Palliative Radiation Treatment
What is palliative radiation?
Radiation is the use of high-energy x-rays to damage the DNA of cells, which leads to the death of cancer cells. Palliative radiation is the use of radiation to treat a specific area, and in some cases to reduce side effects such as pain and bleeding. Palliative radiation is done to improve the quality of life of the patient. Palliative radiation treatment is much shorter (fewer doses) than traditional radiation treatment.
What are the side effects associated with palliative radiation?
Although you will only receive a few treatments, you could have side effects. These are often short-term side effects, lasting 1-4 weeks after your treatment has ended. The side effects you have are in relation to the part of the body being treated. Side effects can include:
Worsening of Symptoms
Often, palliative radiation is used to treat symptoms or side effects being caused by the cancer itself. These symptoms may worsen before they start to improve. These can include pain, a change in strength, worsening headaches, or change in vision. If you are having any worsening of your symptoms it is important to notify your team.
Fatigue is a very common side effect of cancer and its treatments. It is a feeling of exhaustion and can be physical, emotional, and mental. In the first few weeks after you complete radiation, you may feel even more tired than if you were receiving daily radiation therapy. This is normal. Fatigue may continue for 2-3 weeks after radiation therapy, and then slowly start to improve. Rest when you can to combat fatigue. Activity can also help combat fatigue. Ask your provider if it is ok to exercise. When your body is tired, take a rest.
Skin Care and Hair Loss
Radiation can cause your skin to become red, dry, itchy, and irritated. You should use a gentle soap or shampoo and lukewarm water to wash the affected skin. Your radiation team will discuss with you which lotions you should use. Apply these creams/lotion as needed. You should not use heating packs or ice packs on the area until your provider tells you that you can.
If you had hair loss and/or scalp irritation, do not dye or perm your hair for one month after treatment is complete. If your treatment is directed to your head/scalp, you should not use a hairdryer or curling iron on a hot setting for the next few weeks. Do not use products like hairspray directly on the scalp. The irritation and redness will start to resolve 2-3 weeks after radiation is finished. Hair loss can be either temporary or permanent.
You will need to protect your skin from the sun. For a few weeks after treatment try to avoid sun exposure in the area of your body that was treated. When outside, stay covered and use sunscreen that has at least SPF 30.
A pain flare is a temporary increase in pain at the radiation site. It can range from mild to severe. It can start shortly after treatment, to within a few weeks of finishing treatment, and on average last a few hours to a few days. It is thought to be related to inflammation from the radiation. If you have a pain flare, ask the care team how to best manage this pain.
Mouth and Throat Issues
If you receive radiation to your head, your mouth and throat can be affected. You can have sores or blisters on your oral mucosa (the membranes covering your mouth and throat) which can be painful and cause issues with swallowing. Your provider will teach you about mouth care and can prescribe medications to ease the pain. You may also have dry mouth. If your mouth feels dry. make sure to stay hydrated. Take small sips of water throughout the day and suck on sugar-free hard candies to promote saliva production. The esophagus, which is the muscular tube that connects your throat to your stomach, can also become inflamed causing painful swallowing and in some cases a burning sensation in the neck and chest area. As your esophagus heals, your pain will resolve.
Nausea and Vomiting
If you experience nausea and vomiting speak to your provider about medications that can be helpful. Do your best to stay hydrated, and eat frequent meals consisting of bland foods. If certain foods make you nauseous, avoid them until you feel better. Other ways to manage nausea include breathing exercises, getting some fresh air, and using relaxation techniques.
Diarrhea is when you have loose, watery stools more often than your normal bowel habits. It can cause cramping and stomach discomfort. You can speak to your provider about medications to lessen the diarrhea. Avoiding foods that cause you to have diarrhea, taking a fiber supplement, and eating small, frequent meals of bland foods can all help to manage diarrhea.
When should I contact my provider?
You should call your provider if you have any new or worsening side effects such as:
- Worsening headache or other pain.
- New weakness/decrease in sensation/decrease in strength.
- Pain or swelling in one of your legs.
- Change in your mental status (New confusion or extreme tiredness).
- Sudden chest pain or shortness of breath.
- Nausea/Vomiting that is not managed with medications.
- Constipation that lasts for a few days.
- Change in urination/not being able to urinate.
Spencer, K., Parrish, R., Barton, R., & Henry, A. (2018). Palliative Radiotherapy. BMJ. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865075/