Radiation Therapy: What to Expect

Radiation Therapy vs. Chemotherapy

Both radiation therapy and chemotherapy are treatments for cancer, but they work in different ways. Radiation uses powerful beams of energy to kill cancer cells and shrink tumors. Those energy beams come from a machine or radioactive materials such as pellets placed inside your body near the cancer.

Chemotherapy is a strong medicine that you get through a vein (IV) or take by mouth. It kills rapidly dividing cells, which includes cancer cells. Doctors call chemotherapy a systemic treatment because it kills cancer cells all over your body.

Advantages of Radiation Therapy

Doctors use radiation therapy to treat cancer and other diseases because it:

• Slows or stops cancer from growing
• Shrinks tumors to make them easier to remove with surgery
• Cures some early-stage cancers
• Relieves symptoms such as pain and shortness of breath by shrinking tumors
• Is safe and painless
• Works with other treatments like surgery to kill more cancer cells
• May help you avoid surgery
• Can be done in short treatment sessions

Side Effects of Radiation Therapy

There are two categories of radiation side effects: early and late. Early side effects start during or right after treatment and get better a few weeks after you stop treatment.

Early radiation side effects

The most common early side effects are fatigue and skin problems. You might have others, such as hair loss and nausea, depending on where you get radiation. These are some common early side effects of radiation therapy.

Eating problems. Radiation therapy to the head, neck, or parts of the digestive system can cause nausea or loss of appetite. To get the nutrition you need to keep your body strong during treatment, try these tips:

• Eat five or six small meals spread throughout the day instead of three large ones.
• Stick to foods you like.
• Keep healthy snacks on hand so you can eat when you're hungry rather than waiting for mealtimes.

Mouth problems. Before you start radiation to your head or neck, see your dentist for an exam. Radiation can cause mouth problems such as:

• Sores (little cuts or ulcers)
• Dry mouth
• Tooth decay
• Swollen gums
• Trouble swallowing
• Jaw stiffness

Tell your cancer team about any of these problems so they can help you feel better. To manage these side effects:

• Avoid spicy and acidic foods.
• Don't smoke, chew tobacco, or drink alcohol.
• Brush your teeth often with fluoride toothpaste and a soft brush.
• Rinse with a mixture of warm water, salt, and baking soda.

Hearing problems. Radiation therapy to the head can sometimes cause hearing problems. One reason is that fluid builds up and causes swelling in the inner ear, which blocks the flow of sound. Let your doctor know if you have trouble hearing.

Nausea. Radiation to the head, neck, and any part of the digestive tract can cause nausea and vomiting. Your doctor can suggest medicine to control the nausea. Biofeedback and relaxation techniques, such as deep breathing and meditation, may also help reduce feelings of nausea.

Diarrhea. Radiation therapy to your belly can cause diarrhea, which typically starts a few weeks after treatment begins. The doctor can prescribe medications to help control it. They’ll also suggest making changes to your diet, such as eating vegetables cooked instead of raw, avoiding high-fiber foods, and drinking more water and other fluids to prevent dehydration.

It's natural to be less interested in sex during cancer treatment. Your sex drive will usually come back after you finish therapy. Talk to your doctor and partner about other ways to maintain intimacy during this time.

Late radiation side effects 

Late side effects happen from the damage radiation causes to your cells and tissues. For example, scar tissue can affect the function of your lungs or heart. Radiation damage to your belly or pelvis can cause bladder, bowel, fertility, and sexual problems. These changes may appear months or even years after treatment ends. Often, late side effects don’t go away, but not everyone experiences them.

Radiation treatment for one cancer can increase the risk of a different cancer later. The likelihood of developing a second cancer depends on factors like your age, where the radiation was delivered, and your personal and family history of cancer.

Your doctor will help you weigh the risks and benefits of radiation therapy when considering it as a treatment option for you.

