What to expect when you have radiotherapy treatment – and tips for coping with side effects
Radiotherapy is a common form of cancer treatment and many people have been helped by it. This guide explains what to expect if you have been told you need to have radiotherapy.
It also provides practical tips shared by members of the Live Better With cancer community – real people who have been through radiotherapy and found ways to cope with the side effects.
In this guide:
Feeling Tired | Loss of Appetite | Feeling sick (nausea) | Hair Loss | Skin Problems | Mouth Problems | Difficulty swallowing | Difficulty Having Sex | Diarrhoea | Stiff Joints And Muscles | Flu-Like Symptoms
What is radiotherapy?
Radiation therapy – known as radiotherapy – is a cancer treatment that uses high-energy x-rays to destroy cancer cells.
Radiotherapy can be internal or external. Internal radiotherapy involves placing radioactive material inside the body. External radiotherapy involves using a machine to aim x-rays at the area of the body affected by cancer. The most common kind of machine is called a linear accelerator (LINAC).
Radiotherapy can be ‘curative’ or ‘palliative’. Curative treatment is when your doctor gives you radiotherapy to try to destroy a tumour and cure your cancer. If the cancer cannot be cured, your doctor may give radiotherapy as a palliative treatment to ease your symptoms and make you more comfortable.
Sometimes radiotherapy is given along with chemotherapy. This is known as ‘chemoradiation’ treatment.
The kind of radiotherapy your doctor gives you will depend on your situation and the type of cancer you have.
Why does radiotherapy have side effects?
Radiotherapy treats cancer by destroying cancer cells. However, the treatment can also damage normal, healthy cells. These normal cells can usually repair themselves (unlike cancer cells, which are destroyed forever), but when they are damaged you may suffer side effects.
The side effects can range from tiredness to hair loss. How bad the side effects are can be very different from person to person.
Here are some of the most common radiotherapy side effects – plus tips from the Live Better With Cancer community for coping with them.
Feeling tired (fatigue)
When you have radiotherapy your body has to repair the damage caused to healthy cells. This can make you feel very tired. You might feel weak and that you have little energy. Usually people feel more tired towards the end of their treatment than at the beginning. The feeling of ‘fatigue’ can continue for weeks or even months after treatment.
Here are some tips and recommendations from the Live Better With community for coping with tiredness:
- Rest when you can. If possible take regular naps during the day.
- Drink plenty of fluids. This helps the body to repair the radiotherapy damage. You should drink about three litres of water a day if possible while having radiotherapy treatment.
- Keep exercising. Try to keep up with your normal exercise routine, or take up light exercise such as walking. This can boost energy levels and increase feel-good endorphins, making you feel less tired. Talk to your healthcare team about suitable activities.
“Don’t be afraid to ask family or friends if they can help with your shopping, childcare or housework.” – Jill, 51
- Ask for help. You may be used to doing everything yourself, from looking after children to the weekly shop. Don’t be afraid to ask others to help you when you’re feeling tired. Loved ones and friends nearly always want to be useful when you’re having treatment.
- Get a better night’s sleep. Aromatherapy oils help a deeper, more restful sleep. Why not spray some lavender on your pillow, or use a natural sleep balm? The Live Better With community recommends Badger Sleep Balm and Cotswold Lavender Slumber Spray.
“Just what I need after a long day. The scent isn’t too strong, just enough to gently lull me off to sleep. I put a bit under my nose, on my temples, and I rub some into my eyebrows which is making them strong and shiny. My new favourite bedtime ritual.” – Review by ‘P’ of Badger Sleep Balm.
- Try mindfulness exercises. Mindfulness can help clear your mind and help you get a better, deeper sleep to restore your energy. Our community likes The Little Book of Mindfulness by Dr Patrizia Collard. Some people find mindfulness colouring books to be very relaxing before a sleep.
Loss of Appetite
Sometimes having radiotherapy means that you don’t feel like eating. Loss of appetite is very common for people being treated for cancer in the stomach or intestines.
Good nutrition (eating healthy foods) during radiotherapy helps you to stay as fit and well as possible. Try these tips:
- Eat smaller, more frequent meals. Try having small meals but more often, rather than a few large meals in a day. Take time to chew your food to allow it to digest.
- Freeze meals. Some Live Better With community members suggest preparing and freezing meals before beginning a course of radiotherapy, in case they became too tired to cook properly during treatment.
