Support for People With Cancer
Radiation Therapy
and You
ationalCancerInstituteN
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health

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For More Information
This booklet is only one of many free booklets for people with cancer.
Here are some others you may find useful:
I
Biological Therapy
I
Chemotherapy and You
I
Eating Hints
I
If You Have Cancer: What You Should Know About Clinical Trials
I
Thinking About Complementary & Alternative Medicine:
A Guide for People With Cancer
I
Pain Control: Support for People With Cancer
I
When Cancer Returns
I
Taking Time: Support for People With Cancer
These booklets are available from NCI (the National Cancer Institute).
NCI is a federal agency that is part of the National Institutes of Health.
Call 1-800-422-6237 (1-800-4-CANCER) or visit www.cancer.gov.
(See page 59 for more information.)
*For information about your specific type of cancer, see the PDQ®
database. PDQ® is NCI's complete cancer database. You can find it
at www.cancer.gov.
Product or brand names that appear in this book are for example only.
The U.S. Government does not endorse any specific product or brand.
If products or brands are not mentioned, it does not mean or imply
that they are not satisfactory.

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About This Book
Rather than read
Radiation Therapy and You is written for you--someone
this book from
who is about to get or is now getting radiation therapy for
beginning to end--
cancer. People who are close to you may also find this
book helpful.
look at only those
This book is a guide that you can refer to throughout
sections you need
radiation therapy. It has facts about radiation therapy and
side effects and describes how you can care for yourself
now. Later, you can
during and after treatment.
always read more.
This book covers:
I
Questions and Answers About Radiation Therapy. Answers to common questions,
such as what radiation therapy is and how it affects cancer cells.
I
External Beam and Internal Radiation. Information about the two types of
radiation therapy.
I
Your Feelings During Radiation Therapy. Information about feelings, such as
depression and anxiety, and ways to cope with them.
I
Side Effects and Ways To Manage Them. A chart that shows problems that may
happen as a result of treatment and ways you can help manage them.
I
Questions To Ask. Questions for you to think about and discuss with your doctor,
nurse, and others involved in your treatment and care.
I
Lists of Foods and Liquids. Foods and drinks you can have during radiation therapy.
I
Words To Know. A dictionary that clearly explains medical terms used in this book.
These terms are in bold print the first time they appear.
I
Ways To Learn More. Places to go for more information--in print, online (Internet),
and by telephone.
Talk with your doctor and nurse about the information in this book. They may suggest
that you read certain sections or follow some of the tips. Since radiation therapy affects
people in different ways, they may also tell you that some of the information in this book
is not right for you.

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Table of Contents
Rather than
Questions and Answers About Radiation Therapy ........................1
read this book
from beginning
External Beam Radiation Therapy ..................................................9
to end--
Internal Radiation Therapy ...........................................................15
look at only
Your Feelings During Radiation Therapy .....................................19
those sections
you need now.
Radiation Therapy Side Effects......................................................21
Radiation Therapy Side Effects At-A-Glance ......................................23
Later, you
Radiation Therapy Side Effects and Ways To Manage Them.............24
can always
Diarrhea..........................................................................................24
read more.
Fatigue ............................................................................................26
Hair Loss.........................................................................................28
Mouth Changes..............................................................................30
Nausea and Vomiting.....................................................................34
Sexual and Fertility Changes .........................................................36
Skin Changes ..................................................................................40
Throat Changes..............................................................................43
Urinary and Bladder Changes.......................................................45
Late Radiation Therapy Side Effects....................................................47
Questions To Ask Your Doctor or Nurse.......................................51
Lists of Foods and Liquids .............................................................53
Clear Liquids .........................................................................................53
Foods and Drinks That Are High in Calories or Protein ...................54
Foods and Drinks That Are Easy on the Stomach..............................55
Words To Know...............................................................................56
Resources for Learning More.........................................................59

