Radiation Side Effects

Hi, I had two tumors one each in upper and lower right lobes. First, they did the tattoos and then the cast. The tattoo shows where the radiation is to be targeted. The cast is for your use only while receiving SRS so you don't move. You lay on the material and they wet it down, then shape it to your body. It dries quickly. Then you lay in it every time. I had 4 treatments for each tumor lasting 20 mins. each. They gave me a break in between. I did end up with esophagitis, very bad sore throat and hard to swallow. I used the magic mouthwash and it was gone within 10 days. I also used Prilosec for heartburn. I wasn't tired and never felt sick. My problem now is radiation scarring to the pectoral muscle and under the armpit. Though targeted, you have to remember that it has to go in and come back out somewhere. This was due to the location of the one tumor, so basically unavoidable. I have pain when I overdo it, but I'm doing very well overall. I started chemo within two weeks and I'm presently NED. Hi, I had two tumors one each in upper and lower right lobes. First, they did the tattoos and then the cast. The tattoo shows where the radiation is to be targeted. The cast is for your use only while receiving SRS so you don't move. You lay on the material and they wet it down, then shape it to your body. It dries quickly. Then you lay in it every time. I had 4 treatments for each tumor lasting 20 mins. each. They gave me a break in between. I did end up with esophagitis, very bad sore throat and hard to swallow. I used the magic mouthwash and it was gone within 10 days. I also used Prilosec for heartburn. I wasn't tired and never felt sick. My problem now is radiation scarring to the pectoral muscle and under the armpit. Though targeted, you have to remember that it has to go in and come back out somewhere. This was due to the location of the one tumor, so basically unavoidable. I have pain when I overdo it, but I'm doing very well overall. I started chemo within two weeks and I'm presently NED.

The best way to deal with fatigue from radiation therapy is creating a balance between getting enough rest and staying active enough. To succumb to the fatigue and give up physical activity would create a vicious cycle resulting in less energy and more fatigue. Yet you don't want to push yourself too much. It is all right to go to bed earlier, get up a little bit later or even take a nap during the day if one feels that tired but it is important to schedule a routine daily activity such as walking and stick with it throughout the course of radiation therapy. The other very important factor is to stay hydrated. Dehydration would negatively impact one's level of energy and may even interfere with their sleep pattern. This is particularly important during the warmer seasons and during the routine daily activity. Extremes of temperature should be avoided. A minimum of 8 cups of fluid per day will prevent dehydration. (That is 64 ounces, 2 quarts, or 1 half-gallon). Beverages containing caffeine do NOT count neither do alcoholic ones. Maintaining good nutrition can help you feel better and have more overall energy. Sticking to a regular schedules such as going to bed at a certain time and eating at regular hours would also be very helpful in creating that fine balance between resting and staying active. The best way to deal with fatigue from radiation therapy is creating a balance between getting enough rest and staying active enough. To succumb to the fatigue and give up physical activity would create a vicious cycle resulting in less energy and more fatigue. Yet you don't want to push yourself too much. It is all right to go to bed earlier, get up a little bit later or even take a nap during the day if one feels that tired but it is important to schedule a routine daily activity such as walking and stick with it throughout the course of radiation therapy. The other very important factor is to stay hydrated. Dehydration would negatively impact one's level of energy and may even interfere with their sleep pattern. This is particularly important during the warmer seasons and during the routine daily activity. Extremes of temperature should be avoided. A minimum of 8 cups of fluid per day will prevent dehydration. (That is 64 ounces, 2 quarts, or 1 half-gallon). Beverages containing caffeine do NOT count neither do alcoholic ones. Maintaining good nutrition can help you feel better and have more overall energy. Sticking to a regular schedules such as going to bed at a certain time and eating at regular hours would also be very helpful in creating that fine balance between resting and staying active.

