Coping With Radiation Treatment

Like other cancer treatments, radiation may cause unpleasant side effects, such as overall fatigue, skin irritation, and other side effects depending on the part of the body being treated.

Every person reacts differently to treatment. Any side effects you might have depend on the type of cancer, location, dose of radiation, and your general health. Some people have no side effects at all, while others have quite a few. There’s no way to know who might have side effects. Before treatment,  ask your cancer care team what you might expect.

Taking care of yourself during treatment

You will need to take special care of yourself to protect your health during radiation treatment. Your cancer care team can give you advice based on your treatment plan and the side affects you might have.

Here are some general tips:

  • Be sure to get plenty of rest. You may feel more tired than usual. Try to get good, restful sleep at night. Severe tiredness, called fatigue, may last for many weeks after treatment ends.
  • Eat a balanced, healthy diet. Depending on the part of your body getting radiation, your cancer care team may suggest changes in your diet. You can learn more about eating well in Nutrition for the Person With Cancer During Treatment.
  • Tell your cancer care team about all medicines and supplements you’re taking. Give your team a full list of everything you take and how often you take it, even things like aspirin, vitamins, or herbs. Don’t forget the ones you take only when you need them, such as sleep aids, antacids, headache remedies, and antihistamines.
  • Take care of the skin in the treatment area. If you get external radiation therapy, the skin in the treatment area may become more sensitive or look and feel sunburned. Ask your cancer care team before using any soaps, lotions, deodorants, medicines, perfumes, cosmetics, powder, or anything else on the treated area. Some of these products may irritate sensitive skin.

How will I feel emotionally?

Many patients feel tired during radiation therapy, and this can affect emotions. You also might feel anxious, depressed, afraid, angry, frustrated, alone, or helpless.

It’s normal to have these kinds of feelings. Living with cancer and going through treatment is stressful. We have a lot of information that can help you understand and manage the emotional changes that often come with cancer and cancer treatment.

Getting involved with a support group and meeting other people with cancer may help. Ask your cancer care team or call the American Cancer Society to learn more about  connecting with others who share your problems and concerns.

Will side effects limit my activity?

Side effects might limit your ability to do some things. What you can do will depend on how you feel. Talk to your cancer care team about this. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and can’t do as much. Your team may suggest you limit activities that might irritate the area being treated.

Common side effects of radiation therapy

Radiation therapy can cause early and late side effects.

  • Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. They’re usually gone within a few weeks after treatment ends. The most common early side effects are fatigue (feeling tired) and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.
  • Late side effects can take months or even years to develop. They can occur in any normal tissue in the body that has received radiation. The risk of late side effects depends on the area treated as well as the radiation dose that was used. Careful treatment planning can help avoid serious long-term side effects. It’s always best to talk to your radiation oncologist about the risk of long-term side effects.

You can learn more about expected side effects to various areas of the body in our detailed information on each cancer type.

Your cancer care team can tell you about your treatment, likely side effects, and things you need to do to take care of yourself. They can also talk to you about any other medical concerns you have. Tell them about any changes in the way you feel and any side effects you have, including skin changes, tiredness, diarrhea, or trouble eating. Be sure that you understand any home care instructions and know who to call if you have more questions. Also be sure you know what to do if you need help after office hours, in case you have problems at night or on the weekend.

Fatigue

Fatigue is feeling tired physically, mentally, and emotionally. It’s very common for people with cancer and often happens with radiation therapy. Most people start to feel tired after a few weeks of radiation therapy. This happens because radiation treatments destroy some healthy cells as well as the cancer cells. Fatigue usually gets worse as treatment goes on. Stress from being sick and daily trips for treatment can make fatigue worse. Managing fatigue is an important part of care.

Fatigue caused by radiation treatment (or the cancer itself) is different from the fatigue of everyday life, and it might not get better with rest. It can last a long time and can get in the way of your usual activities. But it will usually go away over time after treatment ends.  

Only you know if you have fatigue and how bad it is. No lab tests or x-rays can diagnose or describe your level of fatigue. The best measure of fatigue comes from your own report to your cancer care team. You can describe your level of fatigue as none, mild, moderate, or severe. Or you can use a scale of 0 to 10, where a 0 means no fatigue, and a 10 is the worst fatigue you could imagine.

Either way you choose, it’s important to describe your fatigue to your cancer care team. Be sure to talk with them if:

  • Your fatigue doesn’t get better, keeps coming back, or gets worse.
  • You’re more tired than usual during or after an activity.
  • You’re feeling tired, and it’s not related to something you’ve done.
  • You become confused or can’t focus your thoughts.
  • You can’t get out of bed for more than 24 hours.
  • Your fatigue disrupts your social life or daily routine.

If you need to take time off from work, talk to your employer. You may also have some rights that will help you keep your job.