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Questions and Answers About Radiation Therapy
What is radiation
Radiation therapy (also called radiotherapy) is a cancer
therapy?
treatment that uses high doses of radiation to kill cancer cells
and stop them from spreading. At low doses, radiation is used
as an x-ray to see inside your body and take pictures, such as
x-rays of your teeth or broken bones. Radiation used in
cancer treatment works in much the same way, except that it is
given at higher doses.
How is radiation
Radiation therapy can be external beam (when a machine
therapy given?
outside your body aims radiation at cancer cells) or internal
(when radiation is put inside your body, in or near the cancer
cells). Sometimes people get both forms of radiation therapy.
To learn more about external beam radiation therapy, see page
9. To learn more about internal radiation therapy, see page 15.
Who gets
Many people with cancer need radiation therapy. In fact,
radiation therapy?
more than half (about 60 percent) of people with cancer get
radiation therapy. Sometimes, radiation therapy is the only
kind of cancer treatment people need.
What does
Given in high doses, radiation kills or slows the growth of
radiation therapy
cancer cells. Radiation therapy is used to:
do to cancer cells?
I
Treat cancer. Radiation can be used to cure, stop, or slow
the growth of cancer.
I
Reduce symptoms. When a cure is not possible, radiation
may be used to shrink cancer tumors in order to reduce
pressure. Radiation therapy used in this way can treat
problems such as pain, or it can prevent problems such as
blindness or loss of bowel and bladder control.
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How long does
Radiation therapy does not kill cancer cells right away. It takes
radiation therapy
days or weeks of treatment before cancer cells start to die.
take to work?
Then, cancer cells keep dying for weeks or months after
radiation therapy ends.
What does
Radiation not only kills or slows the growth of cancer cells, it
radiation therapy
can also affect nearby healthy cells. The healthy cells almost
do to healthy cells?
always recover after treatment is over. But sometimes people
may have side effects that do not get better or are severe.
Doctors try to protect healthy cells during treatment by:
I
Using as low a dose of radiation as possible. The
radiation dose is balanced between being high enough to
kill cancer cells yet low enough to limit damage to healthy
cells.
I
Spreading out treatment over time. You may get
radiation therapy once a day for several weeks or in smaller
doses twice a day. Spreading out the radiation dose allows
normal cells to recover while cancer cells die.
I
Aiming radiation at a precise part of your body. New
techniques, such as IMRT and 3-D conformal radiation
therapy, allow your doctor to aim higher doses of
radiation at your cancer while reducing the radiation to
nearby healthy tissue.
I
Using medicines. Some drugs can help protect certain
parts of your body, such as the salivary glands that make
saliva (spit).
Does radiation
No, radiation therapy does not hurt while it is being given. But
therapy hurt?
the side effects that people may get from radiation therapy can
cause pain or discomfort. This book has a lot of information
about ways that you, your doctor, and your nurse can help
manage side effects.
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Is radiation
Yes, radiation therapy is often used with other cancer
therapy used with
treatments. Here are some examples:
other types
I
Radiation therapy and surgery. Radiation may be given
of cancer
before, during, or after surgery. Doctors may use radiation
treatment?
to shrink the size of the cancer before surgery, or they
may use radiation after surgery to kill any cancer cells
that remain. Sometimes, radiation therapy is given
during surgery so that it goes straight to the cancer
without passing through the skin. This is called
intraoperative radiation.
I
Radiation therapy and chemotherapy. Radiation may be
given before, during, or after chemotherapy. Before or
during chemotherapy, radiation therapy can shrink the
cancer so that chemotherapy works better. Sometimes,
chemotherapy is given to help radiation therapy work
better. After chemotherapy, radiation therapy can be used
to kill any cancer cells that remain.
Who is on my
Many people help with your radiation treatment and care. This
radiation therapy
group of health care providers is often called the "radiation
team?
therapy team." They work together to provide care that is just
right for you. Your radiation therapy team can include:
I
Radiation oncologist. This is a doctor who specializes in
using radiation therapy to treat cancer. He or she
prescribes how much radiation you will receive, plans how
your treatment will be given, closely follows you during
your course of treatment, and prescribes care you may need
to help with side effects. He or she works closely with the
other doctors, nurses, and health care providers on your
team. After you are finished with radiation therapy, your
radiation oncologist will see you for follow-up visits.
During these visits, this doctor will check for late side
effects and assess how well the radiation has worked.
I
Nurse practitioner. This is a nurse with advanced
training. He or she can take your medical history, do
physical exams, order tests, manage side effects, and closely
watch your response to treatment. After you are finished
with radiation therapy, your nurse practitioner may see
you for follow-up visits to check for late side effects and
assess how well the radiation has worked.
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Radiation nurse. This person provides nursing care during
radiation therapy, working with all the members of your
radiation therapy team. He or she will talk with you about
your radiation treatment and help you manage side effects.
I
Radiation therapist. This person works with you during
each radiation therapy session. He or she positions you for
You are the
treatment and runs the machines to make sure you get the
most important
dose of radiation prescribed by your radiation oncologist.
part of the
I
Other health care providers. Your team may also include
radiation
a dietitian, physical therapist, social worker, and others.
therapy team.
I
You. You are also part of the radiation therapy team.
Your role is to:
·
Arrive on time for all radiation therapy sessions
·
Ask questions and talk about your concerns
·
Let someone on your radiation therapy team know
when you have side effects
·
Tell your doctor or nurse if you are in pain
·
Follow the advice of your doctors and nurses about
how to care for yourself at home, such as:
-
Taking care of your skin
-
Drinking liquids
-
Eating foods that they suggest
-
Keeping your weight the same
Be sure to arrive on time for ALL
radiation therapy sessions.
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Is radiation
Yes, radiation therapy costs a lot of money. It uses complex
therapy expensive?
machines and involves the services of many health care
providers. The exact cost of your radiation therapy depends
on the cost of health care where you live, what kind of
radiation therapy you get, and how many treatments you need.
Talk with your health insurance company about what services
it will pay for. Most insurance plans pay for radiation therapy
for their members. To learn more, talk with the business office
where you get treatment. You can also contact the National
Cancer Institute's Cancer Information Service and ask for the
"Financial Assistance for Cancer Care" fact sheet. See page 59
for ways to contact the National Cancer Institute.
Should I follow
Your body uses a lot of energy to heal during radiation
a special diet
therapy. It is important that you eat enough calories and
while I am getting
protein to keep your weight the same during this time. Ask
your doctor or nurse if you need a special diet while you are
radiation therapy?
getting radiation therapy. You might also find it helpful to
speak with a dietitian.
To learn more about foods and drinks that are high in calories
or protein, see the chart on page 54. You may also want to read
Eating Hints, a book from the National Cancer Institute. You
can order a free copy online at www.cancer.gov/publications
or 1-800-4-CANCER.
Ask your doctor, nurse, or dietitian
if you need a special diet while
you are getting radiation therapy.
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Can I go to work
Some people are able to work full-time during radiation
during radiation
therapy. Others can only work part-time or not at all. How
therapy?
much you are able to work depends on how you feel. Ask your
doctor or nurse what you may expect based on the treatment
you are getting.
You are likely to feel well enough to work when you start
radiation therapy. As time goes on, do not be surprised if you
are more tired, have less energy, or feel weak. Once you have
finished your treatment, it may take a few weeks or many
months for you to feel better.
You may get to a point during your radiation therapy when
you feel too sick to work. Talk with your employer to find
out if you can go on medical leave. Make sure that your
health insurance will pay for treatment when you are on
medical leave.
What happens
Once you have finished radiation therapy, you will need
when radiation
follow-up care for the rest of your life. Follow-up care refers
therapy is over?
to checkups with your radiation oncologist or nurse
practitioner after your course of radiation therapy is over.
During these checkups, your doctor or nurse will see how well
the radiation therapy worked, check for other signs of cancer,
look for late side effects, and talk with you about your
treatment and care. Your doctor or nurse will:
I
Examine you and review how you have been feeling. Your
doctor or nurse practitioner can prescribe medicine or
suggest other ways to treat any side effects you may have.
I
Order lab and imaging tests. These may include blood
tests, x-rays, or CT, MRI, or PET scans.
I
Discuss treatment. Your doctor or nurse practitioner may
suggest that you have more treatment, such as extra
radiation treatments, chemotherapy, or both.
I
Answer your questions and respond to your concerns. It
may be helpful to write down your questions ahead of time
and bring them with you. You can find sample questions
on pages 51 and 52.
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After radiation
You have gone through a lot with cancer and radiation
therapy is over,
therapy. Now you may be even more aware of your body and
what symptoms
how you feel each day. Pay attention to changes in your body
and let your doctor or nurse know if you have:
should I
look for?
I
A pain that does not go away
I
New lumps, bumps, swellings, rashes, bruises, or bleeding
I
Appetite changes, nausea, vomiting, diarrhea, or constipation
I
Weight loss that you cannot explain
I
A fever, cough, or hoarseness that does not go away
I
Any other symptoms that worry you
See "Resources for Learning More" on page 59 for ways to
learn more about radiation therapy.External Beam
Make a list of questions and problems
you want to discuss with your doctor or nurse.
Be sure to bring this list to your follow-up visits.
See pages 51 and 52 for sample questions.
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External Beam Radiation Therapy
What is external
External beam radiation therapy comes from a machine that
beam radiation
aims radiation at your cancer. The machine is large and may
therapy?
be noisy. It does not touch you, but rotates around you,
sending radiation to your body from many directions.
External beam radiation therapy is a local treatment, meaning
that the radiation is aimed only at a specific part of your body.
For example, if you have lung cancer, you will get radiation to
your chest only and not the rest of your body.
External beam radiation therapy comes from a machine that aims
radiation at your cancer.
How often will I
Most people get external beam radiation therapy once a day,
get external beam
5 days a week, Monday through Friday. Treatment lasts for
radiation therapy?
2 to 10 weeks, depending on the type of cancer you have and
the goal of your treatment. The time between your first and
last radiation therapy sessions is called a course of treatment.
Radiation is sometimes given in smaller doses twice a day
(hyperfractionated radiation therapy). Your doctor may
prescribe this type of treatment if he or she feels that it will
work better. Although side effects may be more severe, there
may be fewer late side effects. Doctors are doing research to
see which types of cancer are best treated this way.
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Where do I go for
Most of the time, you will get external beam radiation therapy
external beam
as an outpatient. This means that you will have treatment at a
radiation therapy?
clinic or radiation therapy center and will not have to stay in
the hospital.
What happens
You will have a 1- to 2-hour meeting with your doctor or nurse
before my first
before you begin radiation therapy. At this time, you will have
external beam
a physical exam, talk about your medical history, and maybe
radiation
have imaging tests. Your doctor or nurse will discuss external
beam radiation therapy, its benefits and side effects, and ways
treatment?
you can care for yourself during and after treatment. You can
then choose whether to have external beam radiation therapy.
If you agree to have external beam radiation therapy, you will
be scheduled for a treatment planning session called a
simulation. At this time:
I
A radiation oncologist and radiation therapist will define
your treatment area (also called a treatment port or
treatment field). This refers to the places in your body that
will get radiation. You will be asked to lie very still while
x-rays or scans are taken to define the treatment area.
I
The radiation therapist will then put small marks (tattoos or
dots of colored ink) on your skin to mark the treatment
area. You will need these marks throughout the course of
radiation therapy. The radiation therapist will use them
each day to make sure you are in the correct position.
Tattoos are about the size of a freckle and will remain on
your skin for the rest of your life. Ink markings will fade
over time. Be careful not to remove them and make sure to
tell the radiation therapist if they fade or lose color.
Tell your radiation therapist if your
ink marks begin to fade or lose color.
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I
You may need a body mold. This is a plastic or plaster
form that helps keep you from moving during treatment. It
also helps make sure that you are in the exact same
position each day of treatment.
I
If you are getting radiation to the head, you may need a
mask. The mask has air holes, and holes can be cut for
your eyes, nose, and mouth. It attaches to the table where
If you are getting radiation
you will lie to receive your treatments. The mask helps
to the head, you may need a
keep your head from moving so that you are in the exact
mask.
same position for each treatment.
If the body mold or mask makes you feel anxious, see page 13
for ways to relax during treatment.
What should I
Wear clothes that are comfortable and made of soft fabric,
wear when I get
such as cotton. Choose clothes that are easy to take off, since
external beam
you may need to change into a hospital gown or show the area
radiation therapy?
that is being treated. Do not wear clothes that are tight, such
as close-fitting collars or waistbands, near your treatment area.
Also, do not wear jewelry, BAND-AIDS®, powder, lotion, or
deodorant in or near your treatment area, and do not use
deodorant soap before your treatment.
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What happens
I
You may be asked to change into a hospital gown or robe.
during treatment
I
You will go to a treatment room where you will receive
sessions?
radiation.
I
Depending on where your cancer is, you will either sit in a
chair or lie down on a treatment table. The radiation
therapist will use your body mold and skin marks to help
you get into position.
I
You may see colored lights pointed at your skin marks.
These lights are harmless and help the therapist position
you for treatment each day.
I
You will need to stay very still so the radiation goes to the
exact same place each time. You can breathe as you always
do and do not have to hold your breath.
The radiation therapist will leave the room just before your
treatment begins. He or she will go to a nearby room to
control the radiation machine and watch you on a TV screen
or through a window. You are not alone, even though it may
feel that way. The radiation therapist can see you on the
screen or through the window. He or she can hear and talk
with you through a speaker in your treatment room. Make
sure to tell the therapist if you feel sick or are uncomfortable.
He or she can stop the radiation machine at any time. You
cannot feel, hear, see, or smell radiation.
Your entire visit may last from 30 minutes to 1 hour. Most of
that time is spent setting you in the correct position. You will
get radiation for only 1 to 5 minutes. If you are getting IMRT,
your treatment may last longer. Your visit may also take longer
if your treatment team needs to take and review x-rays.
Your radiation therapist can see, hear, and
talk with you at all times while you are
getting external beam radiation therapy.
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Will external beam
No, external beam radiation therapy does not make people
radiation therapy
radioactive. You may safely be around other people, even
make me
babies and young children.
radioactive?
How can I relax
I
Bring something to read or do while in the waiting room.
during my
I
Ask if you can listen to music or books on tape.
treatment sessions?
I
Meditate, breathe deeply, use imagery, or find other ways
to relax. To learn more about ways to relax, see Facing
Forward: Life After Cancer Treatment, a book from the
National Cancer Institute. You can order a free copy at
www.cancer.gov/publications or 1-800-4-CANCER.
For ways to learn more about external beam radiation therapy,
see the Resources for Learning More on page 59.
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Internal Radiation Therapy
What is internal
Internal radiation therapy is a form of treatment where a
radiation therapy?
source of radiation is put inside your body. One form of
internal radiation therapy is called brachytherapy. In
brachytherapy, the radiation source is a solid in the form of
seeds, ribbons, or capsules, which are placed in your body in
or near the cancer cells. This allows treatment with a high
dose of radiation to a smaller part of your body. Internal
radiation can also be in a liquid form. You receive liquid
radiation by drinking it, by swallowing a pill, or through an IV.
Liquid radiation travels throughout your body, seeking out
and killing cancer cells.
Brachytherapy may be used with people who have cancers of
the head, neck, breast, uterus, cervix, prostate, gall bladder,
esophagus, eye, and lung. Liquid forms of internal radiation
are most often used with people who have thyroid cancer or
non-Hodgkin's lymphoma. You may also get internal
radiation along with other types of treatment, including
external beam radiation, chemotherapy, or surgery.
What happens
You will have a 1- to 2-hour meeting with your doctor or
before my first
nurse before you begin internal radiation therapy. At this
internal radiation
time, you will have a physical exam, talk about your medical
treatment?
history, and maybe have imaging tests. Your doctor will
discuss the type of internal radiation therapy that is best for
you, its benefits and side effects, and ways you can care for
yourself during and after treatment. You can then choose
whether to have internal radiation therapy.
How is
Most brachytherapy is put in place through a catheter, which
brachytherapy
is a small, stretchy tube. Sometimes, it is put in place through
put in place?
a larger device called an applicator. When you decide to have
brachytherapy, your doctor will place the catheter or applicator
into the part of your body that will be treated.
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What happens
You will most likely be in the hospital when your catheter or
when the catheter
applicator is put in place. Here is what to expect:
or applicator is
I
You will either be put to sleep or the area where the
put in place?
catheter or applicator goes will be numbed. This will help
prevent pain when it is put in.
I
Your doctor will place the catheter or applicator in your body.
I
If you are awake, you may be asked to lie very still while
the catheter or applicator is put in place. If you feel any
discomfort, tell your doctor or nurse so he or she can give
you medicine to help manage the pain.
Tell your doctor or nurse if you are in pain.
What happens
Once your treatment plan is complete, radiation will be placed
after the catheter or
inside the catheter or applicator. The radiation source may be
applicator is placed
kept in place for a few minutes, many days, or the rest of your
in my body?
life. How long the radiation is in place depends on which type
of brachytherapy you get, your type of cancer, where the
cancer is in your body, your health, and other cancer
treatments you have had.
What are the types
There are three types of brachytherapy:
of brachytherapy?
I
Low-dose rate (LDR) implants. In this type of
brachytherapy, radiation stays in place for 1 to 7 days. You
are likely to be in the hospital during this time. Once your
treatment is finished, your doctor will remove the
radiation sources and your catheter or applicator.
I
High-dose rate (HDR) implants. In this type of
brachytherapy, the radiation source is in place for 10 to 20
minutes at a time and then taken out. You may have
treatment twice a day for 2 to 5 days or once a week for
2 to 5 weeks. The schedule depends on your type of
cancer. During the course of treatment, your catheter or
applicator may stay in place, or it may be put in place
before each treatment. You may be in the hospital during
this time, or you may make daily trips to the hospital to
have the radiation source put in place. Like LDR implants,
your doctor will remove your catheter or applicator once
you have finished treatment.
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I
Permanent implants. After the radiation source is put in
place, the catheter is removed. The implants always stay in
your body, while the radiation gets weaker each day. You
may need to limit your time around other people when the
radiation is first put in place. Be extra careful not to spend
time with children or pregnant women. As time goes by,
almost all the radiation will go away, even though the
implant stays in your body.
What happens
I
Your body will give off radiation once the radiation source is
while the radiation
in place. With brachytherapy, your body fluids (urine,
is in place?
sweat, and saliva) will not give off radiation. With liquid
radiation, your body fluids will give off radiation for a while.
I
Your doctor or nurse will talk with you about safety
measures that you need to take.
I
If the radiation you receive is a very high dose, safety
measures may include:
·
Staying in a private hospital room to protect others
from radiation coming from your body
·
Being treated quickly by nurses and other hospital staff.
They will provide all the care you need, but they may
stand at a distance and talk with you from the doorway
to your room.
I
Your visitors will also need to follow safety measures,
which may include:
·
Not being allowed to visit when the radiation is first
put in
·
Needing to check with the hospital staff before they go
to your room
·
Keeping visits short (30 minutes or less each day). The
length of visits depends on the type of radiation being
used and the part of your body being treated.
·
Standing by the doorway rather than going into your
hospital room
·
Not having visits from children younger than 18 and
pregnant women
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You may also need to follow safety measures once you leave
the hospital, such as not spending much time with other
people. Your doctor or nurse will talk with you about the
safety measures you should follow when you go home.
What happens
I
You will get medicine for pain before the catheter or
when the catheter
applicator is removed.
is taken out after
I
The area where the catheter or applicator was might be
treatment with
tender for a few months.
LDR or HDR
I
implants?
There is no radiation in your body after the catheter or
applicator is removed. It is safe for people to be near
you--even young children and pregnant women.
I
For 1 to 2 weeks, you may need to limit activities that take
a lot of effort. Ask your doctor what kinds of activities are
safe for you.
For ways to learn more about internal radiation therapy, see
Resources for Learning More on page 59.
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Your Feelings During Radiation Therapy
At some point during radiation therapy, you may feel:
I
Anxious
Having cancer and
I
Depressed
going through treatment
I
Afraid
is stressful.
I
Angry
I
Frustrated
I
Helpless
I
Alone
It is normal to have these kinds of feelings. Living with cancer
and going through treatment is stressful. You may also feel
fatigue, which can make it harder to cope with these feelings.
How can I cope
There are many things you can do to cope with your feelings
with my feelings
during treatment. Here are some things that have worked for
during radiation
other people:
therapy?
I
Relax and meditate. You might try thinking of yourself in
a favorite place, breathing slowly while paying attention to
each breath, or listening to soothing music. These kinds of
activities can help you feel calmer and less stressed.
I
Exercise. Many people find that light exercise (such as
walking, biking, yoga, or water aerobics) helps them feel
better. Talk with your doctor or nurse about types of
exercise that you can do.
I
Talk with others. Talk about your feelings with someone
you trust. You may choose a close friend, family member,
chaplain, nurse, social worker, or psychologist. You may
also find it helpful to talk to someone else who is going
through radiation therapy.
I
Join a support group. Cancer support groups are
meetings for people with cancer. These groups allow you to
meet others facing the same problems. You will have a
19