Even though the new radiation technology has given us the capability to spare patients from significant skin burns, depending on the type of cancer and its location, sometimes either the skin itself is the target of radiation or it is impossible to spare it completely. Skin burn from radiation in many ways is similar to a sunburn. There are a number of products that radiation oncologists may recommend to alleviate the discomfort from the skin burn. These include but are not limited to Aquaphor ointment, Miaderm Lotion, Aloe Vera gel, Calendu, RadX Radiation Therapy cream, Radia-Guard lotion and many other products. If the skin has blistered or the shiny and moist part of skin is exposed Silvadene cream and/or a variety of gel wound dressings may be recommended. In worst case scenarios, your radiation oncologist may decide to advise a break in the course of treatment but this has to be weighed carefully against the negative impact of breaks during radiation on the final outcome of treatment. Avoiding sun exposure and products containing alcohol is advisable. Cleaning the area with mild and fragrance-free soap and water to prevent infection is essential. If the affected area is in perineal area, sitz baths with water and Hydrogen Peroxide would be helpful. Women should avoid wearing wired bras if the treatment area includes the chest. Please do not use any product without consulting your radiation oncologist first. Even though the new radiation technology has given us the capability to spare patients from significant skin burns, depending on the type of cancer and its location, sometimes either the skin itself is the target of radiation or it is impossible to spare it completely. Skin burn from radiation in many ways is similar to a sunburn. There are a number of products that radiation oncologists may recommend to alleviate the discomfort from the skin burn. These include but are not limited to Aquaphor ointment, Miaderm Lotion, Aloe Vera gel, Calendu, RadX Radiation Therapy cream, Radia-Guard lotion and many other products. If the skin has blistered or the shiny and moist part of skin is exposed Silvadene cream and/or a variety of gel wound dressings may be recommended. In worst case scenarios, your radiation oncologist may decide to advise a break in the course of treatment but this has to be weighed carefully against the negative impact of breaks during radiation on the final outcome of treatment. Avoiding sun exposure and products containing alcohol is advisable. Cleaning the area with mild and fragrance-free soap and water to prevent infection is essential. If the affected area is in perineal area, sitz baths with water and Hydrogen Peroxide would be helpful. Women should avoid wearing wired bras if the treatment area includes the chest. Please do not use any product without consulting your radiation oncologist first.

Side effect of radiation therapy entirely depends on the area we are irradiating. For example the side effects of radiation the the brain because of a brain metastasis are entirely different from the side effects due to the radiation of a bone metastasis in a bone. Generally speaking though some fatigue and minor skin reaction would be involved with radiation no matter where it is given. Due to significant improvements in the radiation technology in the past couple of decades, we are increasingly capable of sparing most of normal tissue and critical organs from unnecessary radiation and focus radiation on the area we intend to irradiate. That is even in radiation therapy field we are moving into the direction of targeted therapy and are able to deliver higher doses of radiation to the cancer only without causing major side effects which is usually as a result of unnecessary radiation to the normal tissues. Side effect of radiation therapy entirely depends on the area we are irradiating. For example the side effects of radiation the the brain because of a brain metastasis are entirely different from the side effects due to the radiation of a bone metastasis in a bone. Generally speaking though some fatigue and minor skin reaction would be involved with radiation no matter where it is given. Due to significant improvements in the radiation technology in the past couple of decades, we are increasingly capable of sparing most of normal tissue and critical organs from unnecessary radiation and focus radiation on the area we intend to irradiate. That is even in radiation therapy field we are moving into the direction of targeted therapy and are able to deliver higher doses of radiation to the cancer only without causing major side effects which is usually as a result of unnecessary radiation to the normal tissues.

Acute side effects from radiation typically last anywhere from 3-6 weeks following completion of radiation therapy. Depending on the extent of the skin-related side effects, which may be related to a person's individual anatomy, side effects may persist on the longer side of this time scale. Acute side effects from radiation typically last anywhere from 3-6 weeks following completion of radiation therapy. Depending on the extent of the skin-related side effects, which may be related to a person's individual anatomy, side effects may persist on the longer side of this time scale.

I've had lymphatic massage and a compression garments for my left arm to help with my lymphedema. »Interestingly enough, it was my osteopath who started loosening some on my arm and pectoral muscles that did the best job of all. I was an inch bigger in the upper arm before I saw him a few times and after a few weeks both arms were back to the exact same size. Now I wear my compression garment only for airflight. What a relief and do I need to tell you it's not very sexy during summer time! LOL Typically using lymphatic massage or compresion garments. Garments are offered FREE through http://crickettsanswerforcancer.com
Yes. I said FREE! :) Good luck!

