Radiation Treatment Side Effects and Diet

M. D. Anderson Cancer Center
Date: August 2011

During my treatments, every week I would go in to see the doctor.  It was my week of consultation and they, you know, they do your physical examination and they ask you, you know, how you're feeling and I was able to tell them what you know, any symptoms that I had up first, you know it wasn't as bad but as you know my treatments went on, I told them that I was feeling this particular way and it did get tough.  But I was able to you know talk to the doctor and the nurses and they really help me out with all my side effects.  Anything that I had, they were able to help me out with the medications or any kind of lotions so I was really thankful for that.

Are there side effects?  Side effects of radiation therapy depend upon the area being treated and the type and strength of the radiation used.  Acute side effects start soon after your treatment begins and end shortly after your therapy ends.  The most common acute side effect of radiation therapy is fatigue.  Chronic side effects also called late side effects may take months or years to appear but they are usually permanent.  Talk to your doctor or nurse about any side effects you may have.  There are many ways to help you feel better.  Side effects are caused by damage to the normal cells surrounding the cancer.  The early effects may begin within a few days or weeks after you start treatment and can continue for several weeks after your treatment is complete.  Most side effects will go away eventually but there are ways to reduce the discomfort you may be feeling.  Your doctor or nurse will help you to manage any effects that you may have during your treatment.  You should tell your doctor about any side effects immediately.  Head and neck.  Radiation to the head and neck can cause redness, irritation and sores in the mouth, dry mouth or thick saliva, difficulty swallowing, taste or smell changes, nausea, earache, sore throat, stiff jaw, tooth problems and sore mouth, skin changes.  Breasts, side effects may include fatigue, skin changes, shoulder stiffness, breast or nipple soreness, swelling from fluid build up.  Lumpectomy side effects.  If you have radiation therapy following a lumpectomy, you may also notice skin may darkened, pores become larger and more noticeable, increased or decreased sensitivity of the skin, skin or fatty tissue may feel thicker and firmer.  Chest.  Side effects may include difficulty or soreness when swallowing, cough or fever, change in the amount or color of mucus, shortness of breath, skin changes.  Abdominal.  Side effects may include nausea, diarrhea.  Pelvis.  Side effects may include nausea, diarrhea, bladder irritation with frequent urination, effects on fertility.  Brain.  Radiation therapy can sometimes cause significant changes in brain function causing memory loss, visual changes, headaches, nausea, hair loss, fatigue, skin changes.  Managing side effects.  Fatigue, feeling tired and the lack of energy are the most common complaints of cancer patients.  Fatigue can be caused by a number of reasons such as low blood counts, pain, poor nutrition or even the cancer itself.  Usually, fatigue will go away after your treatment is completed.  Skin problems, after approximately two to three weeks of treatment, your skin may feel irritated or look red, almost like a sun burn or a tan.  Your skin might be dry and itchy.  Some patients may have what is called, a moist reaction of the skin, especially in areas where there are skin folds.  When this happens, your skin is wet and may be very sore.  Be sure to tell your doctor or nurse if your skin develops a moist reaction because special care is needed to prevent infection.  Most skin reactions go away after a while.  For a few people, the skin will stay slightly darker than before and may be extra sensitive to sun exposure.  Taking care of your skin, some ways to take extra care of your skin during your radiation therapy are bathe or shower with lukewarm water and mild soap, pat dry, don't rub.  Wear loose comfortable clothes.  Avoid heating pads, ice packs or anything that is hot or cold against your skin.  Don't rub, scratch or scrub the skin in the area.  Avoid exposure to the sun.  Wear protective clothes like a hat or long sleeves.  Tooth and mouth care, head and neck.  Make an appointment to see you dentist before you start therapy and visit often during therapy.  Your dentist can give you special instructions on gentle tooth care to help prevent cavities or other mouth problems.  If you wear dentures, they may not fit well during treatment.  You may need to stop wearing them for a while to avoid getting sores on your gums.  Your doctor or dentist can prescribe medicine to help with mouth soreness or difficulty swallowing.  Dry mouth.  Sip cool drinks throughout the day.  Keep a glass of water by your bed at night.  Try sugar-free candy or gum.  Avoid tobacco, caffeine and alcohol.  Moisten food with gravy or sauce to make it easier to eat.  Difficulty eating or swallowing.  Avoid spicy foods or foods that have a dry rough texture like crackers.  Avoid tart, acidic or salty foods and beverages like pickles or citrus juices.  Eat small frequent meals unless otherwise instructed.  Cut food into small bite size pieces.  Try prepared liquid dietary supplements.  If familiar foods don't taste right, try new or different foods.  Eat soft creamy foods like cream soups, mashed potatoes, yogurt, eggs, custards, puddings, cooked cereals, ice cream, macaroni and cheese, and casseroles.  Puree or liquify foods in a blender.  Ask your doctor for medicine to help reduce the pain in your throat and to make swallowing easier.  Nausea, radiation therapy can cause you to lose your appetite and might cause problems with eating, digestion and food absorption.  Your doctor, mid-level provider or nurse will let you know if you need a specific diet.  In addition, a dietician will educate you regarding maintaining your weight which promotes healing.  There are also medicines to help improve your appetite and control nausea.  Eat small amounts of food.  Eat frequently unless otherwise instructed.  Eat and drink slowly.  Avoid fried and fatty foods.  Drink cool liquids between meals.  Avoid foods with a strong smell.  Eat foods that are cool or served at room temperature.  If nausea or vomiting is severe, try a clear liquid diet, broth and clear juices or bland, easy to digest food like dry toast or gelatin.  Helping you eat.  Other ways you can help yourself are to eat when you're hungry instead of waiting for a meal time.  Eat several small meals instead of three big meals.  Make your meals as pleasant as possible with the soft lighting or music or whatever helps you enjoy eating.  If you enjoy company, try to eat with your family or friends or turn on the TV or radio for company.  Try new recipes or foods that look appetizing.  Keep simple meals in the freezer.  Keep healthy snacks around for nibbling.