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chance to talk about your feelings and listen to other people
talk about theirs. You can learn how others cope with
cancer, radiation therapy, and side effects. Your doctor,
nurse, or social worker can tell you about support groups
near where you live. Some support groups also meet over
the Internet, which can be helpful if you cannot travel or
find a meeting in your area.
I
Talk to your doctor or nurse about things that worry or
upset you. You may want to ask about seeing a counselor.
Your doctor may also suggest that you take medicine if you
find it very hard to cope with these feelings.
Ways to
To learn more about ways to cope with your feelings, read
Learn More
Taking Time: Support for People with Cancer, a book from the
National Cancer Institute. You can get a free copy at
www.cancer.gov/publications or 1-800-4-CANCER.
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
CancerCare, Inc.
Toll-free:
1-800-813-HOPE (1-800-813-4673)
E-mail:
info@cancercare.org
Online:
www.cancercare.org
Offers free support, information, financial assistance, and
practical help to people with cancer and their loved ones.
The Wellness Community
Toll-free:
1-888-793-WELL (1-888-793-9355)
Phone:
202-659-9709
Online:
www.thewellnesscommunity.org
E-mail:
help@thewellnesscommunity.org
Provides free psychological and emotional support to people
with cancer and their families.
20

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Radiation Therapy Side Effects
Side effects are problems that can happen as a result of
treatment. They may happen with radiation therapy because
the high doses of radiation used to kill cancer cells can also
damage healthy cells in the treatment area. Side effects are
different for each person. Some people have many side effects;
others have hardly any. Side effects may be more severe if you
also receive chemotherapy before, during, or after your
radiation therapy.
Talk to your radiation therapy team about your chances of
having side effects. The team will watch you closely and ask if
you notice any problems. If you do have side effects or other
problems, your doctor or nurse will talk with you about ways to
manage them.
Common
Many people who get radiation therapy have skin changes and
Side Effects
some fatigue. Other side effects depend on the part of your
body being treated.
Skin changes may include dryness, itching, peeling, or blistering.
These changes occur because radiation therapy damages healthy
skin cells in the treatment area. You will need to take special
care of your skin during radiation therapy. To learn more,
see page 40.
Fatigue is often described as feeling worn out or exhausted.
There are many ways to manage fatigue. To learn more,
see page 26.
Depending on the part of your body being treated, you may
also have:
I
Diarrhea
I
Hair loss in the treatment area
I
Mouth problems
I
Nausea and vomiting
I
Sexual changes
21

---

I
Swelling
I
Trouble swallowing
I
Urinary and bladder changes
Most of these side effects go away within 2 months after
radiation therapy is finished.
Late side effects may first occur 6 or more months after
radiation therapy is over. They vary by the part of your body
that was treated and the dose of radiation you received. 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. See page 47 for more information on late side effects.
Radiation Therapy Side Effects and Ways To Manage Them,
starting on page 24, explains each side effect in more detail
and includes ways you and your doctor or nurse can help
manage them.
Radiation Therapy
Radiation therapy side effects depend on the part of your body
Side Effects
being treated. You can use the chart on page 23 to see which
At-A-Glance
side effects might affect you. Find the part of your body being
treated in the column on the left, then read across the row to
see the side effects. A checkmark means that you may get this
side effect. Ask your doctor or nurse about your chances of
getting each side effect.
To learn more about each side effect, see the page listed in the
top row of the table on page 23.
Talk to your radiation therapy team about your
chances of getting side effects. Show them the
chart on the next page.
22

---

Radiation Therapy Side Effects At-A-Glance
I
Find the part of your body being treated in the column on the left.
I
Read across the row.
I
A checkmark means you may get the side effect listed.
Diarrhea
Fatigue
Hair Loss
Mouth
Nausea
Sexual
Skin
Throat
Urinary
Other
(on the
Changes
and
and
Changes
Changes
and
Side
part of
Vomiting
Fertility
Bladder
Effects
the body
Changes
Changes
being
treated)
More
More
More
More
More
More
More
More
More
information
information
information
information
information
information
information
information
information
on page 24
on page 26
on page 28
on page 30
on page 34
on page 36
on page 40
on page 43
on page 45
Brain