- Eat plenty when you are hungry. When you do have an appetite, eat extra portions.
- Eat well. Choose fresh and colourful foods for your diet including dark green, red and orange vegetables, seafood and lean meat and poultry. The Live Better With community recommends The Royal Marsden Cancer Cookbook, by Dr Clare Shaw and Nourish: The Cancer Care Cookbook, by Christine Bailey
“Eating nutrient-dense meals is a factor in recovery from radiation therapy. Eating low nutrient meals will not give the body what it needs to heal and as a result, will slow down recovery time.” – The Southeast Radiation Oncology Group
- Get help. Ask your dietician for advice on the best eating plan during treatment and recovery.
Feeling sick (nausea)
Radiotherapy can make you feel like being sick, especially if the treatment is close to your stomach area. This feeling of nausea will usually go away when your treatment session is over, but some people do feel ‘queasy’ for a few hours after external radiotherapy. Here are some tips:
- Eat a bland snack before treatment, such as toast and apple juice. You can also try nibbling on dry biscuits or crackers.
- Drink plenty. Sip on water and other fluids to prevent dehydration.
- Try ginger. Ginger is well-known for helping soothe your stomach when you are feeling sick. There are many products contain ginger to choose from, such as ginger tea, ginger beer, ginger chews or ginger biscuits. Try Gin-Gin Ginger Chews.
“At first I couldn’t think about eating without thinking about throwing up. Drinking ginger tea helped control the nausea.” – Simon, 67
- Wear anti-sickness wristbands. Acupuncture wristbands like Sea-Bands have been clinically proven to reduce radiotherapy-induced nausea.
Radiotherapy can mean that you lose hair in the area being treated, such as your scalp or face. You may lose hair on the opposite side of the area being treated, where the radiotherapy beam passes through the ‘exit site’.
Your hair will usually grow back a few months after the treatment has finished. However, sometimes the new hair can be a little different, perhaps thinner or curlier.
“My radiotherapy was directly targeted at my head, which resulted in hair loss. Talk to your hairdresser about how to make your remaining hair look as good as possible. Mine recommended a new style and it felt great!” – Lizzie, 45
- Stay confident. You may like to use a hat, scarf, turban, wig, toupee or nothing! Do whatever feels most comfortable and gives you the most confidence.
- Try bamboo. If you do use headwear, try a hat (or wig liner) made from bamboo. Bamboo is highly breathable in hot weather but keeps you warm when the weather turns chilly. It is also three times more absorbent than cotton which helps with sweating. Bamboo also has antibacterial properties. See bamboo hats here.
- Use a biotin shampoo. Try a natural strengthening shampoo and conditioner. The Live Better With Community recommends Biotin Shampoo and Biotin conditioner, which contain vitamin B7.
- Beware of sunburn. Make sure you protect areas where you have hair loss from sunburn, using chemical-free sunscreens. Try Caribbean Blue Sunscreen.
Radiotherapy exposes your skin to radiation, which can make it sore, dry or itchy. It might also become red, burned or look darker than usual. Here are some tips to help:
“I placed small pieces of silk cloth under my straps and waistband to prevent chafing on my sore skin.” – Beth, 42
- Follow skincare instructions from your treatment team – and let them know about any changes to the skin (such as rashes, cracks, blisters or peeling)
- Don’t scrub your skin to try to remove dye outlines. Let the dye outlines wear off gradually.
- Avoid very hot or very cold water. Use warm water rather than hot when showering and avoid hot-water bottles, heat packs, wheat bags and ice packs on the treatment areas.
- Use creams. Various creams can help burnt skin, especially ones with a paraffin base (such as E45 or aqueous cream). However, you should check with your nurse or doctor first.
- Avoid harsh and perfumed soaps or deodorants. Instead, try to use fragrance-free products which contain moisturisers such as aqueous cream or calendula cream.
- Wear loose, soft clothing made from natural fibres to prevent rubbing on sore areas
“I found nursing bras or camisoles were much more comfortable on my skin than anything else I tried.” – Angela, 65
- Stay out of the sun and cover your skin before going out. The UV rays from the sun can cause more skin damage.
- Avoid chlorinated swimming pools. Chlorine is very drying, and can make your skin reaction worse.
- Be careful with razors. Men having radiotherapy to the head and neck should use an electric razor instead of wet shaving to minimise further skin irritations.
