Frequently Asked Questions About Radiation Therapy
General Questions About Radiation Therapy
Important Health Issues in Radiation Therapy
Radiation treatment can be very effective but it is very important
to be aware of recommendations for dealing with the following potential
health issues that can accompany treatment:
What is Radiation Therapy? (back
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Cancers are growths or collections of abnormal cells. Many of these
cells are sensitive to radiation. Radiation therapy is the medical
specialty that uses different forms of radiation to damage these
cancer cells. There are many forms of radiation, and the choice
for you depends on your type of cancer and its location. This is
because various types of cancer react to radiation in different
ways, so treatments vary for specific types.
How is the radiation given? (back
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Similar to an x-ray, radiation therapy does not hurt. Often, radiation
is delivered using a machine that beams the radioactive material
right at the cancer. This is called external radiation therapy.
In some cases, radiation is not beamed through a machine but instead
comes from radioactive material placed in or near the tumor. Surgery
is used to insert radiation implants in the tumor. Then cancer cells
will be destroyed from inside the body. This is called low-dose-rate
brachytherapy.
Radiation treatments take only a few minutes and often are given
over a period of several weeks. You are not radioactive during or
after external radiation therapy. However, if you are hospitalized
for insertion of radioactive sources, you will be kept in a protected
room until the sources are removed or no longer pose any hazard
to loved ones.
Does radiation affect more than just the cancer
cells? (back to top)
Radiation can affect normal cells surrounding the cancer cells.
However, through careful treatment planning, we can direct radiation
to the cancer while trying to spare most normal tissue near the
cancer. To do this, we may have to treat the cancer from both sides
of your body or from several different angles, and we may deliver
treatments with more than one type of radiation. This may require
the use of more than one machine.
In addition, we use special lead shields to cover the parts of
the body not being treated. We also use dye or felt-tip markers
to mark the target area on the skin. These marks are needed until
treatments is complete. Finally, with careful scheduling of radiotherapy
treatments, we may be able to kill the cancer cells while allowing
normal cells to recover.
What can I expect when I come for treatment?
(back to top)
On your first visit, plan to spend two to three hours. You usually
will need to undress and get into a robe that we provide. You do
not need to remove your jewelry or watch unless you wear it on the
specific area being treated.
We may draw on your skin to indicate the area of radiation treatment.
The marking fluid will stain clothing, so you should wear old clothing.
We then will take x-ray pictures (called simulator films) to confirm
the treatment area. Occasionally, the treatment area, and thus the
lines, will be changed as the treatment progresses. These changes
are made under the direction of the radiotherapist. Please do not
wash off these markings.
The radiotherapy technician will help position you on the table
for each treatment and then leave the treatment room. You should
not move during the set up or the treatment. Actual treatment time
takes only a few minutes, but you may spend 15 to 20 minutes in
the treatment room being set up accurately.
Undergoing the treatments is very similar to having an x-ray examination;
however you may breathe normally. The treatments cause no pain or
discomfort, but the therapy machine may frighten you the first time.
The treatment machines are large and make various noises when operated.
Be assured, however, that we will be in continuous contact with
you through closed-circuit television or mirrors and a two-way intercom
system. If you should have any problems, we will turn off the machine
immediately and help you. When the machine is turned off, the release
of radiation stops immediately.
Your treatments usually will be given daily, Monday through Friday,
with a rest on weekends. Your technician will notify you of any
holidays on which you will not receive treatment. We will try to
make your daily appointments convenient for you. If you find it
necessary to change a treatment time, please call your radiotherapy
station.
Your radiotherapy physician will examine you and review your progress
once a week or more often if necessary. This review will require
a longer than normal visit. Since radiotherapy may cause a drop
in your blood count, periodic blood tests will be required.
What are the side effects of radiation therapy?
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Although radiation therapy is not painful, it can cause unwanted
side effects. You may be more tired than usual. The skin where radiation
is aimed may feel like it has been sunburned and will need to be
protected from the sun. Your hair may fall out but only in the area
receiving radiation. If the radiation therapy aims at the stomach,
you may experience nausea or vomiting, diarrhea or a loss of appetite.