Headache
Blurry vision
Breast


Tenderness
Swelling
Chest



Cough
Shortness
of breath
Head and




Earaches
Neck
Taste
changes
Pelvic






Area
Rectum





Stomach






and
Abdomen
23

---

Radiation Therapy Side Effects and Ways to Manage Them
Diarrhea
What it is
Diarrhea is frequent bowel movements which may be soft,
formed, loose, or watery. Diarrhea can occur at any time
during radiation therapy.
Why it occurs
Radiation therapy to the pelvis, stomach, and abdomen
can cause diarrhea. People get diarrhea because radiation
harms the healthy cells in the large and small bowels.
These areas are very sensitive to the amount of radiation
needed to treat cancer.
Radiation to the shaded area may
cause diarrhea.
Ways to manage
When you have diarrhea:
I
Drink 8 to 12 cups of clear liquid per day. See page 53 for ideas of drinks and foods
that are clear liquids.
If you drink liquids that are high in sugar (such as fruit juice, sweet iced tea,
Kool-Aid®, or Hi-C®) ask your nurse or dietitian if you should mix them with water.
I
Eat many small meals and snacks. For instance, eat 5 or 6 small meals and snacks
rather than 3 large meals.
I
Eat foods that are easy on the stomach (which means foods that are low in fiber, fat,
and lactose). See page 55 for other ideas of foods that are easy on the stomach. If your
diarrhea is severe, your doctor or nurse may suggest the BRAT diet, which stands for
bananas, rice, applesauce, and toast.
24

---

I
Take care of your rectal area. Instead of toilet paper, use a baby
wipe or squirt of water from a spray bottle to clean yourself after
bowel movements. Also, ask your nurse about taking sitz baths,
which is a warm-water bath taken in a sitting position that covers
only the hips and buttocks. Be sure to tell your doctor or nurse if
your rectal area gets sore.
I
Stay away from:
·
Milk and dairy foods, such as ice cream, sour cream, and cheese
·
Spicy foods, such as hot sauce, salsa, chili, and curry dishes
·
Foods or drinks with caffeine, such as regular coffee, black tea, soda, and chocolate
·
Foods or drinks that cause gas, such as cooked dried beans, cabbage, broccoli, soy
milk, and other soy products
·
Foods that are high in fiber, such as raw fruits and vegetables, cooked dried beans,
and whole wheat breads and cereals
·
Fried or greasy foods
·
Food from fast food restaurants
I
Talk to your doctor or nurse. Tell them if you are having diarrhea. He or she
will suggest ways to manage it. He or she may also suggest taking medicine, such
as Imodium®.
Ways to learn more
To learn more about dealing with diarrhea during cancer treatment, see Eating Hints, a book
from the National Cancer Institute. You can get a free copy at www.cancer.gov/publications
or 1-800-4-CANCER.
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
25

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Radiation Therapy Side Effects and Ways to Manage Them
Fatigue
What it is
Fatigue from radiation therapy can range from a mild to
Fatigue is a common
an extreme feeling of being tired. Many people describe
side effect, and there
fatigue as feeling weak, weary, worn out, heavy, or slow.
is a good chance that
you will feel some
Why it occurs
level of fatigue from
Fatigue can happen for many reasons. These include:
radiation therapy.
I
Anemia
I
Anxiety
I
Depression
I
Infection
I
Lack of activity
I
Medicines
Fatigue can also come from the effort of going to radiation therapy each day or from
stress. Most of the time, you will not know why you feel fatigue.
How long it lasts
When you first feel fatigue depends on a few factors, which include your age, health, level
of activity, and how you felt before radiation therapy started.
Fatigue can last from 6 weeks to 12 months after your last radiation therapy session. Some
people may always feel fatigue and, even after radiation therapy is over, will not have as
much energy as they did before.
Ways to manage
I
Try to sleep at least 8 hours each night. This may be more sleep
than you needed before radiation therapy. One way to sleep better
at night is to be active during the day. For example, you could go
for walks, do yoga, or ride a bike. Another way to sleep better at
night is to relax before going to bed. You might read a book, work
on a jigsaw puzzle, listen to music, or do other calming hobbies.
I
Plan time to rest. You may need to nap during the day. Many people say that it helps to
rest for just 10 to 15 minutes. If you do nap, try to sleep for less than 1 hour at a time.
26

---

I
Try not to do too much. With fatigue, you may not have enough energy to do all the
things you want to do. Stay active, but choose the activities that are most important to
you. For example, you might go to work but not do housework, or watch your
children's sports events but not go out to dinner.
I
Exercise. Most people feel better when they get some exercise each day. Go for a
15- to 30-minute walk or do stretches or yoga. Talk with your doctor or nurse about
how much exercise you can do while having radiation therapy.
I
Plan a work schedule that is right for you. Fatigue may affect the amount of energy
you have for your job. You may feel well enough to work your full schedule, or you
may need to work less--maybe just a few hours a day or a few days each week. You
may want to talk with your boss about ways to work from home so you do not have to
commute. And you may want to think about going on medical leave while you have
radiation therapy.
I
Plan a radiation therapy schedule that makes sense for you. You may want to schedule
your radiation therapy around your work or family schedule. For example, you might
want to have radiation therapy in the morning so you can go to work in the afternoon.
I
Let others help you at home. Check with your insurance company to see whether it
covers home care services. You can also ask family members and friends to help when
you feel fatigue. Home care staff, family members, and friends can assist with
household chores, running errands, or driving you to and from radiation therapy
visits. They might also help by cooking meals for you to eat now or freeze for later.
I
Learn from others who have cancer. People who have cancer can help each other by
sharing ways to manage fatigue. One way to meet other people with cancer is by
joining a support group--either in person or online. Talk with your doctor or nurse to
learn more about support groups.
I
Talk with your doctor or nurse. If you have trouble dealing with fatigue, your doctor
may prescribe medicine (called psychostimulants) that can help decrease fatigue, give
you a sense of well-being, and increase your appetite. Your doctor may also suggest
treatments if you have anemia, depression, or are not able to sleep at night.
Ways to learn more
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
27

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Radiation Therapy Side Effects and Ways to Manage Them
Hair Loss
What it is
Hair loss (also called alopecia) is when some or all of your hair falls out.
Why it occurs
Radiation therapy can cause hair loss because it damages cells that grow quickly, such as
those in your hair roots.
Hair loss from radiation therapy only happens on the part of your body being treated.
This is not the same as hair loss from chemotherapy, which happens all over your body.
For instance, you may lose some or all of the hair on your head when you get radiation to
your brain. But if you get radiation to your hip, you may lose pubic hair (between your
legs) but not the hair on your head.
How long it lasts
You may start losing hair in your treatment area 2 to 3 weeks after your first radiation
therapy session. It takes about a week for all the hair in your treatment area to fall out.
Your hair may grow back 3 to 6 months after treatment is over. Sometimes, though, the
dose of radiation is so high that your hair never grows back.
Once your hair starts to grow back, it may not look or feel the way it did before. Your hair
may be thinner, or curly instead of straight. Or it may be darker or lighter in color than it
was before.
Ways to manage hair loss on your head
Before hair loss:
I
Decide whether to cut your hair or shave your head. You may feel more in control of
hair loss when you plan ahead. Use an electric razor to prevent nicking yourself if you
decide to shave your head.
I
If you plan to buy a wig, do so while you still have
hair. The best time to select your wig is before
radiation therapy begins or soon after it starts. This
way, the wig will match the color and style of your own
hair. Some people take their wig to their hair stylist.
You will want to have your wig fitted once you have lost
your hair. Make sure to choose a wig that feels
comfortable and does not hurt your scalp.
28

---

I
Check with your health insurance company to see whether it will pay for your wig.
If it does not, you can deduct the cost of your wig as a medical expense on your
income taxes. Some groups also sponsor free wig banks. Ask your doctor, nurse, or
social worker if he or she can refer you to a free wig bank in your area.
I
Be gentle when you wash your hair. Use a mild shampoo, such as a baby shampoo.
Dry your hair by patting (not rubbing) it with a soft towel.
I
Do not use curling irons, electric hair dryers, curlers, hair bands, clips, or hair sprays.
These can hurt your scalp or cause early hair loss.
I
Do not use products that are harsh on your hair. These include hair colors, perms, gels,
mousse, oil, grease, or pomade.
After hair loss:
I
Protect your scalp. Your scalp may feel tender after hair loss.
Cover your head with a hat, turban, or scarf when you are outside.
Try not to be in places where the temperature is very cold or very
hot. This means staying away from the direct sun, sun lamps, and
very cold air.
I
Stay warm. Your hair helps keep you warm, so you may feel colder once you lose it.
You can stay warmer by wearing a hat, turban, scarf, or wig.
You will lose hair only on
Ways to learn more
the part of your body
being treated.
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
American Cancer Society
Toll-free:
1-800-ACS-2345 (1-800-227-2345)
Phone:
404-320-3333
Online:
www.cancer.org
Offers a variety of services to people with cancer and their families.
29

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Radiation Therapy Side Effects and Ways to Manage Them
Mouth Changes
What they are
Radiation therapy to the head or neck can cause problems such as:
I
Mouth sores (little cuts or ulcers in your mouth)
I
Dry mouth (also called xerostomia)
and throat
I
Loss of taste
I
Tooth decay
I
Changes in taste (such as a metallic taste when you
eat meat)
I
Infections of your gums, teeth, or tongue
Radiation to the shaded area may
I
Jaw stiffness and bone changes
cause mouth changes.
I
Thick, rope-like saliva
Why they occur
Radiation therapy kills cancer cells and can also damage healthy cells such as those in the
glands that make saliva and the soft, moist lining of your mouth.
How long they last
Some problems, like mouth sores, may go away after treatment ends. Others, such as taste
changes, may last for months or even years. Some problems, like dry mouth, may never
go away.
Visit a dentist at least
2 weeks before starting radiation
therapy to your head or neck.
30

