The concept of radiotherapy can be scary.
The thought of willingly putting radiation into your body can seem odd, but this treatment can be used at many different stages of cancer to combat your illness. Radiotherapy can be used in the earliest stages of cancer or when it has begun to spread making it a highly flexible treatment for many cancers, although not all. Your doctor will guide you through the process, but having an online guide to refer to can be massively helpful when you find your thoughts running away with you at home.
What is radiotherapy?
Radiotherapy uses radiation such as x-rays to destroy cancer cells. It can be targeted effectively so that only the cancer cells within your body are affected by the high-energy rays. But radiation may be emitted onto some normal cells very close to the radiation site which may cause side effects. However, these tend to get better as your normal cells recover. While there is always a risk with radiotherapy, the ability to utilize this treatment in a targeted way is developing every year. Specialists continue to do research to make radiotherapy as effective as possible.
Why select radiotherapy as a treatment?
You can feel incredibly vulnerable as a cancer patient. You know that there is something harmful within your body but you have to rely on a team of experts to treat it in the most effective way. Your oncologist and doctors will meet to discuss your options and sometimes radiotherapy will be deemed the most effective course of treatment for your cancer.
Radiotherapy can be used to:
- Try and cure your cancer completely – this is called curative radiotherapy.
- Help to make other cancer treatments more effective. It can often be combined with chemotherapy to hit your cancer cells with a sort of double whammy, depending on the cancer type. This is called chemoradiation. Chemotherapy drugs can make the cancer cells more sensitive to radiotherapy meaning that the treatment becomes more effective. Unfortunately, this is not the case for all types of cancer and having such an intense treatment regimen can make your potential side effects worse.
- Reduce the chances of cancer returning after surgery – this is called adjuvant radiotherapy.
- Help manage pain and other symptoms when a cure is not possible – this is called palliative radiotherapy.
Radiotherapy is often deemed the most effective course of treatment for those cancer patients who have undergone surgery. However, the success rates as a curative approach vary depending on cancer type and patient.
Types of radiotherapy treatment
Radiotherapy is not a one size fits all approach. There are many different ways to get radiation into your body and target the cancer cells. Your medical team will assess the most appropriate type for you. This may include:
- External radiotherapy: this is when a machine fires a beam of radiation directly towards the cancer cells in your body. This is highly targeted and specific.
- Radiotherapy implants are sometimes used to place radioactive pieces of metal into your body as close as possible to cancer cells. This approach may have an impact on your normal cells meaning that side effects can be more apparent.
- Radiotherapy tablets, drink and injections can be used if your cancer is more widespread.
- Intrabeam radiotherapy is one of the newest treatments that can be used during breast cancer surgery. This targets the exact spot where cancer cells have been and is an effective form of adjuvant radiotherapy.
Watch an expert describe what happens and advises what questions to ask if you’re referred for radiotherapy
Your radiotherapy team
- Consultant clinical psychologist – This medical professional is an expert in using radiotherapy and chemotherapy to treat and potentially cure cancer. These will be the doctors that plan your course of treatment, working out dosages and treatment plan timeframes. You will probably keep the same consultant throughout your treatment, but you may see a member of their team for appointments. These individuals will have a thorough knowledge of your treatment so you can feel confident in your plan.
- Radiographers – You will get to know a team of radiographers throughout your treatment. These individuals will operate the machine that emits a beam of radiation to targeted cancer cells within your body. They will pinpoint the exact area to target and can help contribute to your treatment plan. They will be the faces you see when you turn up to radiotherapy sessions and will help with after-care advice.
- Radiologist – A radiologist will look at any CT scans or x-rays you have throughout the course of your treatment. They may suggest adaptations to your treatment depending on scan results.
- Nurses – Many nurses are specialist cancer care nurses who are armed with a wealth of knowledge about how best to cope with potential side effects. They will be there to hold your hand or simply give advice. You will meet many different nurses throughout your radiotherapy sessions and follow-ups.
- Other professionals that you may encounter include a dietician if you are struggling with appetite post-treatment. You may meet a physiotherapist if your joints become stiff during treatment. If you are struggling mentally with your diagnosis and treatment, you will be directed towards a counselor. While you might not enjoy the thought of talking to a stranger about your feelings, this objective professional can help you address any anxieties and stresses you are facing. This could be ideal if you don’t feel comfortable talking to family or friends.
