Radiotherapy

Radiotherapy is a treatment modality usually used to treat cancers.

Occasionally non-cancerous conditions may also be treated. Radiotherapy is a high-energy, targeted X-ray treatment which kills tumour cells by damaging DNA. It’s usually delivered once a day on weekdays (Monday to Friday), excluding weekends and public holidays. The treatment, including set-up, takes about 15 minutes in most cases. Certain treatments may take longer. The overall treatment course may range from one day to several weeks, depending on each individual case.

There are specially qualified staff, called radiotherapists, who work at radiotherapy units, and they position you every day and deliver the treatment that has been planned and prescribed by your radiation oncologist. They will take X-rays to check positioning and adjust as necessary. These X-rays are also checked by your doctor.

Side effects

Any treatment modality (medication, surgery, chemotherapy, radiotherapy) has certain side effects. Most side effects relating to radiotherapy are specific to the area being treated. Your doctor will discuss details relating to these side effects with you during the consultation.

Below is a short guide as to the common side effects that you might experience when receiving radiotherapy. There may also be some uncommon side effects, as people may react differently to radiotherapy.

Radiotherapy side effects are usually divided into early and late side effects. Early (acute) side effects, by definition, may occur from the start of radiotherapy or within three months. They tend to be quite common but are usually transient and reversible.

Late (chronic) side effects, by definition, may occur at any time beyond three months from radiotherapy, even years later. These tend to be less common than the early side effects but may be chronic and permanent.

Examples of side effects

Fatigue is a common side effect during a course of radiotherapy. The severity varies from patient to patient and may range from mild to severe. Most patients are somewhere in between. It’s important not to overexert yourself and to rest when needed. Gentle exercise may actually improve the fatigue.

Loss of appetite and nausea are other fairly common side effects. Try to adopt a reasonably well-balanced diet, even though you may not always feel like eating. It’s also important to maintain a good fluid intake to stay well-hydrated.

Acute skin effects vary depending on the area being treated but may include redness, itchiness and peeling. It’s important to care for the skin in the treated area to reduce side effects.

• Use a mild soap and a gentle cream like aqueous.
• Don’t scrub or vigorously rub the skin.
• Don’t shave the treated area with a flat blade. You may use an electric shaver instead but avoid aftershave lotions on the skin.
• Also avoid exposing the area to the sun for prolonged periods.

Some other acute side effects (depending on the area of the body that is being treated and the dose of radiotherapy delivered) may include diarrhoea, hair loss, shortness of breath, cough, heartburn, pain due to inflammation, headaches and others. These are usually discussed in greater detail by your radiation oncologist and the treating team of radiotherapists.

Late or chronic side effects also vary based on the area of the body treated. Before your course of radiotherapy starts, ask your radiation oncologist to explain these.

Many patients find the idea of having radiotherapy scary. Fortunately, technology has greatly improved over the years and these days many radiotherapy treatment courses are much better tolerated than in the past. Talk to your radiation oncologist before starting treatment and ask questions should you be unsure of any aspect of your treatment.

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