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Ways to manage
I
If you are getting radiation therapy to your head or neck, visit a dentist at least 2
weeks before treatment starts. At this time, your dentist will examine your teeth and
mouth and do any needed dental work to make sure your mouth
is as healthy as possible before radiation therapy. If you cannot
get to the dentist before treatment starts, ask your doctor if you
should schedule a visit soon after treatment begins.
I
Check your mouth every day. This way, you can see or feel
problems as soon as they start. Problems can include mouth
sores, white patches, or infection.
I
Keep your mouth moist. You can do this by:
·
Sipping water often during the day
·
Sucking on ice chips
·
Chewing sugar-free gum or sucking on sugar-free hard candy
·
Using a saliva substitute to help moisten your mouth
·
Asking your doctor to prescribe medicine that helps
increase saliva
I
Clean your mouth, teeth, gums, and tongue.
·
Brush your teeth, gums, and tongue after every meal and
at bedtime.
·
Use an extra-soft toothbrush. You can make the bristles
softer by running warm water over them just before
you brush.
·
Use a fluoride toothpaste.
·
Use a special fluoride gel that your dentist can prescribe.
·
Do not use mouthwashes that contain alcohol.
·
Gently floss your teeth every day. If your gums bleed or
hurt, avoid those areas but floss your other teeth.
·
Rinse your mouth every 1 to 2 hours with a solution of
1/4 teaspoon baking soda and 1/8 teaspoon salt mixed in
1 cup of warm water.
·
If you have dentures, make sure they fit well and limit how
long you wear them each day. If you lose weight, your
dentist may need to adjust them.
·
Keep your dentures clean by soaking or brushing them
each day.
31

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I
Be careful what you eat when your mouth is sore.
·
Choose foods that are easy to chew and swallow.
·
Take small bites, chew slowly, and sip liquids with your meals.
·
Eat moist, soft foods such as cooked cereals, mashed potatoes, and scrambled eggs.
·
Wet and soften food with gravy, sauce, broth, yogurt, or other liquids.
·
Eat foods that are warm or at room temperature.
I
Stay away from things that can hurt, scrape, or burn your mouth, such as:
·
Sharp, crunchy foods such as potato or corn chips
·
Hot foods
·
Spicy foods such as hot sauce, curry dishes, salsa, and chili
·
Fruits and juices that are high in acid such as tomatoes, oranges, lemons,
and grapefruits
·
Toothpicks or other
sharp objects
Do not use tobacco or drink alcohol
·
All tobacco products,
while you are getting radiation therapy
including cigarettes, pipes,
cigars, and chewing tobacco
to your head or neck.
·
Drinks that contain alcohol
I
Stay away from foods and drinks that are high in sugar. Foods and drinks that have a
lot sugar (such as regular soda, gum, and candy) can cause tooth decay.
I
Exercise your jaw muscles.
Open and close your mouth 20 times as
far as you can without causing pain. Do
this exercise 3 times a day, even if your
jaw isn't stiff.
Exercise your jaw 3 times a day.
32

---

I
Medicine. Ask your doctor or nurse about medicines that can protect your saliva
glands and the moist tissues that line your mouth.
I
Call your doctor or nurse when your mouth hurts. There are medicines and other
products, such as mouth gels, that can help control mouth pain.
I
You will need to take extra good care of your mouth for the rest of your life. Ask your
dentist how often you will need dental check-ups and how best to take care of your
teeth and mouth after radiation therapy is over.
Ways to learn more
National Oral Health Information Clearinghouse
Phone:
301-402-7364
Online:
www.nidcr.nih.gov
A service of the National Institute of Dental and Craniofacial Research that provides oral
health information for special care patients.
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
Smokefree.gov
Toll-free:
1-877-44U-QUIT (1-877-448-7848)
Online:
www.smokefree.gov
Provides resources, including information on quit lines, a step-by-step cessation guide, and
publications, to help you or someone you care about quit smoking.
33

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Radiation Therapy Side Effects and Ways to Manage Them
Nausea and Vomiting
What they are
Radiation therapy can cause nausea, vomiting, or both.
Nausea is when you feel sick to your stomach and feel like
you are going to throw up. Vomiting is when you throw
up food and fluids. You may also have dry heaves, which
happen when your body tries to vomit even though your
stomach is empty.
Why they occur
Nausea and vomiting can occur after radiation therapy to
the stomach, small intestine, colon, or parts of the brain.
Radiation to the shaded area may
cause nausea and vomiting.
Your risk for nausea and vomiting depends on how much
radiation you are getting, how much of your body is in
the treatment area, and whether you are also having
chemotherapy.
How long they last
Nausea and vomiting may occur 30 minutes to many hours after your radiation therapy
session ends. You are likely to feel better on days that you do not have radiation therapy.
Ways to manage
I
Prevent nausea. The best way to keep from vomiting is to prevent nausea. One way to
do this is by having bland, easy-to-digest foods and drinks that do not upset your
stomach. These include toast, gelatin, and apple juice. To learn more, see the list of
foods and drinks that are easy on the stomach on page 55.
I
Try to relax before treatment. You may feel less nausea if you
relax before each radiation therapy treatment. You can do
this by spending time doing activities you enjoy, such as
reading a book, listening to music, or other hobbies.
34

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I
Plan when to eat and drink. Some people feel better when they eat before radiation
therapy; others do not. Learn the best time for you to eat and drink. For example, you
might want a snack of crackers and apple juice 1 to 2 hours before radiation therapy.
Or, you might feel better if you have treatment on an empty stomach, which means not
eating 2 to 3 hours before treatment.
I
Eat small meals and snacks. Instead of eating 3
Eat 5 or 6 small meals and
large meals each day, you may want to eat 5 or 6
snacks each day instead
small meals and snacks. Make sure to eat slowly
and do not rush.
of 3 large meals.
I
Have foods and drinks that are warm or cool
(not hot or cold). Before eating or drinking, let hot food and drinks cool down and
cold food and drinks warm up.
I
Talk with your doctor or nurse. He or she may suggest a
special diet of foods to eat or prescribe medicine to help
prevent nausea, which you can take 1 hour before each
radiation therapy session. You might also ask your doctor
or nurse about acupuncture, which may help relieve nausea
and vomiting caused by cancer treatment.
Ways to learn more
To learn more about dealing with nausea and vomiting
Learn more from Eating
during cancer treatment, see Eating Hints, a book from
Hints, a book from the
the National Cancer Institute. You can get a free copy at
www.cancer.gov/publications or 1-800-4-CANCER.
National Cancer Institute.
To get a free copy,
National Cancer Institute
contact the Cancer
Cancer Information Service
Information Service.
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
35

---

Radiation Therapy Side Effects and Ways to Manage Them
Sexual and Fertility Changes
What they are
Radiation therapy sometimes causes sexual changes, which can include hormone changes
and loss of interest in or ability to have sex. It can also affect fertility during and after
radiation therapy. For a woman, this means that she might not be able to get pregnant and
have a baby. For a man, this means that he might not be able to get a woman pregnant.
Sexual and fertility changes differ for men and women.
Be sure to tell your doctor if you are pregnant
before you start radiation therapy.
Problems for women include:
I
Pain or discomfort when having sex
I
Vaginal itching, burning, dryness, or atrophy (when
the muscles in the vagina become weak and the walls
of the vagina become thin)
I
Vaginal stenosis, when the vagina becomes less elastic,
narrows, and gets shorter
I
Symptoms of menopause for women not yet in
menopause. These include hot flashes, vaginal dryness,
Radiation to the shaded area
and not having your period.
may cause sexual and
fertility changes.
I
Not being able to get pregnant after radiation therapy
is over
Problems for men include:
I
Impotence (also called erectile dysfunction or ED),
which means not being able to have or keep an
erection
I
Not being able to get a woman pregnant after radiation
therapy is over due to fewer or less effective sperm
36

---

Why they occur
Sexual and fertility changes can happen when people get radiation therapy to the pelvic
area. For women, this includes radiation to the vagina, uterus, or ovaries. For men, this
includes radiation to the testicles or prostate. Many sexual side effects are caused by scar
tissue from radiation therapy. Other problems, such as fatigue, pain, anxiety, or
depression, can affect your interest in having sex.
How long they last
After radiation therapy is over, most people want to have sex as much as they did before
treatment. Many sexual side effects go away after treatment ends. But you may have
problems with hormone changes and fertility for the rest of your life. If you are able to get
pregnant or father a child after you have finished radiation therapy, it should not affect the
health of the baby.
Ways to manage
For both men and women, it is important to be open and
honest with your spouse or partner about your feelings,
concerns, and how you prefer to be intimate while you are
getting radiation therapy.
For women, here are some issues to discuss with your doctor or nurse:
I
Fertility. Before radiation therapy starts, let your doctor or nurse know if you think
you might want to get pregnant after your treatment ends. He or she can talk with you
about ways to preserve your fertility, such as preserving your eggs to use in the future.
I
Sexual problems. You may or may not have sexual problems. Your doctor or nurse can
tell you about side effects you can expect and suggest ways for coping with them.
I
Birth control. It is very important that you do not get pregnant while having radiation
therapy. Radiation therapy can hurt the fetus at all stages of pregnancy. If you have
not yet gone through menopause, talk with your doctor or nurse about birth control
and ways to keep from getting pregnant.
I
Pregnancy. Make sure to tell your doctor or nurse if you are already pregnant.
Talk to your doctor or nurse
if you want to have
children in the future.
37

