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What do you need to know?

Having radiotherapy treatment

When you first attend the Spire Oncology Centre a therapy radiographer will explain the treatment process, any possible side effects and their management during and after radiotherapy. 

Your first appointment at the Spire Oncology Centre will be for a CT scan to aid the planning of your radiotherapy. Following this, your next appointment will be for your first radiotherapy treatment. 

The therapy radiographers will give you some small dots on your skin in permanent ink, called tattoos. This allows the position of your treatment to be replicated on a daily basis. Your next appointment will be for your first radiotherapy treatment. The subsequent number of treatments will have been defined by your oncologist as indicated on your appointment list.

You may have been given a gown to wear for your treatment sessions, it is your choice to wear this or not. Please inform the therapy radiographers if you do not wish to wear one.

The therapy radiographers will ask you to lie on the couch in the position you were at the CT planning appointment. They will use the tattoo dots to accurately align you for treatment. When you are in the correct position the radiographers will inform you that they are leaving the room. You will be asked to remain as still as possible and breathe normally.

The therapy radiographers will be observing you via a camera link and can speak to you over their intercom system. The radiotherapy machine will move around you - it will not touch you and there is nothing to feel or see while the radiotherapy treatment is taking place.

The average treatment appointment time takes approximately 20-30 minutes.

You will be given time to discuss any questions or concerns you may have with the therapy radiographers before you start the treatment.

Preparing for treatment

Your first appointment at the centre will be for a CT scan to aid the planning of your radiotherapy treatment. When you arrive at the centre, a therapy radiographer will explain to you the procedure required for the preparation needed for the CT scan. The therapy radiographer will be able to answer any questions and address any concerns you may have.

Skin care during radiotherapy

Radiotherapy may cause a change to your skin in the treatment area. This normally occurs 10-12 days after starting the radiotherapy treatment. Everyone is different in how they react to the radiotherapy treatment and this varies from person to person.

The skin reaction commonly caused by radiotherapy is called erythema. This can be noticed as a pink/reddening discolouration of the skin. Sometimes it can feel dry and itchy and in some cases the skin may peel and break. 

Your skin may get particularly sore around your bottom and sometimes in your groin area.

Your skin will be monitored daily by your team of radiographers and they can advise you regarding how to look after your skin.

Other considerations during your treatment

Fatigue 

Some people can experience tiredness during their course of radiotherapy. Some people manage to continue working whilst they are having radiotherapy whilst others find they are too tired. It is best to listen to your body and do as much as you feel capable, resting when necessary. 

Light exercise can help with energy levels. It is advisable to drink plenty of fluids as this can help combat tiredness, 2 litres of water (3-4 pints) is recommended for your daily intake, try to consume caffeinated drinks in moderation as these can dehydrate you. Your radiotherapy team will be able to advise you of ways to help manage tiredness if this becomes an issue for you.

Eating well

It is recommended that you follow a balanced healthy diet during treatment. We will advise you if you need to change your diet during radiotherapy. Drinking plenty of fluids is also advised.

Emotional effects

A cancer diagnosis can bring with it many feelings of fear, anxiety, low mood and depression.

We understand that going through diagnosis and cancer treatment can be both difficult for you and your friends and family. At the Spire Oncology Centre we are here to provide a supportive environment. Please mention to the therapy radiographers if you feel you need some emotional support.

Clothing

It may be more comfortable to wear loose clothing made of natural fibres around the treatment area. Some people find that the ink marks put on the skin can rub off on to clothing. These should wash off but it may be advisable to wear older clothes for your treatment.

Sun exposure

Your skin in the treatment area will always be more sensitive to the sun even after the radiotherapy treatment has finished.

It is best to avoid direct sun exposure to the treatment area whilst you are undergoing radiotherapy. Please do not put any sun protection creams on your skin whilst having treatment and for a couple of weeks after the radiotherapy has finished, until your treatment reaction has settled down. 

In the future, it is recommended to cover the area of treatment that may be exposed to the sun or use a sun block SPF 50.

Swimming

You can swim while having radiotherapy treatment, but it is important to carefully wash and moisturise your treatment area afterwards. If you find swimming irritates your skin you may need to stop while you’re having treatment. The radiographers will advise you if it is best to avoid swimming all together.

 

Side effects during radiotherapy

Radiotherapy side effects can depend on how an individual reacts to the treatment. Radiotherapy side effects normally start to become noticeable approximately halfway through your course of treatment. Information is provided on some of the possible side effects for radiotherapy to the bowel.