Radiotherapy can be nerve-wracking, however, you will be supported by a well qualified and sensitive medical team in hospital when you receive your treatment. Most cancer patients have several sessions over the course of a few weeks. While many patients suffer no ill effects, some cancer patients find that side effects do occur. Side effects tend to occur when normal healthy cells are damaged because of radiation. You could suffer from red skin, sores on your skin, fatigue, hair loss where the radiation is targeted, nausea, a lack of appetite, a general feeling of malaise, a change in bowel habit or a sore mouth. These can vary greatly, going from a minor niggle to significantly impacting the quality of life of patients.
What actually happens?
Prior to your treatment
Your doctors will want you to feel informed and comfortable with the radiotherapy deemed most appropriate for you. When you are diagnosed with cancer, there may be multiple different treatment pathways available to you and it can be difficult to work out the best option for you. This is why you need to trust the medical team developing your treatment plan.
If radiotherapy is selected for you, it’s ok to want to ask questions. Consider what the aim of the treatment is. Will this course of radiotherapy have a cure as its aim or will the radiotherapy to improve the quality of your life? Consider asking about potential side effects and think about how you will combat them. Think about how effective the radiotherapy may or may not be and consider the impact it may have on your quality of life. It is also reasonable to ask about other potential treatments.
Your treatment will then be planned in detail. A CT scan will be carried out to work out exactly where the cancer is in your body and how large the tumours are. Your body may be marked with a permanent ink to show the administering staff member exactly where to target your therapy. Your medical team will then work out the highest possible dose of radiation that can be given to you safely to try and eliminate the cancer cells. If you are having radiotherapy to your head, a custom made mask will be moulded for you to wear during radiotherapy sessions.
Your treatment will usually be given in multiple sessions over the course of several weeks. Treatment plans can be intense, meaning that you will probably receive radiotherapy daily Monday to Friday for several weeks, with breaks at the weekend. Many doctors use the term, ‘fraction’ to describe sessions, while others may use the term, ‘attendance.’ You can have a paper copy of your plan to chart your progress throughout your treatment.
If you are having external radiotherapy, you will lie on a bed as a machine emits a beam of radiation targeted towards the cancer cells in your body. You will have an intercom to talk to your medical team if you need and you should feel relatively comfortable as the treatment progresses. You need to keep still, but the treatment lasts mere minutes, and you won’t have to stay in hospital meaning that you can head home after each session.
Radioactive pieces of metal can be placed inside the body close to cancer cells to target them with radiation. Sometimes an implant is only placed in the body for minutes or you could have the implant inside your body for a few weeks. You won’t be able to feel the tiny implants, but because they make you slightly radioactive, you may need to refrain from seeing people. For this reason, a hospital stay may be necessary until the implants are removed.
Drinks, tablets and injections
Sometimes a radioactive liquid can be used to treat some types of cancers. This liquid may be drunk, taken in capsule form or injected. The treatment is simple yet does make you radioactive in the same way as an implant does. For this reason, you may need to stay in hospital until the radiation in your body diminishes. When you do return home, you may need to keep isolated for a few days.
After radiotherapy treatment
After each individual session, a nurse may call you to ask how you are feeling and to check up on any potential side effects. Use this as an opportunity to ask questions and discuss options for the future.
Once you have completed your full treatment plan, you won’t simply be sent home to recover. There should be follow-up sessions to check the impact of the treatment, to see whether the cancer has shrunk or cleared, and if other interventions are necessary. Your doctor will explain the results of any follow-up scans, tests, and monitoring.
Be aware that in a few cases you may need to have your treatment plan extended. This is common if your cancerous tumour is shrinking. This shows that the radiotherapy is working but that you might need further sessions. Sometimes, you will have a gap between bouts of sessions to give your body time to recover. This is also common if you suffer from severe side effects.
How to deal with radiotherapy side effects
Look after your skin
Many people find that their skin can become sore after radiotherapy. A simple emollient and cooling cream will prevent your skin from getting dry and will have a soothing effect. It’s important that you moisturise regularly before and after your treatments. When washing, use unperfumed soap and shower gels. The sort of sensitive bath products made for babies are ideal. Always pat rather than rub when washing and drying to be more gentle on your skin.
Be gentle to your skin and don’t shave for a little while. Razors can cause cuts and grazes at the best of times on healthy skin, and more sensitive areas can become very sore when shaving. Always refrain from wearing tight fitting clothing so you don’t irritate your skin and consider linen and loose fitting attire while undergoing radiotherapy treatment. Don’t go swimming and always wear sunscreen with at least factor 50 to protect your skin when out and about in the sunshine.
