This brochure is designed to inform you and your family/carers about radiation therapy. It aims to give you some idea of what to expect during and after your treatment, and we hope to relieve any concerns you may have.

It does not replace discussion with the health professionals involved in your care, and we encourage you to raise questions and concerns.

Our experienced staff members are available to assist you. Please do not hesitate to ask for advice.

Radiation therapy is the use of radiation to destroy cancer cells

It works because cancer cells are more sensitive to radiation than normal cells. When a small dose of radiation is given each day over several weeks, normal cells can recover from radiation but cancer cells cannot.

Radiation therapy can be used with the aim to cure a cancer, or it may be given to relieve symptoms.

Side effects are predictable for most patients, depending on your treatment site, the dose being given, the number of treatments and your general health. Reactions may begin to occur within the second or third week of treatment. If you feel any discomfort in the treated area, please inform the nursing staff promptly.

Skin reaction

After two to three weeks of treatment your skin may start to become red and irritated. Towards the end of treatment the reaction can become more intense and you may experience some superficial skin loss, especially in the region of the perineum (genital/anal regions) if it is in the treatment area.

The degree of reaction varies from person to person. Some patients having treatment to the pelvis will not be affected at all, but others get significant redness and weeping, which requires special intervention. Your treatment team will suggest appropriate management.

Fatigue

You may become increasingly tired as you progress toward the end of your treatment. This is a normal reaction to the radiation therapy and each person is affected to varying degrees. Finding a balance between rest and activity will help you cope.

Bowel irritation (including diarrhoea)

This is not uncommon after two to three weeks of radiation therapy to the pelvis. There may be an increase in how often you feel the need to use your bowels. You may also experience some discomfort if you strain and you may notice some blood and/or mucus in the bowel motions. There may be anal soreness if the anal canal is near the area being treated. These side effects can be more pronounced if you are also receiving chemotherapy.

• It is important to report diarrhoea, mucous or blood to the nursing staff as the severity needs to be monitored. A temporary change of diet or medication may be required, and sometimes a break in treatment may be necessary.
• If dietary changes are required, nursing staff will discuss with you in detail any changes that are necessary. A referral to a dietitian can be organised if required.
• These changes are usually temporary and will resolve within two to three weeks after you finish treatment.

Bladder irritation

If the bladder is within the treatment area some symptoms of bladder inflammation/irritation are common. This may cause a burning sensation when passing urine (dysuria), increased urinary frequency, and there may occasionally be blood, mucous or particles in the urine. Should these symptoms occur please report to the nursing staff or doctor promptly for advice and treatment options

Moisturise twice a day

You will be recommended a skin moisturiser to use during treatment. At the start of treatment, apply cream to the area being treated TWICE A DAY. As treatment progresses you may need to apply the cream three to four times per day. If changes to your skin occur in the treatment area, inform the nursing staff as you may need to use a different cream.

Wear loose fitting clothing

Avoid wearing tight fitting clothing that could potentially rub or irritate the skin. Loose cotton underwear is best.

Avoid excessive temperatures

Avoid exposure of the treatment area to excessive temperatures, such as: direct sunlight, heat packs, ice packs, electric blankets, saunas or hot spas.

Wash with warm water and pat dry

You may wash the skin that is being treated with warm water and a mild non-perfumed soap. Pat the skin dry – do not rub. Salt water washes or the use of baby nappy wipes to cleanse the area after each bowel action may be recommended.

Do not use talcum powder in the treated area.

When do the side effects settle?

The treatment keeps on working even though you have stopped coming in for treatment. Therefore the symptoms may get a little worse before they get better. Generally the side effects will have settled within two to four weeks of finishing your treatment course.

Skin discomfort and sensitivity

The skin in the treated area will begin to settle within four weeks after treatment. If you experience discomfort in the area you may need to take some pain medication during this period. When all side effects have settled, you can resume your normal skin care routine. You may use the lotions, creams, soaps and deodorants that you used before your therapy started.