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I
Stretching your vagina. Vaginal stenosis is a common problem for women who have
radiation therapy to the pelvis. This can make it painful to have sex. You can help by
stretching your vagina using a dilator (a device that gently stretches the tissues of the
vagina). Ask your doctor or nurse where to find a dilator and how to use it.
I
Lubrication. Use a special lotion for your vagina (such as Replens®) once a day to keep
it moist. When you have sex, use a water- or mineral oil-based lubricant (such as K-Y
Jelly® or Astroglide®).
I
Sex. Ask your doctor or nurse whether it is okay for you to have sex during radiation
therapy. Most women can have sex, but it is a good idea to ask and be sure. If sex is
painful due to vaginal dryness, you can use a water- or mineral oil-based lubricant.
For men, here are some issues to discuss with your doctor or nurse:
I
Fertility. Before you start radiation therapy, let your doctor or nurse know if you think
you might want to father children in the future. He or she may talk with you about
ways to preserve your fertility before treatment starts, such as banking your sperm.
Your sperm will need to be collected before you begin radiation therapy.
I
Impotence. Your doctor or nurse can let you know whether you are likely to become
impotent and how long it might last. Your doctor can prescribe medicine or other
treatments that may help.
I
Sex. Ask if it is okay for you to have sex during radiation therapy. Most men can have
sex, but it is a good idea to ask and be sure.
If you want to father children in the future,
your sperm will need to be collected before
you begin treatment.
38

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Ways to learn more
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
American Cancer Society
Toll-free:
1-800-ACS-2345 (1-800-227-2345)
Phone:
404-320-3333
Online:
www.cancer.org
Offers a variety of services to patients and their families. It also supports research,
provides printed materials, and conducts educational programs.
fertileHope
Toll-free:
1-888-994-HOPE (1-888-994-4673)
Online:
www.fertilehope.org
Dedicated to helping people with cancer faced with infertility.
39

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Radiation Therapy Side Effects and Ways to Manage Them
Skin Changes
What they are
Radiation therapy can cause skin changes in your treatment area. Here are some common
skin changes:
I
Redness. Your skin in the treatment area may look as if you have a mild to severe
sunburn or tan. This can occur on any part of your body where you are getting
radiation.
I
Pruritus. The skin in your treatment area may itch so much that you always feel like
scratching. This causes problems because scratching too much can lead to skin
breakdown and infection.
I
Dry and peeling skin. This is when the skin in your treatment area gets very dry--
much drier than normal. In fact, your skin may be so dry that it peels like it does after
a sunburn.
I
Moist reaction. Radiation kills skin cells in your treatment area, causing your skin to
peel off faster than it can grow back. When this happens, you can get sores or ulcers.
The skin in your treatment area can also become wet, sore, or infected. This is more
common where you have skin folds, such as your buttocks, behind your ears, under
your breasts. It may also occur where your skin is very thin, such as your neck.
I
Swollen skin. The skin in your treatment area may be swollen and puffy.
Why they occur
Radiation therapy causes skin cells to break down and die. When people get radiation
almost every day, their skin cells do not have enough time to grow back between
treatments. Skin changes can happen on any part of the body that gets radiation.
How long they last
Skin changes may start a few weeks after you begin radiation therapy. Many of these
changes often go away a few weeks after treatment is over. But even after radiation therapy
ends, you may still have skin changes. Your treated skin may always
look darker and blotchy. It may feel very dry or thicker than before.
And you may always burn quickly and be sensitive to the sun. You will
always be at risk for skin cancer in the treatment area. Be sure to avoid
tanning beds and protect yourself from the sun by wearing a hat, long
sleeves, long pants, and sunscreen with an SPF of 30 or higher.
40

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Ways to manage
I
Skin care. Take extra good care of your
skin during radiation therapy. Be gentle
Take extra good care of your
and do not rub, scrub, or scratch in the
skin during radiation therapy.
treatment area. Also, use creams that your
Be gentle and do not rub,
doctor prescribes.
scrub, or scratch.
I
Do not put anything on your skin that is
very hot or cold. This means not using heating pads, ice packs, or other hot or cold
items on the treatment area. It also means washing with lukewarm water.
I
Be gentle when you shower or take a bath. You can take a lukewarm shower every
day. If you prefer to take a lukewarm bath, do so only every other day and soak for less
than 30 minutes. Whether you take a
shower or bath, make sure to use a mild
soap that does not have fragrance or
Be careful not to wash off the
deodorant in it. Dry yourself with a soft
ink markings you need for
towel by patting, not rubbing, your skin.
radiation therapy.
Be careful not to wash off the ink markings
that you need for radiation therapy.
I
Use only those lotions and skin products that your doctor or nurse suggests. If you
are using a prescribed cream for a skin problem or acne, you must tell your doctor or
nurse before you begin radiation treatment. Check with your doctor or nurse before
using any of the following skin products:
·
Bubble bath
·
Hair removers
·
Perfume
·
Cornstarch
·
Makeup
·
Powder
·
Cream
·
Oil
·
Soap
·
Deodorant
·
Ointment
·
Sunscreen
If you use any skin products on days you have radiation therapy, use them at least
4 hours before your treatment session.
I
Cool, humid places. Your skin may feel much better when you are in cool, humid
places. You can make rooms more humid by putting a bowl of water on the radiator or
using a humidifier. If you use a humidifier, be sure to follow the directions about
cleaning it to prevent bacteria.
I
Soft fabrics. Wear clothes and use bed sheets that are soft, such as those made
from cotton.
I
Do not wear clothes that are tight and do not breathe, such as girdles and pantyhose.
I
Protect your skin from the sun every day. The sun can burn you even on cloudy days
41

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or when you are outside for just a few minutes. Do not go to the
beach or sun bathe. Wear a broad-brimmed hat, long-sleeved shirt,
and long pants when you are outside. Talk with your doctor or nurse
about sunscreen lotions. He or she may suggest that you use a
sunscreen with an SPF of 30 or higher. You will need to protect your
skin from the sun even after radiation therapy is over, since you will
have an increased risk of skin cancer for the rest of your life.
I
Do not use tanning beds. Tanning beds expose you to the same harmful effects as
the sun.
I
Adhesive tape. Do not put bandages, BAND-AIDS®, or other types of sticky tape on
your skin in the treatment area. Talk with your doctor or nurse about ways to bandage
without tape.
I
Shaving. Ask your doctor or nurse if you can shave the treated area. If you can shave,
use an electric razor and do not use pre-shave lotion.
I
Rectal area. If you have radiation therapy to the rectal area, you
are likely to have skin problems. These problems are often worse
after a bowel movement. Clean yourself with a baby wipe or
squirt of water from a spray bottle. Also ask your nurse about sitz
baths (a warm-water bath taken in a sitting position that covers
only the hips and buttocks.)
I
Talk with your doctor or nurse. Some skin changes can be very
serious. Your treatment team will check for skin changes
each time you have radiation therapy. Make sure to report
any skin changes that you notice.
I
Medicine. Medicines can help with some skin changes.
They include lotions for dry or itchy skin, antibiotics to treat
infection, and other drugs to reduce swelling or itching.
Ways to learn more
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
42

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Radiation Therapy Side Effects and Ways to Manage Them
Throat Changes
What they are
Radiation therapy to the neck or chest can cause the lining of
your throat to become inflamed and sore. This is called
esophagitis. You may feel as if you have a lump in your
throat or burning in your chest or throat. You may also have
trouble swallowing.
Radiation to the shaded area
may cause throat changes.
Why they occur
Radiation therapy to the neck or chest can cause throat changes because it not only kills cancer
cells, but can also damage the healthy cells that line your throat. Your risk for throat changes
depends on how much radiation you are getting, whether you are also having chemotherapy,
and whether you use tobacco and alcohol while you are getting radiation therapy.
How long they last
You may notice throat changes 2 to 3 weeks after starting radiation. You will most likely
feel better 4 to 6 weeks after radiation therapy has finished.
Ways to manage
I
Be careful what you eat when your throat is sore.
·
Choose foods that are easy to swallow.
·
Cut, blend, or shred foods to make them easier to eat.
·
Eat moist, soft foods such as cooked cereals, mashed potatoes, and scrambled eggs.
·
Wet and soften food with gravy, sauce, broth, yogurt, or other liquids.
·
Drink cool drinks.
·
Sip drinks through a straw.
·
Eat foods that are cool or at room temperature.
I
Eat small meals and snacks. It may be easier to eat a small amount of food at one
time. Instead of eating 3 large meals each day, you may want to eat 5 or 6 small meals
and snacks.
I
Choose foods and drinks that are high in calories and protein. When it hurts to
swallow, you may eat less and lose weight. It is important to keep your weight the
same during radiation therapy. Having foods and drinks that are high in calories and
protein can help you. See the chart of foods and drinks that are high in calories and
protein on page 54 for ideas.
43

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I
Sit upright and bend your head slightly forward when you are eating or drinking.
Remain sitting or standing upright for at least 30 minutes after eating.
I
Don't have things that can burn or scrape your throat, such as:
·
Hot foods and drinks
·
Spicy foods
·
Foods and juices that are high in acid, such as tomatoes and oranges
·
Sharp, crunchy foods such as potato or corn chips
·
All tobacco products, such as cigarettes, pipes, cigars, and chewing tobacco
·
Drinks that contain alcohol
I
Talk with a dietitian. He or she can help make sure you eat enough to maintain your
weight. This may include choosing foods that are high in calories and protein and
foods that are easy to swallow.
I
Talk with your doctor or nurse.
Let your doctor or nurse know if you
Let your doctor or nurse know
notice throat changes, such as trouble
if you:
swallowing, feeling as if you are choking,
or coughing while eating or drinking.
I
Have trouble swallowing
Also, let him or her know if you have
I
Feel as if you are choking
pain or lose any weight. Your doctor can
prescribe medicines that may help relieve
I
Cough while you are eating
your symptoms, such as antacids, gels that
or drinking
coat your throat, and pain killers.
Ways to learn more
To learn more about dealing with throat problems, the following books from the
National Cancer Institute may help you: Eating Hints and Pain Control: Support
for People With Cancer. You can get free copies at www.cancer.gov/publications or
1-800-4-CANCER (1-800-422-6237).
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
Smokefree.gov
Toll-free:
1-877-44U-QUIT (1-877-448-7848)
Online:
www.smokefree.gov
Provides resources, including information on quit lines, a step-by-step cessation guide, and
publications, to help you or someone you care about quit smoking.
44

