Coping with radiotherapy
Radiotherapy for non-Hodgkin’s lymphoma (NHL) can affect normal healthy cells as well as lymphoma cells, so the treatment has to be carefully planned so that as few healthy cells are affected as possible.
However, normal cells can repair themselves much more easily than lymphoma cells. So in this way, radiotherapy can control or destroy lymphoma cells, while causing only temporary damage to normal cells. This temporary damage is the reason for some of the side effects of this treatment.
Possible side effects of radiotherapy and how to deal with them
Most side effects of radiotherapy depend on which part of your body is being treated. They are usually minor, and there are many things you can do to help make them easier to deal with.
Often, the side effects are mild to start with and become more of a problem as the treatment course continues.
However, all of the side effects mentioned in this section are temporary, including hair loss. They may last for a few weeks or even several months after the course has finished, but they will go away.
Nausea (feeling sick), vomiting (being sick) or diarrhoea can be caused by treatment to your abdomen
Your healthcare team will be able to give you anti-sickness (anti-emetic) medication if you need it. There are many different anti-emetics, and some kinds work better for some people than others. So, if one anti-emetic does not seem to work, you should ask if you can try another.
Managing nausea and vomiting: find out more
If you experience diarrhoea, you should drink plenty of fluids to make sure that you don’t get dehydrated. Speak to a member of your healthcare team about the best kind of drinks to have, or if you are find that diarrhoea is a problem.
A sore mouth or throat and difficulty swallowing can be caused by treatment to your neck or upper chest
Washing your mouth with bicarbonate of soda mixed with warm water can often help. Also, make sure to clean your teeth, gently, after each meal to prevent infection. If you have dentures, it may be more comfortable to leave them out as much as possible. If swallowing is difficult, eating liquidised or semi-solid food will help.
You may also notice that some foods taste different from normal during treatment. If so, it might help to eat cold rather than hot foods and avoid foods with strong odours. Avoiding favourite foods might also be advisable, so that they don’t become associated with treatment.
Hair loss can be caused by treatment to your head, or any other area with hair on it
As radiotherapy is usually focused on defined areas, you will probably not experience large amounts of hair loss from your head. It may therefore be possible to easily disguise any hair loss by restyling your remaining hair or by wearing a hat or scarf. However, if you are finding hair loss on your head distressing, you may want to consider wearing a wig. Your healthcare team will be able to advise you on wig-fitting services.
Managing hair loss: find out more
Red and sore skin can sometimes be caused by the skin in the area being treated being burned by the radiation
If your skin does become sensitive, you should avoid using perfumed soaps, creams or deodorants in those areas, as this may irritate your skin. Your healthcare team will be able to advise you on how best to look after the skin in the treatment area.
Feeling tired and lethargic is also a very common symptom of radiotherapy
It is important to have adequate rest. It might be necessary to take time off work and to adjust your daily schedule. Other people, however, find that they can continue as normal. Everyone is different.
Managing fatigue: find out more
You may also be more prone to infection during radiotherapy
The number of white blood cells in your blood may also be reduced, which can make you more prone to infection during the course of treatment. It is therefore advisable to try and minimise your risk of infections as much as possible. Following these simple guidelines can help:
- Always wash your hands well before preparing food
- Take care to avoid cuts and scratches by wearing gloves for gardening or housework
- Avoid large crowds and people with colds and flu, if possible
- Some doctors recommend that patients do not have dental treatment during a course of chemotherapy, as this can increase the risk of mouth infection
- Try not to go swimming, due to the risk of picking up an infection from the water or changing room
- If planning a holiday abroad, patients should check with their GP first, as some vaccines should be avoided. These include measles, mumps, rubella and MMR, oral polio vaccines, liquid typhoid, BCG, and yellow fever
Rarely, radiotherapy can have long-term effects
In some cases, radiotherapy can have more serious long-term side effects. These possibilities – both how you feel and what to do about them – should be discussed with your doctor before you begin treatment.
Radiotherapy to your pelvis or groin area can affect your fertility, and this is true for both men and women. As far as possible, the testes or ovaries are shielded from the radiation during treatment. For men, it might be possible to consider sperm banking, before treatment begins. Options for preserving fertility in women may also become available in the future.
Radiotherapy can also increase the risk of some cancers in the target area, for example, in your skin. It is therefore important that you keep any follow-up appointments and attend regular screening so that any problems can be caught as early as possible. You can also take positive steps to reduce your risk of cancer, such as giving up smoking or always using sunscreens when you’re in the sun.
Long-term breast cancer screening after radiotherapy is an important consideration for women who have had radiotherapy to the breast, especially in those with a history of breast cancer in their family. Men may also be affected and ought to consider screening if there is a family history of breast cancer.
Thyroid cancer is also more common after radiotherapy to the neck, so regular checks of your thyroid can also be advisable.
Other long-term effects can occur because of scarring, which results when tissues heal after the radiotherapy. One example of this can be breathlessness that occurs after scarring of lung tissue.