BREAST CANCER INDIA

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RADIATION THERAPY: SIDE EFFECTS


This page has been written by : Dr. Rohit Malde, Consultant Radiation Oncologist, BNH - HCG Hospital, Mumbai


Side Effects due to Radiation Therapy

Many patients have few or no side effects during their treatment and are able to carry on their normal activities. Every patient is different and you may not have the same side effects as somebody else. Your doctor will discuss with you any side effects you may experience.



Acute Side-effects

These are seen immediately after or during radiotherapy. The skin in the treated area may become dry, red and itchy, a reaction similar to mild sunburn. Some patients have a more severe skin reaction when the skin may break down and become painful. If a patient has had chemotherapy, the severity of the skin reaction may be increased. In such a situation, the following things may help:

  • Using an unscented moisturiser on the skin in the treated area like Aqueous cream or Aloe Vera Gel (can be applied 2-3 times a day)

  • Wash the treated area very gently with lukewarm water and / or a mild unperfumed soap, e.g. baby soap (Johnsons and Johnson) or Dove

  • Pat the area dry using a soft towel and do not rub the area. A shower is preferable to a bath, if possible

  • Avoid use of deodorant during Radiotherapy

  • Wear loose fitting clothes that do not rub the skin of the treated area

  • Do not expose the treated area to bright sunlight during Radiotherapy and for several months after your treatment has finished

  • Protect the skin in the treated area by using a high factor or total block sun cream and covering the area with your clothes



Tiredness

It is quite common to feel more tired than usual during the treatment and for several weeks after the treatment has finished. (Tiredness can be worse if one has had recent chemotherapy). It is important to rest when one feels the need to do so and ask family and friends to help when they can. If immediate help is not available, then one must do only the things that are necessary. Gradually, you will get back to normal activities.



Feeling sick (nausea)

Radiotherapy to your chest wall very rarely makes you feel sick. It can happen when the lower end of the treatment field has to include a small area of the upper abdomen (tummy) to ensure the chest wall is treated properly. If you do feel sick, please inform your doctor.



Late Side Effects

These are seen many years following radiotherapy

  • Some women may have chest wall pain & tenderness, tiredness and fatigue for several months after completion of treatment. Permanent effects may include a change in the colour of the treated skin, usually becoming darker. Tiny red streaks in the skin may develop, caused by changes in the tiny blood vessels in the skin. This is called telangiectasia; it affects the appearance of your skin but does not usually cause other problems.

  • Radiotherapy can make rib bones brittle after treatment and very rarely, this may result in rib fracture. This can be painful but usually heals without treatment

  • Lymphoedema (swelling of the arm on the effected side) may occur after surgery to the axilla (armpit). Radiotherapy may increase this probability, particularly when the lymph gland area is treated

  • There may be some damage to the lungs causing shortness of breath which is less than 1 in 100

  • Treatment to the left breast may involve treating a small area of the heart. In the past this was associated with a small increase in the risk of heart disease (less than 1 in 100 patients). Modern Radiotherapy planning has further reduced this risk

  • Damage to the nerves (brachial plexus neuropathy) which can cause numbness, pain and weakness in the arm and hand. This is indeed very rarely seen with Modern Radiotherapy

  • Radiation induced Cancer- Angiosarcoma is again very rare.