also have effects on your fertility and sexual activity.

Fertility

Radiation therapy to an area that includes the testes can reduce both the number of sperm and their ability to function. This does not mean, though, that fertility and pregnancy cannot occur. If you want to father a child and are concerned about reduced fertility, talk to your doctor before starting treatment. One option may be to bank your sperm ahead of time.

Other than studies that looked at survivors of atomic bomb blasts, there is little information about radiation’s effect on the children conceived by men during or after getting radiation therapy. Doctors often advise men to avoid getting a woman pregnant during and for some weeks after treatment because of the uncertain risk, especially if there is radiation to or near the genital area.

Sexual Activity

With some types of radiation therapy involving the pelvis, men and women may notice some change in their ability to enjoy sex or a decrease in their level of desire. Radiation may affect the nerves that make a man able to have an erection. If a man is having seed implant radiation therapy, he should check with his doctor about safety precautions, such as, using condoms. If erection problems do occur, it is usually gradual over the course of many months or years. Talk with your doctor about treatment options if this is a concern for you.

General Skin Care

• When possible, please keep your skin clean and dry.
• You may shower or bathe daily using a mild soap such as Dove or Neutrogena. Please do not wash off your marks. You may wash around the marks and pat them dry. Rubbing and/ or scrubbing the affected skin may increase your risk of skin breakdown.
• Chemical products such as those used to perm or color hair should not be used while undergoing brain radiation treatments. Onslow Radiation Oncology is a joint venture of Onslow Memorial Hospital and Pitt County Memorial Hospital
• DO NOT expose treated skin to direct sunlight. Wearing a hat or scarf over the head is recommended while outdoors.

DO NOT use creams, lotions or ointments on the treated area that have not been approved or prescribed by your radiation oncology nurse or radiation doctor. Even approved ointments should not be applied immediately before your treatment. We will discuss this with you on your first day of treatment.

If you get radiation therapy to any part of the pelvis, you might have one or more digestive problems, such as, diarrhea. You may have some irritation of the bladder, too, which can be uncomfortable and cause you to urinate often. You may also have effects on your fertility and sexual activity.

Fertility

Do not try to become pregnant during radiation therapy because radiation can cause harm to the fetus. Women should talk to their doctor about birth control options and how radiation may affect their fertility. If you are pregnant, let your doctor know before beginning treatment.

Depending on the radiation dose, women having radiation therapy in the pelvic area may stop having their menstrual periods and have other symptoms of menopause. Treatment also can result in vaginal itching, burning, and dryness. Report these symptoms to your doctor so you can learn about options for relieving these side effects.

Sexual Activity

With some types of radiation therapy involving the pelvis, men and women may notice some change in their ability to enjoy sex or a decrease in their level of desire. During treatment to the pelvis, some women are advised not to have sex. Some women may find it painful. You most likely will be able to resume having sex within a few weeks after your treatment ends, but check with your doctor first. Some types of treatment may have more long-term effects, such as, scar tissue that could affect the ability of the vagina to stretch during sex. Again, your doctor may be able to offer suggestions if this happens to you.