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Radiation Therapy Side Effects and Ways to Manage Them
Urinary and Bladder Changes
What they are
Radiation therapy can cause urinary and bladder problems,
which can include:
I
Burning or pain when you begin to urinate or after you
empty your bladder
I
Trouble starting to urinate
I
Trouble emptying your bladder
Radiation to the shaded area
I
Frequent, urgent need to urinate
may cause urinary and
bladder changes.
I
Cystitis, a swelling (inflammation) in your urinary tract
I
Incontinence, when you cannot control the flow of urine from your bladder, especially
when coughing or sneezing
I
Frequent need to get up during sleep to urinate
I
Blood in your urine
I
Bladder spasms, which are like painful muscle cramps
Why they occur
Urinary and bladder problems may occur when people get radiation therapy to the
prostate or bladder. Radiation therapy can harm the healthy cells of the bladder wall and
urinary tract, which can cause inflammation, ulcers, and infection.
How long they last
Urinary and bladder problems often start 3 to 5 weeks after radiation therapy begins.
Most problems go away 2 to 8 weeks after treatment is over.
45

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Radiation Therapy Side Effects and Ways to Manage Them
Ways to manage
Drink 6 to 8 cups
I
Drink a lot of fluids. This means 6 to 8 cups of fluids each
of fluids each day.
day. Drink enough fluids so that your urine is clear to light
yellow in color.
I
Avoid coffee, black tea, alcohol, spices, and all
tobacco products.
I
Talk with your doctor or nurse if you think you have
urinary or bladder problems. He or she may ask for a
urine sample to make sure that you do not have an
infection.
I
Talk to your doctor or nurse if you have incontinence.
He or she may refer you to a physical therapist who will
assess your problem. The therapist can give you exercises
to improve bladder control.
I
Medicine. Your doctor may prescribe antibiotics if your problems are caused by an
infection. Other medicines can help you urinate, reduce burning or pain, and ease
bladder spasms.
Ways to learn more
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
46

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Late Radiation Therapy Side Effects
Late side effects are those that first occur at least 6 months after radiation therapy is over.
Late side effects are rare, but they do happen. It is important to have follow-up care with
a radiation oncologist or nurse practitioner for the rest of your life.
Whether you get late side effects will depend on:
I
The part of your body that was treated
I
The dose and length of your radiation therapy
I
If you received chemotherapy before, during, or after radiation therapy
Your doctor or nurse will talk with you about late side effects and discuss ways to help
prevent them, symptoms to look for, and how to treat them if they occur.
Some late side effects are brain problems, infertility, joint problems, lymphedema, mouth
problems, and secondary cancers.
Brain Changes
What they are
Radiation therapy to the brain can cause problems months or years after treatment ends.
Side effects can include memory loss, problems doing math, movement problems,
incontinence, trouble thinking, or personality changes. Sometimes, dead tumor cells can
form a mass in the brain, which is called radiation necrosis.
Ways to manage
You will need to have check-ups with your doctor or nurse for the rest of your life. If you
have symptoms, you will have tests to see whether they are due to the cancer or late side
effects.
If you have late side effects, your doctor or nurse practitioner:
I
Will talk with you about ways to manage late side effects
I
May refer you to a physical, occupational, or speech therapist who can help with
problems caused by late side effects
I
May prescribe medicine or suggest surgery to help with the symptoms
47

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Late Radiation Therapy Side Effects
Infertility
What it is
For men, infertility means not being able to get a woman pregnant. For women, it means
not being able to get pregnant.
Ways men with infertility can become a parent:
I
Donor sperm. This means getting a woman pregnant with sperm given by another man.
I
Adoption. Taking on legal responsibility for someone else's child
and raising the child as your own.
Ways women with infertility can become a parent:
I
Donor embryos. Another couple donates a fertilized egg that your
doctor implants in your uterus to carry until birth.
I
Donor eggs. An egg (donated by someone else) is fertilized by your partner's sperm.
Your doctor implants the fertilized egg in your uterus to carry until birth.
I
Surrogacy. Another woman carries and gives birth to your child. She can also donate
her egg, which is fertilized by your partner's sperm.
I
Adoption. Taking on legal responsibility for someone else's child and raising the child
as your own.
Joint Changes
What they are
Radiation therapy can cause scar tissue and weakness in the part of the body that was
treated. This can lead to loss of motion in your joints, such as your jaw, shoulders, or hips.
Joint problems can show up months or years after radiation therapy is over.
Ways to manage
Notice early signs of joint problems. These signs include:
I
Trouble getting your mouth to open wide
I
Pain when you make certain movements, such as reaching
over your head or putting your hand in a back pocket
Talk with your doctor or nurse. He or she may refer you to a
physical therapist who will assess your joint problems. The therapist can give you exercises
to decrease pain, increase strength, and improve movement.
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Late Radiation Therapy Side Effects
Lymphedema
What it is
Swelling in an arm or a leg caused by a build up of lymph fluid. Lymphedema can happen
if your lymph nodes were removed during surgery or damaged by radiation therapy.
Tell your doctor or nurse if you notice swelling in the arm or leg
on the side where you had radiation.
Ways to manage
I
Meet with your doctor or nurse. Ask about your risk of
lymphedema and ways to prevent it. Your doctor or nurse
may suggest exercises, medicines, or compression garments (special wraps to put on
your legs or arms). You might also want to ask for a referral to a
physical therapist.
I
Be active. Exercise can help prevent and treat lymphedema. Ask your
doctor, nurse, or physical therapist which exercises are safe for you to do.
I
Take care of your arm or leg.
·
Use skin lotion at least once a day.
·
Avoid sunburn. Use sunscreen with an SPF of 30 or higher and wear
long sleeves and long pants if you need to be in the sun.
·
Wear gloves when you garden or cook.
·
Clip your toenails straight across, file your fingernails, and do not cut your cuticles.
·
Keep your feet clean and wear dry, cotton socks.
·
Clean cuts with soap and water and then use antibacterial ointment.
·
Avoid extreme hot or cold, such as ice packs or heating pads.
·
Do not put pressure on your arm or leg. For example, do not cross your legs when
sitting or carry your purse on the side that had radiation.
·
Wear loose clothes that do not have tight elastic cuffs or waistbands.
I
Notice early signs of lymphedema. Let your doctor or nurse know if you have:
·
Pain or a sense of heaviness in your arm or leg
·
A feeling of tightness in your arm or leg
·
Trouble putting on your shoes or rings
·
Weakness in your arm or leg
·
Redness, swelling, or other signs of infection
49

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Late Radiation Therapy Side Effects
Mouth Changes
What they are
Radiation therapy to your head and neck can cause late side effects in your mouth.
Problems may include dry mouth, cavities, or bone loss in the jaw.
Ways to manage
I
Visit your dentist. You may be asked to have
your teeth checked every 1 to 2 months for at
least 6 months after radiation treatment
ends. During this time, your dentist will look
for changes in your mouth, teeth, and jaw.
I
Exercise your jaw. Open and close your
mouth 20 times as far as you can without
causing pain. Do this exercise 3 times a day,
even if your jaw isn't stiff.
Exercise your jaw 3 times a day.
I
Take good care of your teeth and gums.
This means flossing, using daily fluoride treatments, and
brushing your teeth after meals and before you go to bed.
I
Have your dentist contact your radiation oncologist before you
have dental or gum surgery. This includes not having teeth
pulled from the part of your mouth that received radiation.
There may be other options than surgery.
Secondary Cancer
What it is
Radiation therapy can cause a new cancer many years after you have finished treatment.
This does not happen very often.
Ways to manage
You will need to have check-ups with your radiation oncologist or nurse practitioner for
the rest of your life to check for cancer--the one you were treated for and any new cancer
that may occur.
See Resources for Learning More on pages 59 and 60 for ways to learn more about late
side effects.
50

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Questions To Ask Your Doctor or Nurse
Here are some questions you might want to ask your doctor or nurse. You may want to
write down their answers so you can review them again later.
What kind of radiation therapy will I get?
______________________________________________________________________________
______________________________________________________________________________
How can radiation therapy help?
______________________________________________________________________________
______________________________________________________________________________
How many weeks will my course of radiation therapy last?
______________________________________________________________________________
______________________________________________________________________________
What kinds of side effects should I expect during my course of
radiation therapy?
______________________________________________________________________________
______________________________________________________________________________
Will these side effects go away after radiation therapy is over?
______________________________________________________________________________
______________________________________________________________________________
51

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What kind of late side effects should I expect after radiation therapy is over?
______________________________________________________________________________
______________________________________________________________________________
What can I do to manage these side effects?
______________________________________________________________________________
______________________________________________________________________________
What will you do to manage these side effects?
______________________________________________________________________________
______________________________________________________________________________
How can I learn more about radiation therapy?
______________________________________________________________________________
______________________________________________________________________________
Which sections should I read in this book?
______________________________________________________________________________
______________________________________________________________________________
52