The best items to get for your skin are unperfumed items without any irritants and any emollient is a safe item to use and we have put a few suitable items together in this collection.
Ensure that you keep any sort of heat away from your skin. This can irritate and inflame, so ensure that you bathe or shower in warm, not hot, water. If you are having radiotherapy to the brain, a hairdryer can be uncomfortable, so allow your hair to dry naturally.
Skin soreness can be annoying, but it does tend to get better a month after your final treatment. You may look slightly more tanned than before but the soreness and tenderness should diminish.
Be kind to yourself
When you head for a radiotherapy session, you might not feel the radiation entering your body or targeting your cells. This is why the fatigue that can hit you post-treatment can come as a real shock. It’s crucial that you look after yourself and take it easy. Radiotherapy tiredness can hit at any time so you need to ensure that you can relax and take naps if needed.
Get plenty of rest which may mean cutting your work hours or taking some time off while your treatment is ongoing. If you find it difficult to head to the shops, ask someone to pick up your groceries for you. Don’t force yourself into doing tasks that you don’t feel that you are up to. This can compound your tiredness and impact your mental health. By resting, you can recover from the tiredness quicker.
When you feel up to it, go for short leisurely walks rather than embarking on full on sessions. Being outdoors, breathing in some fresh air and getting out of the house can lift your mood and help you to feel more alert and refreshed. But don’t push yourself too hard, and if you need a bed day, take it! This is a short term fatigue that will improve when your treatment is complete. Ask friends for help and rely on your support network. If you feel short of breath or suffer heart palpitations at any point, you must get in touch with your doctor as you may need supplementary treatment for anaemia while you are undergoing radiotherapy.
Understand the mental health impact
If you find yourself losing your hair at the spot where the radiotherapy is being targeted on your body, this can be upsetting. You might feel self-conscious, embarrassed, or nervous about what others may think. Feeling that people are staring or gawping can make you want to stay indoors all the time and keep away from social situations.
If you do begin to lose your hair, this will happen around two weeks after your treatment begins. Unlike chemotherapy, this won’t necessarily be all of your hair, but only where the radiotherapy is being targeted. If you feel distressed, think about talking to your friends who can boost your confidence. If you lose the hair on your head, you might want to brave the shave and embrace a buzz cut or you might want to opt for a wig. Consider your feelings and go with what makes you feel most comfortable.
If you feel sick, the nausea can really begin to grate. This may prevent you from eating, leaving you feeling weak and making any radiotherapy induced fatigue even worse. Pick up the phone and ask your doctor about possible treatments to help with feeling sick. These can also help with any diarrhoea that you may be suffering and can help you feel relatively normal again. Most nausea comes in waves, so have a peppermint tea, try and graze rather than eat big meals, and maybe try sipping some flat Coke to try and prevent the worst waves of feeling sick.
Having a sore mouth can also prevent you from eating and drinking. If you can, consider ice cream or frozen pineapple as a nutrient source. Mouth ulcers can niggle so use over the counter remedies and take anti-inflammatories to manage any pain. These problems rarely last longer than a few weeks post-treatment, so look after your mental health. Do things that you enjoy at home, spend some time in the garden, and take up a new hobby like baking, art, or reading to help you channel your thoughts down more positive avenues.
Listen to your emotions
It is tough going through any sort of cancer treatment. Physically, you can feel poorly, you can lose your hair, and you can lose weight. However, the mental and emotional impact of going through such a testing time cannot be underestimated. People who have never been touched by depression and anxiety before are feeling that their mental health is under threat. If you are feeling stressed and nervous, your chances of developing depression are increased.
If you can, use your support network and keep talking to those friends and family who care about you. They will want to help and be there for you, in whatever capacity this might be. You might want a shoulder to cry on, you might want to hit something, and you might want to rant and rave. Your support network can help facilitate all of these options.
When its all over
As your radiotherapy ends, you may feel a little lost as you don’t feel like you are actively trying to thwart your cancer anymore. However, it’s crucial that you place your trust in your medical team. Waiting for results from follow-up scans and tests can be stressful, but try to have a mindful attitude to this. These tests need to be analysed in detail to give an accurate prognosis for you. You may feel tired, emotional and sad. This is normal and you need to give yourself time to recover and feel able to move forward with your treatment plan and your life in a more general sense.
You will still need to look after yourself, your skin and your mental health
You might choose to reassess and change your life for the better or you may simply want to return to the routine of your life that you have missed for so long. Whatever you choose to do, go slow, look after yourself and we hope that your treatment and recovery go as smoothly as possible.