Skin problems

Your skin in the radiation treatment area might look red, irritated, swollen, blistered, sunburned, or tanned. After a few weeks, your skin might become dry, flaky, or itchy, or it may peel. This is sometimes called radiation dermatitis. It’s important to let your cancer care team know about any skin changes. They can suggest ways to ease the discomfort, lessen further irritation, and prevent infection.

Most skin reactions slowly go away after treatment ends. In some cases, though, the treated skin will stay darker and might be more sensitive than it was before.

You need to be gentle with your skin. Here are some ways to do this:

  • Do not wear tight, rough-textured, or stiff clothes over the treatment area. This includes anything tight or elastic that squeezes the area. Instead, wear loose clothing made from soft, smooth fabrics. Do not starch your clothes.
  • Do not rub, scrub, scratch, or use adhesive tape on treated skin. If your skin must be covered or bandaged, use paper tape or other tape for sensitive skin. Try to put the tape outside the treatment area, and don’t put the tape in the same place each time.
  • Do not put heat or cold (such as a heating pad, heat lamp, or ice pack) on the treatment area without talking to your cancer care team first. Even hot water may hurt your skin, so use only lukewarm water for washing the treated area.
  • Protect the treated area from the sun. Your skin may be extra sensitive to sunlight. If possible, cover the treated skin with dark-colored or UV-protective clothing before going outside. Ask your cancer care team if you should use sunscreen. If so, use a broad spectrum sunscreen with a sun protection factor (SPF) of at least 30. Reapply the sunscreen often. Continue to give your skin extra protection from sunlight, even after radiation therapy ends.
  • Use only lukewarm water and mild soap. Just let water run over the treated area. Do not rub. Also be careful not to rub away the ink marks needed for your radiation therapy until it’s done.
  • Check with your cancer care team before shaving the treated area. They might recommend that you use an electric shaver.
  • Ask your cancer care team before using anything on the skin in the treatment area. This includes powders, creams, perfumes, deodorants, body oils, ointments, lotions, hair-removal products, or home remedies while you’re being treated and for several weeks afterward. Many skin products can leave a coating on the skin that can cause irritation, and some may even affect the dose of radiation that enters the body.

Hair loss

Radiation therapy can cause hair loss (the medical word for this is alopecia [AL-o-PEE-shuh]). But hair is only lost in the area being treated. For instance, radiation to your head may cause you to lose some or all the hair on your head (even eyebrows and lashes), but if you get treatment to your hip, you won’t lose the hair on your head.

Most people find that their hair grows back after treatment ends, but it can be hard to deal with hair loss. When it does grow back, your hair may be thinner or a different texture than it was before. Ask your cancer care team if you have any questions or concerns about hair loss.

If you do lose your hair, your scalp may be tender and you may want to cover your head. Wear a hat or scarf to protect your head when you’re in the sun. If you prefer to wear a hairpiece or wig, be sure the lining doesn’t irritate your scalp. Your local American Cancer Society office may be able to help you get wigs or hats.

Low blood counts

Rarely, radiation therapy can lower white blood cell or platelet counts. These blood cells help your body fight infection and prevent bleeding. If your blood tests show low blood counts, your treatment might be stopped for a week or so to allow your blood counts to return to normal. This side effect is more likely if you’re also getting chemotherapy.

See Understanding Your Lab Test Results to learn more about blood cells and what changes in the numbers of these cells means.

Eating problems

Radiation to the mouth or throat, or parts of the digestive system (like the stomach or intestines) might cause eating and digestion problems. For instance, you might have sores in your mouth or throat, nausea, vomiting, or loss of appetite. But even if you have trouble eating or lose interest in food during treatment, try to eat protein and some high-calorie foods. Doctors have found that patients who eat well can better handle cancer treatment and side effects.

Coping with short-term diet problems may be easier than you think. There are a number of guides and recipe booklets for people who need help with eating problems. See our Nutrition for the Person with Cancer during Treatment for advice on managing eating problems and some easy recipes to try.

Radioprotective drugs for reducing side effects

Doctors look for ways to reduce side effects caused by radiation therapy while still using the doses needed to kill cancer cells. One way to reduce side effects is by using radioprotective drugs. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.

Radioprotective drugs are an active area of research. Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.

How long do side effects last?

Radiation side effects often start during the second or third week of treatment depending on the prescribed dose and schedule. (See External Beam Radiation Therapy.) Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation. In the meantime, there are ways to reduce the discomfort they may cause. If you have bad side effects, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment you’re getting. Tell your cancer care team about any side affects you notice so they can help you with them.

People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your cancer care team. If needed, they should be able to suggest ways to help you feel better.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Chao KSC, Perez CA, Brady LW (Eds). Radiation Oncology Management Decisions. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2011.

Halperin EC, Perez CA, Brady LW (Eds). Principles and Practice of Radiation Oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2013.

National Cancer Institute. Radiation Therapy for Cancer. 2010. Accessed at www.cancer.gov/about-cancer/treatment/types/radiation-therapy/radiation-fact-sheet on March 21, 2016.

Last Medical Review: February 10, 2017 Last Revised: February 10, 2017

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