Radiotherapy is often used to treat cancer in the mouth, throat, neck or upper chest region. This can affect your mouth and teeth, and change your sense of taste. You might find eating and swallowing difficult.
“I made flavoured ice cubes to add to cold water including mint and lime, which helped with my changed sense of taste.” – Emily, 37
- Keep your mouth moist by sucking on ice cubes and sipping cool drinks. Live Better With community members have suggested always carrying a water bottle.
- Try pineapple chunks – another community tip for dry mouths.
- Use special mouthwashes. There are special toothpastes, mouthwashes and saliva replacements that can really help with a dry mouth. Try Biotene Moisturing Mouthwash.
- Use a flavourless toothpaste if your mouth is sore, so that the mint flavour doesn’t cause more irritation.
- Experiment with new flavours. If your sense of taste changes during radiotherapy, try different ways of preparing food and flavouring food (such as marinating foods or adding spices)
Radiotherapy to the chest can cause the tube through which food passes (the oesophagus) to become temporarily inflamed. This may cause discomfort or difficulty when swallowing. It is known as ‘dysphagia’.
- Tell your doctor. If you are in discomfort, ask your doctor if he can prescribe medication to help ease your swallowing.
- Avoid hot or spicy food, and drinking acidic drinks or spirits during this time, because they can make the problem worse.
- Eat soups. They are a tasty and healthy way of satisfying your appetite and getting your nutrients in one go.
- Use food thickeners. Thin, runny fluids can cause coughing and choking. Thickeners can combat this by preventing food from entering the windpipe, and reduce the risk of choking or needing to cough up food. Try Thick and Easy Food Thickener.
Difficulty Having Sex
Radiotherapy can mean you lose interest in sex for a while. This is especially so if you have side effects like tiredness or nausea, or if you are worried about your condition or treatment. Radiotherapy treatment can also cause soreness, dryness or dysfunction (difficulty getting an erection).
“I used a vaginal dilator which helped to stop my vagina from narrowing. It wasn’t at all as scary or uncomfortable as I thought it would be.” – Anna, 26
- Speak to your doctor or healthcare professional. For women, radiotherapy to the vaginal area may cause your vagina to become sore and narrower. Your radiation therapist can tell you how to treat this using a vaginal dilator, which is a device inserted into your vagina to help prevent it narrowing.
- Use natural lubricants – If you experience dryness in your vagina, try using natural lubricants and intimate moisturisers to replenish moisture.
- Male problems – Men may experience erectile dysfunction (difficulty getting an erection). Don’t be embarrassed about speaking to your doctor or radiotherapist about this.
Some people suffer from diarrhoea during radiotherapy treatment. This usually means that you need to go to the toilet more often in a day than is normal for you, and the stools you pass are much looser than normal.
Diarrhoea is usually a temporary side effect. For others, it can be severe and you will need to tell your doctor or nurse if it is getting worse so they can find out the cause and prescribe anti-diarrhoea medicines.
“I put 2 one-litre bottles of water in the fridge to ensure I was drinking enough. It made it much easier to measure.” – Paul, 53
- Drink lots of fluid (up to two litres a day) to replace lost fluid due to diarrhoea
- Avoid alcohol and coffee as they are diuretics, meaning they cause more fluid to leave your body
Eat small, frequent meals that are made from light foods. There are some great cookbooks to help with ideas. Try The Royal Marsden Cookbook by Dr Clare Shaw or Cancer Fighting Kitchen, by Rebecca Katz
Stiff Joints and Muscles
Radiotherapy can make your muscles tighten up and your joints feel very stiff in the area being treated. You may also have uncomfortable swelling in the affected area. Here are some tips:
- Exercise regularly to help prevent stiffness. Your doctor or radiotherapist may refer you to a physiotherapist who can recommend suitable exercises, such as yoga. Make sure to relax your body after exercise.
- Try natural muscle rubs, which use ingredients such as ginger and cayenne pepper, to stimulate blood flow in the sore area. We recommend Badger Muscle Rub.
Palliative radiotherapy can cause flu-like symptoms. These include headaches, aching joints or muscles, and lack of energy (lethargy).
If you also develop a temperature, it’s important to let your radiotherapy team know. Flu-like symptoms usually settle quickly.
Some practical tips are to drink plenty of fluids like water or flavoured water, and to have lots of rest.
Share your tips for living better with Radiotherapy
Have you found things that help when you’re having radiotherapy? If so, we’d love to hear from you. Share your tips with the Live Better With cancer community here.