If you have radiation treatments to the head or neck, you may experience
a sore throat, headaches, difficulty swallowing, loss of appetite,
loss of taste or a changed sense of smell. Side effects present
at the end of your treatment will generally begin to improve about
a week after the last treatment.
What do I need to do after my last treatment?
(back to top)
This information is designed to complement the specific discharge
instructions found on the patient information card you will receive
during your treatment:
- Your physician or nurse will tell you when you can bathe the
treated area. If the treated area is tanned and dry, you generally
will be able to begin bathing immediately. Bathe or shower in
tepid water using mild soap and your hands on the treated skin.
Do not use a washcloth. Do not soak in the tub for any period
of time. After bathing, pat dry the skin in the treated areas
with a soft towel and apply a thin layer of the prescribed ointment
to the treated areas. Use the ointment three times a day or more
often, as needed, until your skin appears normal.
- The treated area always will be sensitive to injury. Do not
expose it to extreme changes in temperature (hot water bottle
or ice bag).
- Avoid direct sun exposure to the treated area as much as possible.
If you spend more than 20 minutes in the sun and your clothing
or a hat does not cover the treated area, use a sunscreen with
an SPF of 15 of higher.
- Even though your therapy treatments are complete, maintain
good nutrition with an adequate diet and fluids to speed the healing
process.
- We will send a report to your referring physician. You should
have regular follow-up examinations by your referring physician
and/or radiotherapist. We will schedule your follow-up visit for
you at the completion of therapy.
- If you require any surgical procedures or biopsies in the future
that will involve the areas that have been treated, make your
physician aware of the radiation therapy you have received. If
necessary, your physician can contact your radiotherapist for
more information.
High risk for infection (back
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- Avoid using any type of container that has stagnant water such
as humidifiers, flower vases, denture cups and soap dishes. These
are places bacteria like to grow.
- Add 1 teaspoon of chlorine bleach to each quart of water
used in flower vases.
- Add 1 teaspoon of vinegar to each quart of water or use
saline for respiratory equipment; all equipment should be
cleaned with 70 percent alcohol or chlorine bleach solution
and vigorous scrubbing.
- Limit visitors to those without contagious illness that include
colds, viruses, cold sores, influenzas or chicken pox; do not
allow visitors who have recently received vaccinations with living
or attenuated microbes, such as the polio vaccine.
- Avoid crowds such as in shopping malls or grocery stores.
- Avoid cleaning birdcages or cat litter boxes because bacteria
or fungi could lurk in the excreta.
- Eat a high-protein and high-carbohydrate diet.
- Use a mild soap such as Dove or Dial to wash each day; rinse
the skin thoroughly and pat dry.
- Cleanse the perianal area after each bowel movement and
urination.
- Perform skin care daily with a water-soluble lubricant to prevent
dryness of the skin.
- For personal hygiene, take a sponge bath, tub bath or shower
every day.
- Keep nails clean and short.
- Four times a day, perform mouth care as prescribed by your
nurse or physician.
- Promote healing of all skin wounds by changing dressings every
8 hours or as instructed by your physician or nurse.
- Avoid enemas, suppositories and rectal thermometers.
- If constipation is a problem, talk to your physician or nurse
about putting you on a bowel regime.
- Drink at least eight 8-ounce glasses of fluid a day.
- If ordered to do so, take growth factors daily until told to
stop by your physician or nurse.
- Dispose of needles in a thick container such as a coffee can
or egg carton.
- Store in refrigerator at 36 to 45?F.
- Keep appointments for blood work.
- Take your temperature daily in the late afternoon or early
evening. Call your physician immediately if you have a temperature
over 101?F.
- Call your physician immediately if you get severe chills, mouth
sores, pain with swallowing or fever.
High risk of bleeding (back
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- Avoid activities that have the potential for physical injury.
Bleeding occurs more easily when the platelet count is low.
- Wear gloves while working in the garden.
- Wear shoes or slippers when out of bed.
- Avoid tight-fitting clothing.
- Use an electric razor or safety razor when shaving.
- Use an emery board or fine-mesh file for nail care.