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Lists of Foods and Liquids
Clear Liquids
This list may help if you have diarrhea. See page 24 for more information.
Types of Liquids
Includes . . .
Soups
Bouillon
Clear, fat-free broth
Consommé
Strained vegetable broth
Drinks
Apple juice
Clear carbonated beverages
Cranberry or grape juice
Fruit-flavored drinks
Fruit punch
Sports drinks
Tea
Water
Sweets
Fruit ices without fruit pieces
Fruit ices without milk
Honey
Jelly
Plain gelatin dessert
Popsicles
53

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Foods and Drinks That Are High in Calories or Protein
This list may help if you need ideas for keeping your weight the same. See pages 5 and 43
for more information.
Types of Foods
Includes . . .
and Drinks
Soups
Cream soups
Drinks
Instant breakfast shakes
Milkshakes
Whole milk (instead of low-fat or skim)
Main meals and
Beans, legumes
other foods
Butter, margarine, or oil
Cheese
Chicken, fish, or beef
Cottage cheese
Cream cheese on crackers or celery
Deviled ham
Eggs, such as scrambled or deviled eggs
Muffins
Nuts, seeds, wheat germ
Peanut butter
Desserts and
Custards
other sweets
Frozen yogurt
Ice cream
Puddings
Yogurt
Replacements
Powdered milk added to foods (pudding, milkshakes,
and other
or scrambled eggs)
supplements
High-protein supplements, such as Ensure® and
Carnation® Instant Breakfast®
54

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Foods and Drinks That Are Easy on the Stomach
This list may help if you have diarrhea or nausea and vomiting. See pages 24 and 34 for
more information.
Types of Foods
Includes . . .
and Drinks
Soups
Clear broth, such as chicken or beef
Drinks
Clear carbonated beverages
Cranberry or grape juice
Fruit-flavored drinks
Fruit punch
Sports drinks
Tea
Water
Main meals
Boiled potatoes
and snacks
Chicken, broiled or baked without the skin
Crackers
Cream of wheat
Noodles
Oatmeal
Pretzels
Rice
Toast
Sweets
Angel food cake
Canned peaches
Gelatin
Sherbet
Yogurt
55

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Words To Know
3-D conformal radiation therapy (ray-dee-AY-shun): Uses a computer to create a 3-D
picture of a cancer tumor. This allows doctors to give the highest possible dose of
radiation to the tumor, while sparing the normal tissue as much as possible.
Acupuncture (AK-yoo-PUNK-cher): A technique of inserting thin needles through the
skin at specific points on the body to control pain and side effects. It is a type of
complementary and alternative medicine.
Alopecia (al-oh-PEE-shuh): Hair loss; when some or all of your hair falls out.
Anemia (a-NEE-mee-a): A problem in which the number of red blood cells is
below normal.
Applicator: A large device used to place brachytherapy in the body.
Brachytherapy (BRAKE-ee-THER-a-pee): Treatment in which a solid radioactive
substance is implanted inside your body, near or next to the cancer cells.
CT scan: A series of detailed pictures of areas inside the body, taken from different angles;
the pictures are created by a computer linked to an x-ray machine.
Catheter: A flexible tube used to place brachytherapy in the body.
Course of treatment: All of your radiation therapy sessions.
Cystitis: Inflammation in your urinary tract.
Diet: Foods you eat (does not always refer to a way to lose weight).
Dilator (DYE-lay-tor): A device that gently stretches the tissues of the vagina.
Dry heaves: A problem that occurs when your body tries to vomit even though your
stomach is empty.
Erectile dysfunction (e-WRECK-tile dis-FUNK-shun): Not able to have an erection of the
penis adequate for sexual intercourse. Also called impotence.
Esophagitis: Inflammation of the esophagus (the tube that carries food from the mouth
to the stomach).
External beam radiation therapy (ray-dee-AY-shun): Treatment in which a radiation
source from outside your body aims radiation at your cancer cells.
Fatigue: A feeling of being weary or exhausted.
Follow-up care: Check-up appointments that you have after your course of radiation
therapy is over.
Hyperfractionated radiation therapy ((hy-per-FRAK-shuh-NAYT-id ray-dee-AY-shun
THAYR-uh-pee): Treatment in which radiation is given in smaller doses twice a day.
56

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Imaging tests: Tests that produce pictures of areas inside the body.
Implant: Radioactive material put in your body through a sealed thin wire, catheter,
or tube.
Impotence (IM-po-tense): Not able to have an erection of the penis adequate for sexual
intercourse. Also called erectile dysfunction.
IMRT (intensity-modulated radiation therapy): A technique that uses a computer to
deliver precise radiation doses to a cancer tumor or specific areas within the tumor.
Incontinence (in-KAHN-tih-nens): A problem in which you cannot control the flow of
urine from your bladder.
Infertility: Not being able to produce children.
Inflammation: Redness, swelling, pain, and/or a feeling of heat in an area of the body.
Internal radiation therapy (ray-dee-AY-shun): Treatment in which a radioactive
substance is put inside your body.
Intraoperative radiation (ray-dee-AY-shun): Radiation treatment aimed directly at cancer
during surgery.
Late side effects: Side effects that first occur 6 or more months after radiation therapy
is finished.
Local treatment: Radiation is aimed at only the part of your body with cancer.
Lymphedema: A problem in which excess fluid collects in tissue and causes swelling. It
may occur in the arm or leg after lymph vessels or lymph nodes in the underarm or groin
are removed by surgery or treated with radiation.
Medical leave: Taking time off work for a while due to a medical problem.
MRI (magnetic resonance imaging): A procedure in which radio waves and a powerful
magnet linked to a computer are used to create detailed pictures of areas inside the body.
Nausea: When you have an upset stomach or queasy feeling and feel like you are going to
throw up.
Pelvis: The area between your legs. Also called the groin.
Permanent implants: Radioactive pellets or seeds that always stay in your body.
PET (Positron emission tomography) scan: A procedure in which a small amount of
radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed,
computerized pictures of areas inside the body where the glucose is used. Because cancer
cells often use more glucose than normal cells, the pictures can be used to find cancer cells
in the body.
Pruritus: Severe itching.
57

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Psychostimulants: Medicines that can help decrease fatigue, give a sense of well-being,
and increase appetite.
Radiation necrosis: A problem in which dead tumor cells form a mass in the brain.
Radiation oncologist (ray-dee-AY-shun on-KO-lo-jist): A doctor who specializes in using
radiation to treat cancer.
Radiation therapy (ray-dee-AY-shun): High doses of radiation used to treat cancer and
other diseases.
Radiotherapy (RAY-dee-o-THER-a-pee): Another word for radiation therapy.
Simulation (sim-you-LAY-shun): A process used to plan radiation therapy so that the
target area is precisely located and marked.
Sitz bath: A warm-water bath taken in a sitting position that covers only the hips and
buttocks.
Skin breakdown: A side effect from radiation therapy in which the skin in the treatment
area peels off faster than it can grow back.
Support groups: Meetings for people who share the same problems, such as cancer.
Treatment field: One or more places on your body where the radiation will be aimed.
Also called treatment port.
Treatment port: One or more places on your body where the radiation will be aimed.
Also called treatment field.
Urinate (YOOR-in-nate): Emptying your bladder of urine.
Vaginal stenosis (ste-NO-sis): A problem in which the vagina narrows and gets smaller.
Vomiting: When you get sick and throw up your food.
Xerostomia: Dry mouth.
58

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Resources for Learning More
National Cancer Institute
Cancer Information Service
Toll-free:
1-800-4-CANCER (1-800-422-6237)
TTY:
1-800-332-8615
Answers questions about cancer clinical trials and cancer-related services and helps
users find information on the NCI Web site. Provides NCI printed materials.
Online:
www.cancer.gov
Chat online: www.cancer.gov/help
American Cancer Society
Toll-free:
1-800-ACS-2345 (1-800-227-2345)
Online:
www.cancer.org
Offers a variety of services to patients and their families. It also supports research,
provides printed materials, and conducts educational programs.
American Society for Therapeutic Radiology and Oncology
Toll-free:
1-800-962-7876
Online:
www.astro.org
A society of radiation oncology professionals who specialize in treating patients with
radiation therapy. Patients can get information on treating cancer with radiation and find
a radiation oncologist in their area.
CancerCare, Inc.
Toll-free:
1-800-813-HOPE (1-800-813-4673)
Online:
www.cancercare.org
E-mail:
info@cancercare.org
Offers free support, information, financial assistance, and practical help to people with
cancer and their loved ones.
fertileHOPE
Toll-free:
1-888-994-HOPE (1-888-994-4673)
Online:
www.fertilehope.org
Dedicated to helping people with cancer faced with infertility.
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National Brain Tumor Foundation
Toll-free:
1-800-934-2873
Online:
www.braintumor.org
Dedicated to providing information and support for brain tumor patients, their family
members, and health care professionals, while supporting innovative research into better
treatment options and a cure for brain tumors.
National Lymphedema Network
Toll-free:
800-541-3259
Phone:
510-208-3200
Online:
www.lymphnet.org
E-mail:
nln@lymphnet.org
Provides education and guidance to lymphedema patients, health care professionals, and
the general public by disseminating information on the prevention and management of
primary and secondary lymphedema.
National Oral Health Information Clearinghouse
Phone:
301-402-7364
Online:
www.nidcr.nih.gov
A service of the National Institute of Dental and Craniofacial Research that provides oral
health information for special care patients.
The Wellness Community
Toll-free:
1-888-793-WELL (1-888-793-9355)
Phone:
202-659-9709
Online:
www.thewellnesscommunity.org
E-mail:
help@thewellnesscommunity.org
Provides free psychological and emotional support to cancer patients and their loved ones.
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NIH Publication No. 07-7157
Revised March 2007

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