Fatigue from Radiation Therapy

The fatigue you feel from cancer and radiation therapy is different from normal tiredness. It’s a physical and emotional exhaustion that doesn’t get better with rest and can keep you from doing daily activities, such as going to work or spending time with family and friends. Fatigue may even make it harder for you to follow your cancer treatment plan.

You feel so tired because your body has to use a lot of energy to fix cell damage caused by radiation therapy. Pain, anxiety, and stress from your cancer add to the fatigue. Because tiredness can change from day to day, it can be hard to plan your schedule around. 

Managing fatigue

Let your doctor know if you’re experiencing fatigue. They might be able to help. To help yourself feel better, try these tips:

• Get plenty of rest, be as active as you can, and eat a nutritious diet.
• Work with a counselor or take a class at your cancer treatment center to learn ways to conserve energy, reduce stress, and manage fatigue.
• Save your energy for the activities that are most important to you. Tackle them first during times when you have more energy.
• Balance rest with activities. Take breaks throughout the day to nap or just relax.
• Ask for help from family and friends. If fatigue is interfering with your job, ask your manager or HR department whether you can take time off or adjust your schedule.

Fatigue from radiation therapy should go away within a few weeks after your treatment ends.

Skin After Radiation Therapy

The effects of external radiation therapy on your skin are similar to what happens when you spend time in the sun. Your skin may be: 

• Red or sunburned
• Swollen 
• Blistered
• Dry 
• Flaky
• Itchy
• Peeling

To care for radiation-treated skin:

• Wear loose-fitting clothing over the treated area.
• Don't scrub or rub your skin. Use a mild soap and lukewarm water to wash, and then gently pat your skin dry.
• Apply a moisturizer every day. Ask your doctor which type of cream is safest for your skin.
• Use only fragrance-free products, which are less irritating.
• Avoid shaving the treated area.
• Stay out of the sun as much as possible. Cover the treated area with clothing or a hat to protect it. Ask the doctor about using sunscreen if you have to be outdoors. Even after your treatment ends, continue to protect your skin from the sun.
• If you’re having radiation therapy for breast cancer, try not to wear a bra over raw areas. Or wear a soft, cotton bra without an underwire.
• Don't use any tape, gauze, or bandages on your skin unless the doctor tells you to, as they could irritate your skin.

Your skin should start to feel better a few weeks after therapy ends, but it may look darker than before.

Hair After Radiation Therapy

Radiation may cause hair loss in the treated area. You’ll likely see hair loss two to three weeks after you start treatment. Your hair should grow back after you stop radiation, but it may be thinner or have a different texture.

Some people choose to cut their hair short before treatment begins to make the hair loss feel less dramatic. If you lose hair on top of your head, wear a hat or scarf to protect your scalp from the sun when you go outside. You may decide to wear a wig or hair extensions to conceal areas of hair loss. Some health insurance plans will cover the cost of a wig when the hair loss is from cancer or its treatment.

Takeaways

Radiation therapy is a treatment for many cancers and some noncancerous conditions. Side effects from this treatment depend on how much radiation you receive and where on your body the treatment is delivered. Fatigue, skin changes, nausea, and vomiting are all possible side effects of radiation therapy. Ask your doctor what problems you might have from this treatment and how to manage them.

Radiation Therapy FAQs

Is radiation therapy painful?

This treatment is not usually painful, but some people feel pain or burning in the treated area afterward.

What is the success rate of radiotherapy?

Radiotherapy is effective against many cancers. The success rate depends on the type and stage of the cancer being treated. Radiation therapy may cure some early-stage cancers. Combining it with other treatments, such as surgery, can sometimes increase the odds of success.

Is radiation therapy safe?

Radiation therapy has been a cancer treatment for more than 100 years and is considered safe. But the high-energy rays damage healthy cells and tissues, so you may have side effects such as nausea or fatigue. Having radiation also increases your risk of developing another cancer in the future.

What is the cost of radiation therapy?

How much you’ll spend depends on the type of radiation you get and how many treatments you receive. One study found that people with private insurance or Medicare paid an average of $4,000 to $4,600 for breast or prostate cancer radiation.