Short-term side effects

Diarrhoea

Radiotherapy can affect your bowels by making them work faster. This can lead to you opening your bowels or emptying your stoma bag more frequently. Sometimes this can progress to diarrhoea-like symptoms, where motions may become loose and with a sense of urgency. It is advised to tell the radiographers looking after you if you get an onset of loose motions. They will be able to advise you about possible changes to your diet or medication to help manage these symptoms. It is important to drink plenty of fluids to help replace the fluids lost by opening your bowels frequently. Occasionally you may pass some blood in your stools, again please let the radiographers know if this is a symptom you experience.

Tenesmus

Radiotherapy to the bowel may also irritate symptoms of tenesmus, which is a sensation where you need to empty your bowels but may not result in a productive bowel movement. This may mean that you need to go to the toilet several times before you feel your bowels are empty and for some people this can be uncomfortable.

Haemorrhoids (piles)

For those that have pre-existing problems with haemorrhoids or piles, radiotherapy may aggravate this and cause them to flare up. Do not use any existing medication cream until you have been advised by the radiographer, as some creams may interfere with the radiotherapy and cause irritation. Others find that the radiotherapy may cause some soreness inside the back passage, which can make it sore or uncomfortable to open your bowels. Please mention to the radiographers if any of these symptoms occur.

Stomach cramps or abdominal discomfort 

It is not unusual to get some abdominal discomfort during your course of radiotherapy. Some people find that they produce more gas (wind) some can experience abdominal cramps. Please let the radiographers know if you are experiencing any discomfort or any difficulty opening your bowels.

Bladder related side effects

You may find that the radiotherapy affects your bladder function; some people find they have to pass urine more frequently and during the night as well. Occasionally you can experience cystitis-like symptoms caused by the radiotherapy. It is important to inform a radiographer of these symptoms, particularly if your symptoms of burning when passing urine persist for more than a couple of days. This may indicate that you have a urine infection, which will need to be treated with a course of medication. Increasing your fluid intake can help with some of these urinary symptoms as this can help you to pass
your urine easier. Try to avoid too many caffeinated drinks or alcohol throughout the day to avoid irritation to your bladder.

Long-term side effects

Some people find that the side effects from radiotherapy subside quite quickly after the treatment course has finished – for most this occurs three to six weeks after radiotherapy. You may have radiotherapy prior to surgery, in which case it may take longer for you to recover. However, for some people the side effects can become longer term, occurring months or years after the radiotherapy has finished.

Long-term effects to the bowel

You may be left with an increase in daily bowel movements; this can be a result of the radiotherapy, the surgery or both. Please inform your doctor if you notice blood or mucous when you open your bowels. Rarely the radiotherapy can cause permanent damage to the bowel, which may require an operation. Your doctor will discuss this in more detail when they explain the radiotherapy treatment.

Long-term effects to the bladder

The radiotherapy may sometimes affect the lining of bladder in the long term. This may result in your bladder holding less urine and you may need to empty your bladder more frequently therefore changing your urinary habits.


Specific side effects for women

Radiotherapy to the pelvis area can cause some effects to the vagina. You may experience vaginal dryness as the treatment progresses; a waterbased lubricant can be used when having sexual intercourse if required. The radiotherapy can also cause some scarring of the vaginal walls, which may result in some narrowing or shortening of the vagina. This can be prevented in two ways: with regular sexual intercourse or with the use of vaginal dilators. Your therapy radiographer will discuss this with you in more detail when you attend for radiotherapy. 

For some women, radiotherapy treatment can affect their ovaries. This can lead to infertility; your doctor will discuss this in depth if this will affect you. For those that are still having periods the radiotherapy can stop you producing hormones, which can lead to your periods stopping and inducing the menopause. However, it is important to still use contraception for at least a year after your periods have stopped.

We understand that some of these side effects can be difficult to discuss, please try not to feel uncomfortable. The radiographers are more than happy to discuss any concerns you may have.

Specific side effects for men

Radiotherapy to the bowel can sometimes affect a man’s erectile function; this may lead to you having difficulties getting an erection. If this is a concern you can obtain advice from your radiotherapy team on how to manage these symptoms. Radiotherapy may also affect the ability to ejaculate - some people find they ejaculate smaller volumes of semen or experience a dry ejaculation. Radiotherapy can also cause infertility. Your radiotherapy team will discuss this with you in more detail if you have any concerns.