Side effects

Side effects depend on the:

• amount of radiation given
• area of the body treated
• individual response
• type of radiation.

Side effects are commonly grouped into those that develop early on, during, or at the end of the treatment (the acute side effects), and those that develop many months and sometimes years later (chronic side effects).

The inflammation caused by the radiation beams passing through normal tissue results in the acute side effects. These side effects peak about a week after treatment has finished. Most side effects will be greatly improved around six weeks after the treatment has finished. Your doctor will tell you what you are likely to experience.

“My oncologist said ‘You will not feel any effects in yourself until towards the last weeks of treatment’ and I didn’t know what that meant at that time. I felt very tearful, I nearly gave up and threw in the towel in the 2nd to last week.” Silei

Late effects appear many months or years later. The inflammation of the tissues will have settled. Sometimes the initial damage and this healing process might result in scarring and damage to these tissues, which will restrict their function. Your treatment will have been planned specifically to minimise the likelihood of late complications and any significant risks that might exist will be discussed with you.

Feeling tired

Fatigue/tiredness can be a major side effect of radiation treatment. If you do get tired, try to take things easier. Only do as much as you feel comfortable doing. Try to plan rest times in your day. Drinking plenty of fluids, eating well, and having some form of mild physical activity will help you cope better with treatment.

If you’re not sleeping well, tell your treatment team. They might be able to suggest ways to help, or prescribe sleeping tablets or a mild relaxant.

Effects on the skin

The skin in the treatment area might become dry, flaky, red, itchy, or sore – similar to sunburn. It depends on the amount of radiation the skin receives. Your skin might also be more sensitive than usual to the sun. Try to keep treated areas out of the sun during and after treatment. Once the reaction improves, ask your doctor about using a sunscreen (SPF 30+).

Skin care

• Wear soft, loose clothing.
• Tell your treatment team about changes in your skin, such as cracks, blisters, very moist skin, rashes, infections, or peeling, or any changes in your nails.
• Don’t rub, scrub, or scratch treated skin or any sensitive spots.
• Follow skin care advice given by your treatment team; for example, avoid using soap, perfume, deodorant on treated areas; use a soft towel and bath or shower as usual in warm water.
• Do not put hot water bottles or ice packs on treated areas.
• If skin becomes sore, only use products recommended by the treatment team.

“My whole breast was sore – it was so uncomfortable but the nurses put on me this beautiful dressing. And I loved that dressing.” Silei

Hair loss

You only lose some or all of your hair from the part of your body being treated; e.g. scalp, chest, or face. This might be temporary or permanent.

If you have lost or are losing the hair from your head you could consider wearing a wig, hair piece, hat, or scarf for a while. If you decide to wear a hair piece or wig, it is a good idea to get one fitted before you start losing your hair, so that it matches as closely as possible your style and colour. The Ministry of health helps pay the cost of a hair piece, wig, or head covering. Ask your doctor for a certificate that states your entitlement.

Not wanting to eat

Your appetite might be normal during treatment, or you might not feel like eating. Your sense of taste might change, especially if you have radiation treatment to your head and neck.

Eat as well as possible during your treatment to keep your strength up and avoid weight loss. Try different foods until you find food that appeals. Eat smaller amounts more often, or try drinking special liquid supplement foods that you can get from your chemist. Even when you are unable to eat very much it is important to drink plenty of clear fluids.

You may find the Cancer Society’s booklet, Eating Well/KiaPai te Kai, helpful. It has suggestions and recipes. For more information, contact the Cancer Information Helpline 0800 CANCER (226 237). You can also download this booklet from our website.

Your hospital might have its own diet information for cancer patients. You can also ask the hospital or community dietitian for advice about what to eat.

Feeling sick and vomiting

Feeling sick and vomiting might happen if you are having radiation to the oesophagus (gullet), stomach, bowel, brain, or pelvic area. Your radiation oncologist can prescribe medication to help relieve these symptoms. Maintaining a good fluid intake is important.

Bladder and bowel irritation

Bowel problems resulting from pelvic radiation treatment

During radiation treatment to the pelvic area, inflammation of the large bowel (colon and rectum) and anus occurs.

You might find that you have some of the following symptoms:

• loose stool or diarrhoea
• passing blood from the bowel
• needing to rush to the toilet, or leakage from the bowel
• feeling that the bowel has not emptied properly
• passing excess wind
• difficulty emptying the bowels
• bowel pain.

Once the radiation treatment has ended, the inflammation usually settles down over a few weeks or months. But there is some permanent scarring of the bowel.

Bladder problems resulting from pelvic radiation treatment

High doses of radiation treatment for bladder or prostate cancer can cause bladder changes. Radiation to the cervix or uterus might also cause problems.

The cells lining the walls of the bladder can become permanently damaged. This can make them fragile, so they might bleed. The bladder walls might also become scarred and hardened (fibrosed). If this happens, the bladder holds less urine.

You might find that you have some of the following symptoms:

• need to pass urine often (frequency)
• burning sensation when you pass urine
• can’t wait when you need to empty your bladder (urgency)
• blood in your urine (haematuria)
• weak flow of urine and your bladder not emptying completely
• getting up in the night to pass urine.

Less common symptoms:

• a small amount of urine leakage (incontinence) – especially if you laugh, sneeze, exercise, or cough
• pain when passing urine
• passing blood clots
• difficulty passing urine, because the radiation treatment can make the tube that drains urine from the bladder (urethra) narrower. This is known as a stricture.

Contact your doctor if any of these symptoms occur, because treatment is available to alleviate them.

If you have had surgery and radiation treatment to lymph nodes there is an increased risk of lymphodema.

Lymphodema is a long-term swelling of one or more parts of the body due to a drainage system that does not work properly. If this occurs for you, talk to your doctor or nurse about ways to manage this.

Mouth and throat problems

Radiation treatment can give you a sore or dry mouth or throat and your voice might become hoarse if you are receiving treatment to the head and neck region.

Try some of these ideas:

• suck on ice blocks
• drink lots of liquids – carry a sipper bottle with you at all times
• moisten foods with butter
• dunk dry biscuits in tea
• blend foods and eat soups and ice creams
• ask your dentist, doctor, or nurse about artificial saliva
• if you drink alcohol, do so in moderation and avoid spirits
• don’t smoke.

For more advice on living with a dry mouth, contact your local Cancer Society to receive our booklet Dealing with Dry Mouth, or phone the Cancer Information Helpline 0800 CANCER (226 237).

“I did get a few ulcers in the back there though spicy foods didn’t set it off. It was strawberries and berries that did it.” Melinda

If you are having radiation treatment to your mouth, your teeth will be more likely to decay. Discuss dental care with your doctor and dentist before your treatment starts, so any dental work can be arranged before your radiation treatment begins.