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 a type of palliative care. Palliative radiation is the use of radiation to a specific area to shrink a tumor, slow down tumor growth, or to reduce or relieve symptoms such as pain and bleeding. Often, palliative radiation is used to treat symptoms or side effects being caused by the cancer itself. It doesn’t aim to cure cancer. Palliative radiation aims to improve quality of life, so lower doses and fewer treatments are used.

What side effects can I expect with palliative radiation?

Although you might only have 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

Your symptoms may worsen before they start to get better. This can include pain, a change in strength, worsening headaches, or a change in vision. If you are having any worsening of your symptoms, it is important to notify your care team.

Fatigue

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 radiation is done, 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 get better. . Activity can help with feeling fatigued. Ask your care team if you can exercise. When your body is tired, 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 let you know which lotions you should use. Apply these creams/lotions as needed. You should not use heating packs or ice packs on the area until your care team 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 fields include your head/scalp, you should not use a hairdryer or curling iron on a hot setting for a few weeks. Do not use products like hairspray directly on your scalp. The irritation and redness will start to get better 2-3 weeks after radiation is done. Hair loss can be either temporary or permanent. Permanent hair loss usually occurs with higher radiation doses.

You will need to protect your skin from the sun. For a few weeks after treatment try to avoid sun exposure to the area of your body that was treated. Continue to protect this area for many years after treatment. When outside, stay covered and use sunscreen that has at least SPF 30.

Pain Flare

A pain flare is a temporary increase in pain in the treatment area. 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 caused by the radiation. If you have a pain flare, ask your care team how to best manage the pain.

Mouth and Throat Issues

If you had radiation to your head and/or neck, your mouth and throat may be affected. You may get sores or blisters on your oral mucosa (the membranes covering your mouth and throat) which can be painful and may it difficult to swallow. Your care team 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 help make more saliva. Your esophagus, the muscular tube that connects your throat to your stomach, can also become swollen causing painful swallowing and in some cases a burning sensation in the neck and chest area. As your esophagus heals, you will have less pain.

Nausea and Vomiting

If you experience nausea and vomiting speak to your care team 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 fresh air, and using relaxation techniques.

Diarrhea

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 care team about medications to reduce diarrhea. Avoiding foods that cause diarrhea. Taking a fiber supplement and eating small, frequent meals of bland foods can all help manage diarrhea.

When should I call my provider?

You should call your provider if you have any new or worsening side effects such as:

• Seizures.
• 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. 

It is important to let your care team know if you have any side effects so they can help you manage them. Remember, side effects of palliative radiation can happen during or after your treatment ends.