How to Cope with Radiation Therapy Side Effects

Radiation therapy treats cancer by using high energy to kill tumor cells.  Many people who get radiation therapy have skin changes and some fatigue.  Side effects vary from person to person; depend on the radiation dose, and the part of the body being treated. Some patients have no side effects at all, while others have quite a few. There is no way to predict who will have side effects.

Skin changes may include dryness, itching, peeling, or blistering. These changes occur because radiation therapy damages healthy skin cells in the treatment area.

Fatigue is often described as feeling worn out or exhausted.

If you have bad side effects, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment you are getting.

Depending on the part of your body being treated, you may also have:

  • Diarrhea
  • Hair loss in the treatment area
  • Mouth changes such as soreness, dryness and difficulty swallowing (if radiation to head and  neck area)
  • Nausea and vomiting
  • Sexual impact (tenderness and soreness of genital organs if radiation to this area)
  • Blood count changes

Most of these side effects go away within two months after radiation therapy is finished.

Late side effects may first occur six or more months after radiation therapy is over.  Late side effects may include infertility, joint problems, lymphedema, mouth problems, and secondary cancer. Everyone is different, so talk to your doctor or nurse about whether you might have late side effects and what signs to look for.

What can you do to take care of yourself during treatment?

  • Be sure to get plenty of rest. You may feel more tired than normal.
  • Eat a balanced, nutritious diet. Depending on the area of your body getting radiation (for example, the belly or pelvic area), your doctor or nurse may suggest changes in your diet.
  • Take care of the skin in the treatment area. If you get external radiation therapy, the skin in the treatment area may become more sensitive or look and feel sunburned. Ask your doctor or nurse before using any soap, lotions, deodorants, medicines, perfumes, cosmetics, talcum powder, or anything else on the treated area.
  • Do not wear tight clothes over the treatment area. This includes girdles, pantyhose, or close-fitting collars. Instead, wear loose, soft cotton clothing. Do not starch your clothes.
  • Do not rub, scrub, or use adhesive tape on treated skin. If your skin must be bandaged, use paper tape or other tape for sensitive skin.
  • Do not put heat or cold (such as a heating pad, heat lamp, or ice pack) on the treatment area.
  • Protect the treated area from the sun. Your skin may be extra sensitive to sunlight.   Ask your doctor if you should use a lotion that contains a sunscreen.

Did you experience any side effects from your radiation treatment?  What did you do to cope?  Please feel free to share any tips to help others.

Resources

U-M Department of Radiation Oncology

U-M Caring for Yourself after Radiation Therapy

National Cancer Institute, Radiation Therapy and You:  Support for People With Cancer

Care for Caregivers

Caregivers may be spouses, partners, family members, or close friends who give the person with cancer physical and emotional care. Giving care can mean helping with daily needs.  This can include making meals, arranging and transporting to doctor visits, and helping with bathing and dressing.  It can also mean helping your loved one to cope with feelings.

As a caregiver, you may be glad to put the well-being of the person with cancer above your own well-being.  When giving care, it is normal to put your own feelings and needs aside, but you need to take care of yourself too.  If you don’t, you may not be able to care for others.

There are many causes of stress in cancer caregivers.   Everyone has emotional ups and downs, but early attention to symptoms of depression can make a big difference in how the caregiver feels about their role and how well they can do the things they need to do.  There are ways to help reduce stress which may help prevent serious depression.

Tips for a strong patient and caregiver team:

  • Support one another, even though only one person is ill.
  • Communicate openly.
  • Share worries and concerns.
  • Maintain an active lifestyle as much as possible.
  • Continue enjoyable activities.
  • Ask questions to understand and manage symptoms.
  • Help one another cope.

The FOCUS Support Program is an Ann Arbor area support group held at the Cancer Support Community.  It is a free six-week program for cancer patients and caregivers to lean about how to live through and beyond cancer.  The program is unique in that it addresses caregiver concerns and how patients and loved ones can work as a team to manage and cope with the illness.  If you are interested in participating, contact the Cancer Support Community at 734-975-2500.

If you were/are a caregiver, what worked for you?  Please feel free to leave a comment.