My doctor was very clear that I could not use anything except Aquaphor during treatments. Afterward I used Vit. E oil with a bit of lavender mix in. It seemed to help my skin heal. Brenda My doctor was very clear that I could not use anything except Aquaphor during treatments. Afterward I used Vit. E oil with a bit of lavender mix in. It seemed to help my skin heal. Brenda

Sentinel node dissection reduces the rate of upper limb lymphedema, but the following breast irradiation brings with it an increased rate of breast lymphedema, which is more difficult to manage because of the absence of a muscle pump to aid in the draining of affected areas, the difficulty in providing compression, and the severe risk of recurrent infection (delayed breast cellulitis). Currently, there is no cure for lymphedema.
Lymphedema can be treated in several ways. Mild lymphedema can be treated by elevating the affected limb and the use of compression bandages. More severe lymphedema requires additional wrapping and is treated by lymphedema specialists. Exercise is also part of both prevention and treatment of lymphedema. Fortunately, lymphedema is less common due to the use of sentinel lymph node biopsy, which reduces the risk of lymphedema developing.

Watch a video about lymphedema and lymphedema treatment. http://www.cancerquest.org/lymphedema-introduction
Read about lymphedema treatment. http://www.cancerquest.org/treatment-for-lymphedema

Breast cancer patients can report pain in the irradiated breast for years after treatment. Quality of life studies have actually been to assess this issue. In one study, it showed roughly the same percentage of chronic pain (25%) after lumpectomy + RT and after mastectomy without RT. Other prospective trials followed women after lumpectomy WITHOUT radiation and women WITH radiation. One study showed no difference in breast pain between the two groups at 1 year. The other study showed women who received RT to have more pain in the first 2 years but after the 2-year mark, both groups were the same. After lumpectomy, with modern equipment and technology, skin changes referred to as portal hyperpigmentation, should go away within a few weeks of completing therapy. Telengiectasias – or dilations of the skin vasculature — can be a late effect following radiation for breast cancer. This is much more common after mastectomy than it is after lumpectomy. Skin thickening or fibrosis (referred to here as 'scar tissue') can also occur after radiation to the breast. Most of these late toxicities are influenced by total dose and dose per fraction of the radiation when it was given. So that was the LONG answer — the short answer is that side effects from breast cancer treatment are complex. At the very least, they are quite patient-specific and likely reflect a combination of the surgical procedure and the radiation. It is very important to have good follow-up with all of your breast cancer doctors. Breast cancer patients can report pain in the irradiated breast for years after treatment. Quality of life studies have actually been to assess this issue. In one study, it showed roughly the same percentage of chronic pain (25%) after lumpectomy + RT and after mastectomy without RT. Other prospective trials followed women after lumpectomy WITHOUT radiation and women WITH radiation. One study showed no difference in breast pain between the two groups at 1 year. The other study showed women who received RT to have more pain in the first 2 years but after the 2-year mark, both groups were the same. After lumpectomy, with modern equipment and technology, skin changes referred to as portal hyperpigmentation, should go away within a few weeks of completing therapy. Telengiectasias – or dilations of the skin vasculature — can be a late effect following radiation for breast cancer. This is much more common after mastectomy than it is after lumpectomy. Skin thickening or fibrosis (referred to here as 'scar tissue') can also occur after radiation to the breast. Most of these late toxicities are influenced by total dose and dose per fraction of the radiation when it was given. So that was the LONG answer — the short answer is that side effects from breast cancer treatment are complex. At the very least, they are quite patient-specific and likely reflect a combination of the surgical procedure and the radiation. It is very important to have good follow-up with all of your breast cancer doctors.

Nearly 100%. And the mechanisms of this fatigue are the subject of much research. Different cells in the body's immune system have been implicated. These cells can cause inflammation that leads to fatigue. Other more tangible explanations include pain, difficulty sleeping due to the diagnosis and treatment, history of chemotherapy, etc — both disease and treatment related. It is likely a complex, multifactorial reason. Nearly 100%. And the mechanisms of this fatigue are the subject of much research. Different cells in the body's immune system have been implicated. These cells can cause inflammation that leads to fatigue. Other more tangible explanations include pain, difficulty sleeping due to the diagnosis and treatment, history of chemotherapy, etc — both disease and treatment related. It is likely a complex, multifactorial reason.

