Northern Centre for Cancer Care

Radiotherapy to the Spine

An oncologist may have advised a course of radiotherapy to the spine as part of your cancer treatment. This is often given to relieve pain or swelling.

This page has been written to give you general information and aims to answer some of the questions often asked by patients and their carers.

We hope you will find this helpful. If you have any further questions relating to your treatment, please do not hesitate to ask your radiographer, nurse or oncologist at the Northern Centre for Cancer Care (NCCC).


The spinal cord and vertebrae

The spinal cord extends from the base of the brain to the small of the back and is protected by the backbone. The backbone is made up of bones called vertebrae. The spine can be divided into four sections.

The four sections of the spine are the:

  • cervical spine (neck)
  • thoracic spine (chest)
  • lumbar spine (lower back)
  • sacrum / coccyx (pelvis)

Radiotherapy can be given to any or a combination of these areas. The side effects of treatment may differ according to the area treated and the number of treatments prescribed.

Possible short term (early) side effects 

Early side effects are temporary and affect most patients. The side effects generally develop soon after treatment and can last for several weeks.

Effects on the skin

Towards the end of treatment some patients may experience changes in the skin over the area that has been treated. The skin may
  • Feel tight and uncomfortable
  • Become pink or red
  • Become dry and flaky
  • Itch

Your skin will be monitored by your radiographers during radiotherapy and you will be given advice on skincare.

Skin care – what can I do to help? 

We recommend that you take care of your skin during and 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 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 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.

Tiredness or fatigue 

Radiotherapy can sometimes make you feel very tired especially towards the end of your course of treatment and for a number of weeks after. 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.

Nausea, sickness and diarrhoea.

If you are having treatment to your thoracic (mid) or lumbar (lower) spine you may experience some nausea or diarrhoea. Your oncologist may prescribe some anti-sickness and anti-diarrhoea medication to help.

Pain

Radiotherapy may be given to help treat your pain. You may be already taking painkillers to help.

You may also be prescribed a course of steroids. These can be given in tablet form to reduce any swelling in the area helping to improve your symptoms.

Radiotherapy to the cervical spine may cause a sore mouth or throat and radiotherapy to the thoracic spine may cause some difficulty or pain on swallowing. Medication can be prescribed to relieve these symptoms.

Pain flare may occur in a small number of patients having radiotherapy to the spine. 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 after your course of treatment your painkillers may need to be adjusted during this time.

Possible long-term or permanent effects of treatment

Your emotions

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 these feelings persist for more than three weeks it may be helpful 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, dietician and social worker.

A clinical psychology service is also available at NCCC on referral from your oncologist. 5

There is more information available on this subject in the Information Centre at NCCC or on the wards.

Sex

Having radiotherapy to your spine will have no long-term effect on your sex life. However when you are tired 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 NCCC.

Pregnancy

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. You will be asked (if appropriate) to confirm that you are not pregnant by one of the radiographers before starting treatment.

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 also be given a discharge letter with a copy for your GP summarising any side effects you may have and any creams or medication you have been prescribed at NCCC.  You will be sent a follow up appointment to see your specialist team usually between 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 your G.P. or your specialist cancer nurse at your referring hospital for further advice.  Your G.P. will have received information about the treatment you have had.

More Information

Useful Contacts

Palliative Care Team / Macmillan Nurses
0191 2138606 / 2138607 / 2138608 / 2138609

Northern Centre for Cancer Care Macmillan Information and Support Centre, 0191 2138611
Opening hours Monday to Friday from 9am to 4.30pm

Macmillan Cancer Relief, Head office 020 7840 7840, freephone 0808 800 1234, www.macmillan.org.uk 

Maggies Centre (Newcastle), 0191 2336600
e-mail: newcastle@maggiescentres.org

Leaflet to Download

Radiotherapy to the Spine.pdf

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