Resources

Managing Emotions – Finding Strength in Others

Caring For Your Own:  Skills Lab empowers families to be partners in cancer treatment

Family Caregiver Alliance

Why is Pancreatic Cancer so Challenging?

The pancreas is located deep inside the body, so early tumors cannot be seen or felt by health care providers during routine physical exams. This makes it hard to see the pancreas with imaging technologies and sometimes makes it difficult to access to remove cells for a biopsy.

Pancreatic cancer is a relatively rare cancer and it typically affects people older than age 50. Pancreatic cancer is hard to diagnose because the early symptoms are usually vague. Early symptoms may be nothing more than a general feeling of discomfort in the abdomen or an unexplained weight loss.

Another factor that makes pancreatic cancer so deadly is its resistance to treatment. At this time, the only possibility for long-term survival is surgically removing the cancer. Researchers are working on ways to detect the disease earlier, because that might allow more people to be eligible for surgery.

What tests are used to diagnose pancreatic cancer?

  • History and physical exam
  • Computed tomography (CT, CAT) scan
  • Magnetic resonance imaging (MRI)
  • Somatostatin receptor scintigraphy(OctreoScan) – helpful in diagnosing pancreatic neuroendocrine tumors
  • Positron emission tomography (PET) scan
  • Ultrasonography (ultrasound)
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Angiography
  • Blood tests– Elevated blood levels of the tumor markers CA 19-9 and carcinoembryonic antigen (CEA) may point to a diagnosis of  pancreatic cancer made of exocrine cells, but these tests aren’t always accurate
  • Biopsy – A patient’s history, physical exam, and imaging test results may strongly suggest pancreatic cancer, but the only way to be sure is to remove a small sample of tumor and look at it under the microscope. This procedure is called a biopsy.

When disease has advanced beyond surgery’s reach, chemotherapy is the standard treatment. Two drugs are FDA-approved for the treatment of pancreatic cancer: gemcitabine (Gemzar) and erlotinib (Tarceva).

Research focusing on pancreatic cancer is increasing. Researchers are investigating ways to more effectively screen for the disease and examining possibilities for better treatment options.

Continue learning about pancreatic cancer treatment and research at the University of Michigan Comprehensive Cancer Center

Screening and Prevention of Lung Cancer

People who are former smokers, smokers, exposed to secondhand smoke or have worked around materials that increase their risk for lung cancer should be aware of the lung cancer risk. These individuals should talk with their doctors about the benefits and risks of lung cancer screening. Some studies have shown that CT scans can find lung cancers at an early stage. In many cases, the scans can produce inconclusive findings. If you and your doctor decide in favor of testing, then be sure to choose an institution that has experience in lung scanning.

U-M offers a Lung Cancer Screening Clinic which is designed to meet the recommendation from the National Comprehensive Cancer Network to screen high risk patients. All CTs are read by board certified radiologists with special training in radiology of the lungs. Many of these radiologists were readers in the National Lung Screening Trial.

What Does the Screening Include?

The Screening Clinic process includes an initial CT scan, followed by an office visit at our Briarwood location, during which the results will be reviewed with you. You will need to have an additional two scans in consecutive years, for a total of three scans in three years. It is VERY important to understand that screening for lung cancer is a process, not a single test, so achieving the greatest reduction in your risk of dying from lung cancer requires that you be screened over time with these three CT scans, and follow up on any abnormalities.

Will My Insurance Cover the Cost?

The first CT scan will have an initial out-of-pocket cost and if it comes back clear, subsequent scans will also have a cost involved. If there is a nodule found, your future scans will be covered by insurance. The office visits should be covered by your insurance.

Not everyone who meets the initial criteria will be eligible for the clinic. Our team will help guide you as to whether screening can benefit you or not. The Lung Cancer Screening Questionnaire Form will help our team decide whether this screening is a benefit for you.

What are your thoughts about the current lung cancer screening recommendations? Please leave a comment or call the Cancer AnswerLine at 800-865-1125 with any questions.