Lymphedema is a major problem , however its incidence has fallen dramatically with the sentinel node biopsy technique. It will continue to fall with results of a recent study demonstrating no recurrence or survival difference in patients with two positive nodes whether they did or did NOT have a full node dissection. Lymphedema is a major problem , however its incidence has fallen dramatically with the sentinel node biopsy technique. It will continue to fall with results of a recent study demonstrating no recurrence or survival difference in patients with two positive nodes whether they did or did NOT have a full node dissection.

Lymphedema is swelling caused by the accumulation of lymph fluid in tissues. When the fluid accumulates in a place from which is does not have an easy exit (like an arm or leg), swelling, pain and loss of function can occur.

Risk factors for developing lymphedema include medical procedures, infections and injury:
1. Surgery that damages (or removes) lymph nodes or lymphatic vessels. Frequently, cancer surgeons remove lymph nodes to help them stage the disease. If more lymph nodes are removed, the risk is increased.
2. Radiation therapy to treat cancer can cause damage to the lymphatic system and increase risk for lymphedema.
3. Trauma/Injury to the lymphatic system.
4. Infectious disease. Some parasites can invade and impair the function of the lymphatic system. This is much more common outside the United States.

Learn about lymphedema: http://www.cancerquest.org/lymphedema-introduction
Learn about preventing lymphedema: http://www.cancerquest.org/prevention-of-lymphedema Lymphedema is swelling caused by the accumulation of lymph fluid in tissues. When the fluid accumulates in a place from which is does not have an easy exit (like an arm or leg), swelling, pain and loss of function can occur.

Risk factors for developing lymphedema include medical procedures, infections and injury:
1. Surgery that damages (or removes) lymph nodes or lymphatic vessels. Frequently, cancer surgeons remove lymph nodes to help them stage the disease. If more lymph nodes are removed, the risk is increased.
2. Radiation therapy to treat cancer can cause damage to the lymphatic system and increase risk for lymphedema.
3. Trauma/Injury to the lymphatic system.
4. Infectious disease. Some parasites can invade and impair the function of the lymphatic system. This is much more common outside the United States.

Learn about lymphedema: http://www.cancerquest.org/lymphedema-introduction
Learn about preventing lymphedema: http://www.cancerquest.org/prevention-of-lymphedema

The symptoms of lymphedema are grouped by stages.
Stage 0: lymphedema may be present but the patient does not notice any changes. Lymphatic function is reduced in this stage but not to point that causes symptoms..
Stage 1: Swelling is visible and may go away if the affected limb is elevated. There may be some pitting of the skin.
Stage 2: Changes occur to the tissue and elevating the affected limb will not usually reduce the swelling.
Stage 3: The swelling is more severe and changes are often seen in the skin. The skin changes include pitting, thickening, and warty growths.

The stages of lymphedema do not ALL have to occur in any given patient.

The swelling can make it difficult or impossible to perform normal functions with the affected limb. Severe lymphedema can result in joints that are 'frozen' (hard to move) and painful. In breast cancer patients, the shoulder is the joint most likely to be affected by this outcome.

Learn more about lymphedema diagnosis: http://www.cancerquest.org/diagnosis-of-lymphedema
Learn about lymphedema treatment: http://www.cancerquest.org/treatment-for-lymphedema The symptoms of lymphedema are grouped by stages.
Stage 0: lymphedema may be present but the patient does not notice any changes. Lymphatic function is reduced in this stage but not to point that causes symptoms..
Stage 1: Swelling is visible and may go away if the affected limb is elevated. There may be some pitting of the skin.
Stage 2: Changes occur to the tissue and elevating the affected limb will not usually reduce the swelling.
Stage 3: The swelling is more severe and changes are often seen in the skin. The skin changes include pitting, thickening, and warty growths.

The stages of lymphedema do not ALL have to occur in any given patient.

The swelling can make it difficult or impossible to perform normal functions with the affected limb. Severe lymphedema can result in joints that are 'frozen' (hard to move) and painful. In breast cancer patients, the shoulder is the joint most likely to be affected by this outcome.

Learn more about lymphedema diagnosis: http://www.cancerquest.org/diagnosis-of-lymphedema
Learn about lymphedema treatment: http://www.cancerquest.org/treatment-for-lymphedema

There is no way to be sure that you will get (or not get) lymphedema. The more risk factors that someone has, the more likely they are to develop the condition. The risk factors for lymphedema include:
1. Surgery that damages the lymphatic system (removal of lymph nodes or damaging lymphatic vessels).
2. Radiation to areas containing collections of lymph nodes (like under the armpit).
3. Trauma/Injury that damages lymph nodes.
4. Infection with parasites causes a large percentage of lymphedema outside of the United States.

