This page has been written to give you general information and answer some of the questions you may have about radiotherapy to help ease your bone pain caused by bone metastases or secondary cancer, and the side-effects of radiotherapy.
We hope you will find this helpful.
Why would I need radiotherapy?
Secondary bone cancer weakens the bones by damaging healthy bone cells. Radiotherapy can help to make bones stronger and less likely to break. The radiation kills off cancer cells that are destroying and weakening the bone.
Radiotherapy may be used to strengthen the bone. It can also treat bones that have fractured.
After radiotherapy, some of the cancer cells die, so the bone begins to replace the lost tissue and become stronger, less painful and less likely to break.
How long will it take for my symptoms to improve?
Some of your symptoms will be eased within a few days but this may vary for example most bone pain takes one to two weeks to ease.We are all different and respond at different rates. About 3 out of 10 people (30%) will have no pain within a month of treatment. For at least another 4 out of 10 (40%) people, the treatment reduces the pain by half. So at least 7 out of 10 people (70%) will have somewhere between no pain and half as much pain, after their radiotherapy.
Having this treatment may slow down the cancer in the treatment area and give you a better quality of life for a longer time.
Possible short term (early) side-effects
Early side-effects are temporary and affect most patients. The side effects generally develop during or soon after treatment. Occasionally side effects can last for several weeks, however this is unusual.
1. Effects on the skin
Within one week some patients may experience changes in the skin over the area that has been treated. These changes are rarely severe but the skin may:
You will be given advice on how to care for your skin by your radiographers or oncologist.
Skin care – what can I do to help?
We recommend that you take special care of your skin during and up to six weeks after your radiotherapy as the reaction may continue after treatment has finished.
Keep the area cool. Wear loose, preferably cotton clothing that does not rub the skin and will allow air to circulate.
Do not expose the treated area to the sun.
While in the sun the treated area should be covered completely or a high protective factor suncream (25 or above) should be applied. Do not use a sunbed as this could make the reaction worse.
Do not soak the area in the bath or under a long hot shower. You may wash your skin in the treated area using a simple, unperfumed soap applied gently with your hands and rinsed well with warm water. Avoid using flannels or sponges. Pat the area dry with a soft towel or let the skin dry naturally. Do not use a hot water bottle or heat pads on the treated area.
Do not use talcum powder, bubble baths, bath salts, shower gels or body lotions on the treated area as they tend to be highly perfumed and can dry or irritate the skin. You may be given a moisturising cream to soothe the skin from the radiographers or nurses, or your oncologist may prescribe a cream if needed.
2. Nausea and diarrhoea
You may feel sick if you have radiotherapy to the spine or ribs that are near the stomach or the tummy (abdomen) area.
To help control sickness your oncologist can prescribe anti-sickness drugs (anti-emetics). You may find that taking an anti-sickness tablet an hour before your treatment helps.
If you are having treatment to your hips (pelvis), or your bowel is in the treatment area, you may have some diarrhoea. Your oncologist or your own GP can prescribe medicines to help control this.
You may experience some “pain flare” in the area of treatment. This is a swelling around the treatment area in the days following treatment. It can cause a temporary increase in pain and tenderness. As radiotherapy may not help relieve your pain until one to two weeks after your treatment your painkillers may need to be adjusted during this time.
Radiotherapy can sometimes make you feel very tired for a number of weeks after treatment. It may be a while before you feel able to do some of your usual activities. You should rest as much as you need to although gentle exercise may help. Fatigue is something nearly everyone with cancer feels. It affects people differently and it is important to tell the health care team if you are feeling more tired than usual. There are some physical causes, such as anaemia, that are readily treatable.
You may be referred to physiotherapy, occupational therapy, dietician or social worker to help.
Please ask for a booklet on fatigue at the Information Centre in the Northern Centre for Cancer Care (NCCC) which will give you tips to help yourself.
If you are having a course of radiotherapy you may be seen by a member of your specialist team during your treatment. This will be an opportunity to discuss any concerns or problems you may have.
If you are having only one treatment, any further follow up appointments will be discussed at your consultation with the oncologist. If you have financial worries please ask at the Information Centre for more advice and information.
Please tell your treatment radiographers if you have any problems.
Possible long-term or permanent effects of treatment
It is important to make time for yourself. Emotions associated with the reactions to a diagnosis of cancer may come to the surface at various stages during your treatment. Don’t worry if you feel low, this is normal. If you need to talk to someone, please ask, we are here to help. We have a wide range of support services within the department, such as the Palliative Care Team.
A Clinical Psychology service is also available at the NCCC on referral from your oncologist.
Having radiotherapy will have no long-term effect on your sex life. However when you are tired, in pain or have worries about your cancer, your sex drive can be affected. This is personal to each individual and may be an aspect of your life about which you have concerns. You may have questions you wish to ask. Please talk to your radiographer, oncologist or the nurse specialist if you would like to talk about these issues confidentially.
There is more information available on this subject in the Information Centre at the NCCC.
It is very important that women are not and do not become pregnant whilst undergoing radiotherapy. Please inform a member of staff immediately if you think you may be pregnant.
After your radiotherapy has finished
The side effects of radiotherapy can continue for several weeks after treatment has finished. Continue with your skincare routine until any changes return to normal.
You will usually be sent a follow up appointment to see your specialist team approximately four to six weeks after finishing treatment.
You will get a letter giving you a date and time for your appointment. If you are worried about your side effects after your treatment has finished, please contact the information centre or your specialist team at your referring hospital for further advice.