Have your local Meals on Wheels program deliver your food.  Calorie intake.  To increase your calorie intake, add butter or margarine to foods.  Make canned cream soups with milk or half and half instead of water.  Top your vegetables with cream sauce or melted cheese.  Drink milk shakes, eggnog or liquid diet supplements between meals.  Enrich your beverages with powdered milk, honey, yogurt or prepared diet supplements.  Diarrhea.  After a few weeks of radiation therapy, you might develop diarrhea.  When you begin therapy, try to eat a low fiber diet to help you avoid diarrhea.  Avoid raw fruits and vegetables, beans, cabbage and whole grain breads and cereals.  If you do develop diarrhea, tell your doctor or nurse.  They may have other suggestions or you may be given a prescription for medicine to control the diarrhea.  Diet tips.  Other diet tips are try a clear liquid diet, water, weak tea, apple juice, clear broth and plain gelatin.  Avoid high fiber foods or foods that may cause gas and cramps such as whole grain breads and cereals, raw fruits and vegetables, sweets, spicy foods, beans, cabbage and coffee or other beverages with caffeine.  Eat small frequent meals unless otherwise instructed.  If milk or dairy products cause you problems, try lactose free or non-dairy products instead.  Once you complete your treatment, continue to eat a low fat, low-fiber lactose free diet for two weeks.  You may want to begin adding small amounts of foods like rice, bananas, apple sauce, mashed potatoes, dry toast and low-fat cottage cheese.  Bladder irritation.  Drink plenty of fluids.  Avoid caffeine and carbonated beverages.  Hair loss.  Radiation therapy can cause hair loss in the area being treated.  If your head is being treated, you may lose some or all of the hair on your scalp.  For most patients, the hair grows back soon after they complete their treatments.  Your hair may have a slightly different texture or color than before.  The amount of hair that will grow back depends on the kind and amount of radiation you are given.  Some ways to take extra care of your head are cover your head with a hat, scarf or turban, especially if you are in the sun or a cold weather.  Choose a wig or toupee that doesn't irritate your scalp.  Use a sun screen with an SPF or 30 to 45 if not covering your head.  Blood count.  Radiation therapy can have an effect on your blood count causing low levels of white blood cells and platelets which helps you to fight infection and prevent bleeding.  Treating your bone marrow may also lower your red blood cell count.  If either of these should occur, your doctor may stop your treatments until your blood count improves.  Your blood counts will be checked on a regular basis and your treatment schedule will be changed if necessary.  Sexual relations.  Generally, neither men nor women notice any changes in their ability to have or enjoy sex.  You may notice a slight decrease to your desire which usually returns once therapy is done.  Some women may have some discomfort during sex and other women may be advised not to have sex during certain kinds of therapy.  Some men have problems getting an erection while they are undergoing treatment.  Following therapy, these problems may go away as well.  Speak with your doctor or nurse if sexual problems concern you.  Fertility.  Women should not get pregnant during radiation therapy because the baby could be harmed by the radiation.  Some women may stop having periods, menstruating or develop symptoms similar to menopause.  Some women also notice vaginal itching, burning or dryness.  Your doctor will help you to manage these symptoms.  Men may have a decrease in sperm production and sperm effectiveness if radiation included the testicular area.

 

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