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What do you need to know?

The effects of radiotherapy differ for each individual, and depend, amongst other factors, on the dose of radiotherapy received and the period of treatment. If you are still unsure or have any further questions once you have finished reading this leaflet, please speak with a Therapy Radiographer who will be able to advise you on what to expect.

Your first appointment

When you first attend a Spire Oncology Centre a Therapy Radiographer will explain the treatment process and will discuss with you any possible side effects and how we can help you to manage them during and after radiotherapy.

Your first appointment at the centre will be to develop an individual treatment plan for you, and will involve a CT scan. Initially the radiographers will ask you to take off your top items of clothing and a gown will be provided. You will be asked to lie on your back with your arms supported above your head and with a supportive knee rest.

Once you are in a stable position you will have the scan, the purpose of this scan is purely to plan your radiotherapy treatment. The radiographers will need to make some set up marks to ensure that your position is replicated for daily treatment. These will be three small freckle sized dots which with your permission we would like to make into permanent tattoos.

Once the scan has been completed you will be free to leave until you return for your next appointment which will be the start of your radiotherapy treatment.

Radiotherapy treatment

The radiographers will ask you to lie on the couch in the same position you were in at the CT planning appointment and using the same immobilisation equipment. Using your set up marks, the radiographers will align you for treatment. When you are in the correct position the radiographers will inform you that they are leaving the room and you will be asked to remain as still as possible and breathe normally. The radiographers will be watching you on closed circuit cameras and can speak to you via an intercom system.

A scan will be performed prior to delivering any treatment to ensure that you are in the correct position and any adjustments will be made if necessary. Treatment is painless; the radiotherapy machine will move around you but will not touch you. You cannot see or feel the treatment taking place but you will hear a buzzing sound, it is delivered quickly and once treatment is over you are free to leave the department.

Short term side effects

Oesophagitis and difficulty swallowing (dysphagia)

You may find that your oesophagus can become sore and inflamed with the treatment. This can cause you to experience difficulty swallowing and you may experience a loss of appetite and indigestion/heartburn. These are all common side effects of radiotherapy. Your doctor can prescribe medications to help, and you will have an opportunity to raise any problems at your weekly review with a radiographer. If you are finding it increasingly difficult to eat the foods that you usually enjoy, our dietician will be able to offer advice on how you can help maintain a nourishing diet.

Cough

You may already have a cough as a result of your condition, or may develop one as a side effect of treatment. This is quite common and it can be either dry or tickly, or mucus producing, and sometimes as a result of the trauma of coughing, some blood may be produced. Please do not worry, but inform the radiographers. The cough should go away once the treatment is over and a few weeks have passed. If you are coughing up yellow, green or brown mucus, please inform the radiographers, especially if you also feel feverish or unwell, as this can be a sign of a chest infection and you may then need to take antibiotics.

Breathlessness

Symptoms of breathlessness may occur or worsen towards the end of treatment. It is important to be aware that also some weeks after the radiotherapy has finished there may be a recurrence or the first appearance of breathlessness. This is due to a condition called subacute pneumonitis, which is a side effect of the radiotherapy, and may also result in a dry cough and fever. This should getbetter on its own  within a few weeks, although some people may require a short course of steroid tablets. If you are worried, or if the side effects continue for longer than a few weeks after treatment, please contact your radiographer or your GP.

Nausea

If the area being treated is near your stomach you may feel nauseous and might sometimes be sick. Please inform the radiographers if this happens. Anti-sickness tablets to help alleviate these symptoms can be prescribed. If you are feeling nauseous you may not feel like eating, in which case you can be referred to the dietitian who can offer advice on foods which might be more palatable.

Hoarse voice

If the treatment area includes the throat, you may experience hoarseness. Again, this is a normal reaction and is caused by the radiotherapy causing inflammation of the vocal cords. If your throat becomes sore please tell the radiographers who will advise you accordingly.

Chest pain

You may develop pain or aches in the area being treated. This is due to the radiotherapy causing inflammation of the tissues. You may already be experiencing some pain due to your illness, and the radiotherapy may temporarily worsen this. You may have been prescribed painkillers already by the doctor. If not, and the pain is troubling you, please speak to the radiographers, who can arrange for the doctor to prescribe medication for you.

Hair loss 

There may be a temporary loss of chest hair (in male patients) in the area treated. This is a normal reaction. It may take a few months to regrow or the hair loss may be permanent, depending on your individual treatment plan. Your consultant will discuss this with you prior to starting radiotherapy treatment.

Fatigue

Fatigue is a very common side effect of radiotherapy treatment. Tiredness and fatigue usually occurs towards the end of treatment and is a normal reaction. Fatigue may even continue for several weeks after your radiotherapy has finished. This is a normal reaction and nothing to worry about. It is usually caused by a combination of travelling to and from hospital, the effects of the treatment on your body, coping with the stress of a diagnosis of cancer, and continuing with normal life. 

Skin

The treatment area of your skin may become irritated. Whilst skin reactions are not always a common side effect when receiving radiotherapy to the abdomen or thorax, a reaction can sometimes be more pronounced on your back. This can mean that by the end of your treatment programme there is an area of defined redness (much like mild sunburn) which may be dry and irritated. This can start to occur 10-12 days after beginning the radiotherapy treatment. 

Your skin will be monitored daily by your team of radiographers and recommended creams and advice will be given to you when appropriate.

Long term side effects

Dysphagia

As a result of treatment the oesophagus can become narrower making it harder to swallow some foods. It may be necessary to modify your diet and in some situations the oesophagus may need to be widened by putting a stent (a small mesh tube) in place. You will continue to be monitored by your doctor once treatment has finished, and if you experience any of these symptoms please contact them.

Radiation pneumonitis (inflammation of lung tissue)

Inflammation of the lung tissue as a result of radiotherapy can lead to shortness of breath and a dry cough. The doctor will plan your treatment to reduce this risk as much as possible and if you have any concerns please talk to a member of staff or discuss them with your doctor.