- Eat soft, bland foods such as soup, yogurt, ice cream and peanut
butter. Avoid foods that are irritating such as hot, spicy or
rough dishes.
- Use a soft-bristly toothbrush or toothette for oral care, and
avoid using dental floss when the platelet level is less than
50,000. Seek approval from the physician before having dental
work.
- Avoid constipation. If you have difficulty, ask your nurse
for a bowel regimen.
- Avoid blowing your nose forcefully. Only blow gently through
both nostrils simultaneously, if necessary.
- If nose bleeding occurs, sit straight up and apply firm
pressure to the nostrils below the bridge of the nose.
- If the bleeding does not stop, place an ice bag to the bridge
of the nose and at the back of the neck.
- If bleeding continues, call your doctor.
- Do not take medications such as aspirin that have the potential
to start or prolong bleeding. Ask your physician, nurse, or pharmacist
if you are not sure of the contents of any of your medicines.
- Call your physician or nurse for signs of bleeding such as
nose bleeds, blood in your urine, black bowel movements, tiny
purplish spots on your skin or bruises that happen easily.
Fatigue caused by anemia (back
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- Eat a well-balanced nutritious diet.
- Eat foods high in iron such as potatoes, red meats, dark green
leafy vegetables and carrots.
- Eat high-protein and high-carbohydrate foods such as peanut
butter, milk products (cottage cheese, cheese, milk, ice cream,
yogurt, cream cheese), rice, pudding, custard, macaroni, pasta
and potatoes.
- Try nutritional supplements such as Nutra Shake, Ensure or
Carnation Instant Breakfast.
- Add a tablespoon of powdered skim milk to fluids to provide
more protein.
- Take naps or rest periods of 30 minutes to an hour, perhaps
one in the morning and one in the afternoon.
- Sleep later in the morning or go to bed earlier at night.
- Resting all day, however, will increase feelings of fatigue.
- Plan consistent exercise periods, such as walking to a specific
designation once a day.
- For extreme fatigue, prevent tissue breakdown by walking short
distances three times a day, sitting on the side of the bed three
times a day, or turning in bed.
- Provide skin care with water-based skin lotion.
- Don’t be afraid to ask for help. Seek assistance with
activities such as housework, childcare or meal preparation when
experiencing fatigue.
- Tell your physician or nurse if you have pain, trouble sleeping
or difficulty catching your breath.
Nutrition and Medication Guidelines (back
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• We will record your weight weekly and more often if necessary.
It is very important that you maintain an adequate diet and get
sufficient rest. We encourage you to continue some physical activity.
We will discuss any specific restrictions and requirements with
you.
• Your physician will review your current medications, which
can usually be continued throughout the course of radiation. Any
additional medications will be prescribed, as needed.
• A registered dietitian from the Radiation Oncology Department
will help you with your individual nutritional problems. If you
are on a special diet, such as a diabetic or sodium-restricted diet,
the dietitian can help you change the diet plan, as needed.
• Radiation destroys cancer cells, which then need to be eliminated
from the body. Therefore it is important that you drink at least
two quarts of liquid daily.
Skin Care Guidelines (back
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• It is very important that you do not wash off the colored
lines. You should not wash the treatment areas with soap, and you
should not apply lotions, creams or powders, unless directed by
the radiotherapist.
• We encourage good personal hygiene, and you may use soap
and water on any area not being treated.
• Wear only loose-fitting clothing over treatment areas usually
covered with clothing.
• Do not apply heat in any form to the treatment areas. Also,
avoid any exposure of the areas to intense direct sunlight or ultraviolet
rays. Ice packs should not be applied to the treated skin.
• Toward the end of your treatments, skin in the location
that has been receiving radiation may become pink and itchy. In
some cases it will tan and flake like a moderate suntan. Avoid scratching
the skin in the treated area and any clothing that rubs it. The
skin reactions heal quickly after you complete treatment, and you
will be given ointment to soothe the irritation.
Birth Control (back
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It is important that you do not get pregnant while you are receiving
radiotherapy. Please discuss birth control methods with your radiotherapy
physician.
Other special instructions relevant to your particular treatment
will be given to you on a separate card during your first visit.
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