Continue learning about lung cancer and lung cancer screening

Pregnancy and Cancer

Part 2

Questions to Ask Your Physician before Beginning Treatment

  1. How will you work with my obstetrician?
  2. What kind of chemotherapy do you recommend?
  3. What are the risks and benefits of chemotherapy?
  4. Can I have any other type of treatment?
  5. What are the risks and benefits of those other types?
  6. How should I expect to feel during chemotherapy?
  7. Will the chemotherapy affect my delivery?
  8. Will I be able to breast feed?
  9. What can I do to ensure a safe delivery and recovery?
  10. What may happen if I choose to delay the start of treatment until after the birth of my baby?

Women should work with a multidisciplinary team, members of that team should include: gynecologic oncologist, obstetrician, neonatologist and other specialty doctors if required.

Does pregnancy affect the chance of recovery from cancer?  The prognosis (chance of recovery) for a pregnant woman with cancer is often the same as other women of the same age, type and stage of cancer. Pregnancy sometimes affects the behavior of some cancers.  For example, there is research to suggest that the hormonal changes of pregnancy may stimulate the growth of melanoma.

Is pregnancy possible after cancer treatment?  Pregnancy after cancer treatment is considered safe for the mother and baby, and pregnancy does not appear to increase the chances of cancer recurring. Because some cancers do come back, women may be advised to wait a number of years after completing cancer treatment until the risk of recurrence has decreased.  The amount of time varies with each woman; this is dependent on the type of cancer and treatment she received.

Sometimes cancer treatments may cause infertility.  All women of childbearing age should talk with their doctor about treatment related infertility risks.  In addition, there should be discussion about fertility preservation strategies.

Do you have more questions regarding Pregnancy and Cancer?  If so, please leave a comment or contact the Cancer AnswerLine at 800-865-1125.

Additional Resources

U-M Fertility & Gamete Cryopreservation

LiveStrong: Female Infertility and Male Infertility

Pregnancy and Cancer

Part 1 of 2

When a pregnant woman is diagnosed with cancer, her decisions are complicated by concern about how treatment may affect the baby’s health. Ideally, she can delay treatment until the baby is born, but sometimes a delay can allow the cancer to progress and make it harder to treat. The best time for beginning treatment to balance the baby’s and mother’s health needs isn’t always clear.

Diagnosis

Cancer during pregnancy is rare, occurring in approximately one out of every 1,000 pregnancies, and little research is available to guide women and doctors.  Breast cancer is the most common cancer in pregnant women; affecting approximately one in 3,500 pregnancies. The other common cancers in pregnancy are cervical cancer, lymphoma, and melanoma. A pregnant woman with cancer is capable of giving birth to a healthy baby, and some cancer treatments are safe during pregnancy. Cancer rarely affects the fetus directly.

If cancer is suspected during pregnancy, women may be concerned about diagnostic tests such as x-rays. However, research has shown that the level of radiation in diagnostic x-rays is too low to harm the fetus. When possible, women may use a lead shield that covers the abdomen for extra protection. Other diagnostic tests, such as magnetic resonance imaging (MRI), ultrasound, and biopsy, are also considered safe during pregnancy because they don’t use ionizing radiation.

Some diagnostic tests use liquid radioactive iodine to help stage cancer (figure out whether the cancer has spread to other parts of the body). Radioactive iodine cannot be used during pregnancy because it can damage or destroy the fetus’ thyroid gland.

Treatment

When making treatment decisions for cancer during pregnancy, the doctor considers the best treatment options for the mother and the possible risks to the fetus.

The type of treatment given will depend on the following:

  • The trimester of your pregnancy
  • The type, location, size and stage of the cancer
  • What the woman prefers

Because some cancer treatments can harm the fetus, especially during the first trimester (the first three months of pregnancy), treatment may be delayed until the second or third trimesters. When cancer is diagnosed later in pregnancy, doctors may wait to start treatment until after the baby is born, or they may consider inducing labor early.

Some cancer treatments may be used during pregnancy but only after careful consideration to optimize the safety of the mother and the unborn baby. These include surgery and chemotherapy.  Radiation is generally not utilized during pregnancy.  After evaluation your doctor will develop a treatment plan based on individual circumstances.

Read part 2.

Resources

U-M Women’s Health

American Cancer Society: Gestational Trophoblastic Disease