Side effects can vary with each person and with the total dose of radiotherapy you receive. You may experience some and not others.
Side effects usually appear gradually during your course of treatment and may continue for a period after your treatment has finished.
Effects on the skin
Towards the end of treatment most patients experience some changes in the skin in the area that has been treated. The skin may:
- feel tight and uncomfortable
- become pink or red
- become dry and flaky
- itch
Most people will experience some of these changes in the treatment area after the first 10-12 days. Your skin reaction may be worse and happen earlier if you are also having chemotherapy.
Your skin will be monitored by your radiographers during radiotherapy and you will be given advice on how to care for it. You will also be seen once a week in a radiotherapy clinic by your oncologist, specialist nurse or specialist radiographer who will examine your skin and advise on any creams if necessary.
The effects on the skin may continue for up to six weeks after treatment has ended.
Skincare - What can I do to help?
- Gently wash the treated area with warm water and a mild, unperfumed soap.
- Pat the area dry using a soft towel. Don’t rub. Avoid using flannels as they can harbour germs.
- Do not apply your own creams, make up, perfumes, lotions or aftershave to the treated area unless they are advised or prescribed by your radiographer, nurse or oncologist.
- You may be given a moisturising cream from the radiographers or nurses to soothe the skin, or your oncologist may prescribe a cream if needed. Use it twice daily smoothing the cream gently over your neck. Do not rub.
- It is advisable to wear loose clothing around the neck without tight or stiff collars.
- Wherever possible, leave the area being treated open to the air.
- If you need to shave, please use an electric shaver. Try not to shave as often. Shaving involves rubbing the skin which can irritate. The hair in the treatment area will become sparse and fall out after 2-3 weeks. It should re-grow after your treatment reactions have settled.
- Radiotherapy will make your skin more sensitive to the sun. Avoid exposing the area to strong sunlight during and after your course of treatment. Do not use a sun lamp or sun bed. It is advisable to use a sun block (factor 25 or above) or keep the area covered when in the sun.
Effects on the voice
You may already be hoarse before you start your treatment. It is likely that your voice will become more hoarse during your course of radiotherapy. Some patients may find that they temporarily lose their voice.
- It is advisable that you rest your voice as much as possible during treatment.
- Do not strain your voice to make yourself heard. When your treatment has finished it may be a few weeks before your voice starts to recover, and in some cases, may always remain husky.
- This will be assessed at regular follow up appointments and any concerns will be addressed.
Soreness of the throat
The lining of the throat will become sore and inflamed during the treatment which will make it difficult to swallow. This may happen after about 10-12 treatments. Your oncologist can prescribe painkillers to help and will give you advice about a softer diet. Some people manage to eat a soft diet until the soreness has settled. This usually occurs a few weeks after treatment has finished.
A dietician is available in the department for extra advice.
Towards the end of your course of treatment the throat can become too sore to eat and drink even soft foods. Your oncologist or specialist nurse may suggest increasing your painkillers and arrange an appointment for you to discuss dietary requirements with the dietician.
For a few people, swallowing can become even more difficult, e.g. food sticking at the back of the throat or drinks going down the wrong way. Alert your oncologist, radiographer, nurse or dietician if this is happening to you.
A speech and swallowing therapist is available in the weekly review clinic for more advice.
Dry mouth or throat
The radiotherapy can make your mouth and throat dry. This is caused by damage to the salivary glands that produce saliva to keep your mouth moist. Your saliva may become thick and stringy. You may find it helpful to carry a bottle of water for sipping during the day. You may also be given a mouthwash or other treatments to help. Please speak to your radiographer, nurse or oncologist for further advice.
Most people find that the salivary glands gradually recover, but for some it can be a permanent change.
Eating and drinking
It is important that you eat well during your treatment. You may have to eat a softer diet or use supplement drinks when your throat becomes sore. Avoid rough or dry foods such as toast, bacon, hot, spicy or acidic foods.
It is important to drink plenty of fluids (between 1-2 litres daily). This can include water, milk, squash, low sugar fizzy drinks, soups, teas and coffees. Beverages should not be too hot.
Drinking alcohol during your radiotherapy (particularly spirits) should be avoided as it has a drying effect and will make your symptoms worse.
Some people lose their appetite, sense of smell and taste during treatment.
Please ask to see the dietician for further advice.
Smoking during radiotherapy
It is recommended that you stop smoking during your treatment. We appreciate that stopping smoking may be difficult for you. Please ask your radiographer, specialist nurse, oncologist or GP for help with smoking cessation.
Tiredness / Fatigue
Radiotherapy can sometimes make you feel very tired especially towards the end of your course of treatment and may continue for a number of weeks.
You should rest as much as you need to. It may be some time before you feel able to do some of your usual activities.
Fatigue is something nearly everybody with cancer feels. It affects people differently and it is important to tell the health care team if you are feeling much more tired, fatigued or lethargic. There are some physical causes, such as anaemia that are readily treatable. However, some other causes are unavoidable, so it is important to learn to manage it.
Please ask for a booklet on "Fatigue" at the Information Centre that may give you tips to help with this.
Your emotions
It is important to make time for yourself. The radiotherapy can make you feel tired or low, especially towards the end of your course of 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 Macmillan nurses, dietician and social worker.
A Clinical Psychology service is available at NCCT on referral from your oncologist.
Sex
Sexual activity is personal to each individual and may be an aspect of your life about which you have concerns relating to your disease or treatment. You may have questions you wish to ask. Please talk to your oncologist, nurse or radiographer if you would like to talk about these issues confidentially.
Pregnancy
It is very important that women are not and do not become pregnant whilst undergoing treatment. Please inform a member of staff immediately if you think you may be pregnant.
Your Progress
Your oncologist, specialist nurse or radiographer will see you once a week in a radiotherapy clinic during your treatment. You may also see the dietician or the speech and swallowing therapist here.
They will discuss any concerns you may have regarding your radiotherapy such as pain control, dietary requirements, swallowing, communication advice, skincare and psychological support.
