Possible Radiotherapy Side Effects
Swelling of the brain
This may occur prior to surgery, during and after Radiotherapy and it may cause headaches and temporary difficulty in walking, speaking or thinking clearly. Steroid medication is often prescribed to reduce the swelling. However, steroid use has associated side effects including muscle weakness; increased appetite; salt & water retention; indigestion; thirst; visual changes; frequency passing urine; the inability to sleep at night, or agitation and anxiety. The dose of steroids may therefore need to be adjusted, to control the side effects experienced.
Hair loss will occur within the treatment area and generally starts approximately 14 days after treatment begins. The first signs of hair thinning youâ€™ll notice are likely to be finding more hair on your pillow and in your comb or hair brush.
You will be told before you start treatment whether hair loss will be permanent or not. Normally, hair starts to re-grow within two months of completing treatment. In some cases hair loss may be permanent or the re-grown hair may remain patchy.
Losing hair alters one's appearance and your care team are well aware that this can be upsetting. â€˜Will people stare at me in the street?â€™ â€˜How will family and friends react?â€™ You will find that people will â€˜follow your leadâ€™ in this situation. Try and be positive. See this as an opportunity to get a new look. Involve your family in deciding which wig or hat suits you best and theyâ€™re bound to be supportive.
Radiotherapy will only cause hair loss within the area being treated.
A non-profit making service for those experiencing hair loss as a result of treatment or other causes
Ask your nurse for more information
Why not get a new look?
The NHS has an excellent wig service â€“ why spend Â£100 if you can get one free on the NHS? The quality of NHS wigs has improved enormously over the past few years and they are now commercially produced. And, of course, there are also many types of caps, hats and scarves commercially available. Ask your nurse about wigs and other aids available and about the NHS â€˜orthoticsâ€™ service. All patients who make use of the wig design and fitting service at the Norfolk & Norwich University Hospital will receive a 30 minute in depth appraisal of their requirements: It is important that you feel comfortable and confident with what you choose to wear.
Hair and scalp care tips
Choose a short hairstyle â€“ itâ€™s easier to manage and hair loss will be minimised
Use a mild or baby shampoo and wash your hair gently
Avoid washing your hair frequently
Try to let your hair dry naturally after gently dabbing dry with a soft towel
Do not use hair dryers, rollers, tongs, hairspray, gels and mousses
It is important not to irritate your scalp through the use of brushes and combs
Avoid overexposing the scalp to the sun. Use a hat, scarf or turban, preferably made of natural materials such as cotton or silk
Try not to keep your head covered all day as this can add to the scalp irritation caused by the treatment
You may notice some skin changes in the area being treated. After about 3 weeks it may redden and become itchy and darkened, as sunburn does. Do not try and treat this by yourself. Check with your doctor, nurse or radiographer for advice on how to care for your skin. For example you will probably be advised to avoid the use of cosmetics and creams on the treatment area. It is also important that your head is protected in the sun with a hat. You should continue this practice for some years after the radiotherapy has finished. It is Iikely that the skin in the treatment area will be more sensitive to the sun. Please refer to â€˜Skin Care Guidelines during and after radiotherapyâ€™ section (coming soon) or ask the radiographers treating you for advice.
Most people will feel tired and a little sleepy towards the end of their course of radiotherapy. A sleep in the afternoon and periods of rest can help you cope with the tiredness. This feeling of tiredness can last for a few weeks. Additionally some people experience a period of increased tiredness around 6 - 10 weeks after radiotherapy has finished. Should this happen to you it is advisable that you inform your doctor.
You may find that your weight has increased, especially if you have been taking steroid tablets. Try to eat sensibly and avoid snacking between meals.
Occasionally you may experience a temporary deafness due to swelling and narrowing of the ear canal. This condition tends to clear itself 4-6 weeks after treatment.
Damage to normal brain tissue
Most people are concerned about the effect of radiotherapy on their intelligence. Some damage to normal brain tissue will be inevitable. It must be remembered however, that the tumour itself may cause damage and that weâ€™re striving to achieve an often delicate balance between effective treatment and unacceptable side effects. All radiotherapy treatment is aimed at minimising injury to normal tissue.
Treatment side effects can take several months to settle down and during this time the results of scans are often confusing. This is because of swelling caused by the treatment: The mass of dead irradiated cells may cause symptoms similar to that of the tumour itself. The positive effects of treatment will not be obvious for a while and what is more important is how you feel and whether there is improvement in your function and disability.
There are some side-effects that can develop many months or years after the radiotherapy. The degree and frequency will depend on the dose given, the amount of normal brain treated and sometimes the particular site of the brain that has been treated. If, for instance, the pituitary gland or the hypothalamus receives a high radiotherapy dose, regulation of some of the hormones can be upset. This may lead to a loss of periods, or sexual function and sometimes an underactive thyroid. However all of these can be treated by hormone replacements.
Most people are concerned about the effect of radiotherapy on their intelligence. Some damage to the normal brain will be inevitable. It must be remembered however that the tumour itself may cause damage and the best balance must be achieved between treatment effectiveness and side effects. All attempts are made to minimise radiotherapy injury to normal tissues and there are many people surviving well with normal life styles many years after treatment. If there is no tumour recurrence, many individuals can retain their ability to work and function within the lifestyle that they enjoyed before their illness began.
This article has been reviewed by Russell Fitchett, Superintendent Radiographer, Norfolk and Norwich University Hospital.
The next section explainwhen you will notice results from your radiotherapy and gives pointers on what to do when your radiotherapy has ended:
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