Learn more about lymphedema: http://www.cancerquest.org/lymphedema-introduction
Learn about how to prevent lymphedema: http://www.cancerquest.org/prevention-of-lymphedema
There is no way to be sure that you will get (or not get) lymphedema. The more risk factors that someone has, the more likely they are to develop the condition. The risk factors for lymphedema include:
1. Surgery that damages the lymphatic system (removal of lymph nodes or damaging lymphatic vessels).
2. Radiation to areas containing collections of lymph nodes (like under the armpit).
3. Trauma/Injury that damages lymph nodes.
4. Infection with parasites causes a large percentage of lymphedema outside of the United States.

Learn more about lymphedema: http://www.cancerquest.org/lymphedema-introduction
Learn about how to prevent lymphedema: http://www.cancerquest.org/prevention-of-lymphedema

So far, there doesn't seem to be any cream that effectively prevents developing a skin reaction. Link: http://1.usa.gov/nRZ87x So while sometimes women like to start something when radiation begins, I don't know that it makes a difference for the skin, but may make treatment easier to get thought emotionally.

Usually, I'll start with aloe or use Regenecare which has some numbing medicine in it. However, if it starts to peel then aloe's often too drying something moisturizing like Aquaphor is more useful. More serious desquamation/burns sometimes are best treated with Mepilex or other wound care products.

As for symptom relief of burning sensations, it will vary but may range from NSAIDs (anti-inflammatory drugs) to mild narcotics or less commonly something like Neurontin/gabapentin. But it does differ so depends on each person's specific history, symptoms and clinical exam findings.

So far, there doesn't seem to be any cream that effectively prevents developing a skin reaction. Link: http://1.usa.gov/nRZ87x So while sometimes women like to start something when radiation begins, I don't know that it makes a difference for the skin, but may make treatment easier to get thought emotionally.

Usually, I'll start with aloe or use Regenecare which has some numbing medicine in it. However, if it starts to peel then aloe's often too drying something moisturizing like Aquaphor is more useful. More serious desquamation/burns sometimes are best treated with Mepilex or other wound care products.

As for symptom relief of burning sensations, it will vary but may range from NSAIDs (anti-inflammatory drugs) to mild narcotics or less commonly something like Neurontin/gabapentin. But it does differ so depends on each person's specific history, symptoms and clinical exam findings.

Hi Gwen:

There is no direct relationship between weight loss and radiation changes within the breast. Radiation changes can evolve over a period of months, and so may parallel weight loss. However, the weight loss is very likely due to something else. Hi Gwen:

There is no direct relationship between weight loss and radiation changes within the breast. Radiation changes can evolve over a period of months, and so may parallel weight loss. However, the weight loss is very likely due to something else.

There are different type of skin changes that can occur with breast radiation. These include:

1. Pigment change;
2. Change in elasticity
3. Hydration;
4. Depilation (hair loss);
5. Lymphatic flow;
6. Vascularity.

I'm not sure the time course for how long skin changes last has been carefully described, and some are likely interrelated.

Anecdotally, pigment changes usually don't last beyond a month or two but can be a permanent change, more likely persistent tanning than loss of pigment. Skin may be slightly dryer but less common that it's enough to be itchy/flaky. I suspect that make a year or two to improve but may last. A minority of women may also have fluctuating or permanent breast swelling/edema or atrophy. Fine spidery blood vessels, called telangiectasias, may show up months or years later but not that common. There are different type of skin changes that can occur with breast radiation. These include:

1. Pigment change;
2. Change in elasticity
3. Hydration;
4. Depilation (hair loss);
5. Lymphatic flow;
6. Vascularity.

I'm not sure the time course for how long skin changes last has been carefully described, and some are likely interrelated.

Anecdotally, pigment changes usually don't last beyond a month or two but can be a permanent change, more likely persistent tanning than loss of pigment. Skin may be slightly dryer but less common that it's enough to be itchy/flaky. I suspect that make a year or two to improve but may last. A minority of women may also have fluctuating or permanent breast swelling/edema or atrophy. Fine spidery blood vessels, called telangiectasias, may show up months or years later but not that common.