General side effects
The body's reactions depend on the area being radiated. Nevertheless, there are a number of general reactions that can occur during the treatment.
For example:
- Fatigue
- Increased need for sleep
- Reduced appetite
Your doctor will inform you about these in advance and will discuss with you how to manage such reactions.
If you have any complaints, it is best to talk about them with your doctor or with the nurses.
The effects of radiation can linger for quite some time and may not reach their full effect until after several weeks. Sometimes side effects only appear in the week after radiotherapy or increase during this period. If you suffer little or not at all from radiotherapy, this shouldn’t worry you either. The succes of radiotherapy does not depend on whether you have few or many side effects. Talk to your doctor so they can give you the right information.
Specific side effects
Depending on the part of the body being radiated, specific side effects may occur.
Discuss your symptoms with your doctor or nurse. They can give you advice on how best to deal with the symptoms or what to do about them.
Skin reaction
It is very normal for your skin to react to radiotherapy. How much you react depends on a number of factors, such as the dose administered and the location of the radiation.
In the radiation area, your skin may be red, very dry and slightly swollen. Afterwards, it flakes off. The skin at the radiated site is itchy and sensitive. In some cases, it may turn dark red and become shiny and painful. There may be blisters that open up and release fluid. They appear most frequently in the skin folds, for example behind the ears, in the groin or the perineum.
The skin reactions can occur both during and after the radiation sessions. The nurses and your attending physician will monitor them during the treatment. They can also advise you on how best to protect and care for your skin (for example by using a hydrating cream, protective clothing, etc.).
Care during treatment
Treatment demands a lot from your body. To maintain your weight and condition, it is necessary to take in enough energy (calories), fluids and nutrients. In a good nutritional status, you usually cope better with the treatment and have a reduced risk of complications. The dietician is happy to advise you on this. Depending on your wishes and/or the severity of your symptoms, she will continue to monitor you throughout your treatment. You can always make an appointment with the dietician via the proton therapy team nurse, the secretariat or your treating radiotherapist-oncologist.
The following recommendations apply only to the radiated areas. It is not necessary to take care of the rest of your body in the same way.
During radiation
- Protect radiated skin from additional irritation, injury and inflammation for as long as the radiation lasts and until your skin has healed completely.
- Wash the radiated skin with a neutral, unscented soap.
- Preferably use lukewarm water.
- Wash yourself very gently. Use your hands instead of a washcloth.
- Dry the skin very gently by patting it, never rubbing it. Keep skin folds very dry, as the skin opens more easily in these places.
- Place a soft cloth in skin folds.
- Feel free to take a shower or bath. If the marks used during radiation become less clear, do not reapply them yourself.
- Protect your skin in the radiated area from very high and very low temperatures. Never use a hot water bottle or an electric pillow.
- Do not shave the radiation site, e.g. in the armpits.
- If you are radiated in the face, use an electric shaver without shaving products or aftershave, as they may irritate the skin.
- In case of itching, burning or dry skin:
- Use a moisturiser twice a day.
- Cool the skin with a cold, damp washcloth or with a cold pack kept in the fridge (not in the freezer).
- Do not scratch! Gently rubbing with a flat hand will help.
- There are special silicone foam bandages that relieve itching and pain. Ask the nurses at the radiotherapy unit about them, they can help you with this.
- Avoid clothing that rubs against the radiated skin:
- Preferably wear 100 percent cotton clothing if your clothing is in direct contact with the radiated skin.
- Make sure your clothes are soft to the touch. Under no circumstances use starch or harsh laundry products, as they can irritate the skin.
- Wear loose clothes over the treated skin to avoid friction.
- Avoid tight-fitting shirts, tight-fitting collars, belts, and so on.
- A silk scarf prevents friction during and after neck radiation.
- Ladies should not wear a tight-fitting bra or corset. If you do wear a bra, you can protect your skin with a soft cloth. Sometimes it is recommended a cotton camisole be worn under the bra.
- Protect radiated skin from direct sun, cold, wind, and rain. Sunscreen products do not completely block out the sun and can also cause irritation. Rather, cover the radiated skin.
- During radiation, both the doctor and the nurse will check your skin regularly. In case of problems, you can also contact the wound care nurse.
After irradiation
Keep protecting your radiated skin after treatment, even if your skin seems to have healed.
During the first weeks after radiation
- Follow the care instructions you were given, such as applying moisturiser or special bandages.
- Avoid injuries, friction or pressure.
- Avoid products that can cause skin irritation, such as shaving products and aftershaves, as much as possible.
- Should your skin still open after finishing your radiotherapy treatment, contact the wound care nurse immediately for an appointment.
Up to 1 year after irradiation
- Protect your radiated skin from direct sunlight. For example, use a sunscreen with factor 50 or higher if the radiated skin is still exposed to the sun.
- Protect your skin from the direct effects of wind and cold.
Consult your doctor or nurse if the skin at the radiation site
- turns violently red,
- blisters,
- becomes moist and sticky,
- and/or is very painful.