Kidney And Bladder Effects
Certain chemotherapy medications, such as cisplatin, can cause damage to the kidneys and bladder. This can result in a decreased ability of your kidneys to filter your blood. Damage to the bladder can also occur and may be temporary or permanent. Symptoms of bladder irritation may include pain or urgency with urination, or blood in your urine.
How Can I Manage Skin Problems
You may notice that your skin in the treatment area begins to look reddened, irritated, sunburned or tanned. After a few weeks your skin may become very dry. Ask your doctor or nurse for advice on relieving itching or discomfort.
With some kinds of radiation therapy, treated skin may develop a “moist reaction,” especially in areas where there are skin folds. When this happens, the skin is wet and it may become very sore. It’s important to notify your doctor or nurse if your skin develops a moist reaction. You might find it helpful to seek care from an onco-dermatologist, a doctor who specializes in caring for skin problems cancer patients encounter.
Be very gentle with the skin in the treatment area. Avoid irritating treated skin, which can compromise the stratum corneum . When you wash, use only lukewarm water and mild soap. Don’t wear tight clothing over the treatment area. It’s important not to rub, scrub or scratch any sensitive spots. Also avoid putting anything that is very hot or very coldsuch as heating pads or ice packson your treated skin. Don’t use any powders, creams, perfumes, deodorants, body oils, ointments, lotions, or home remedies in the treatment area while you’re being treated or for several weeks afterward . Thats because many skin products can leave a coating on the skin that can interfere with radiation therapy or healing.
Questions To Ask Your Radiation Oncologist
Before your appointment, its helpful to write down the questions you want to ask your radiation therapy care team. Examples of questions you can ask are listed below. Write down the answers during your appointment so you can review them later.
What kind of radiation therapy will I get?
How many radiation treatments will I get?
What side effects should I expect during my radiation therapy?
Will these side effects go away after I finish my radiation therapy?
What kind of late side effects should I expect after my radiation therapy?
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How Your Doctor Can Help
The first step is to try to figure out the source or sources of your fatigue. There may be more than one reason youâre feeling this way.
Your doctor can do tests to check for anemia or hypothyroidism. If you have one of these conditions, treatments can help.
If you think your cancer treatment is the cause, talk to your doctor about ways to help you manage it, or discuss other options.
About Radiation Therapy To The Brain
Radiation therapy uses high-energy rays to treat cancer. It works by damaging the cancer cells and making it hard for them to reproduce. Your body then is naturally able to get rid of these damaged cancer cells. Radiation therapy also affects normal cells. However, your normal cells are able to repair themselves in a way that cancer cells cant.
Radiation can be given to treat primary tumors in your brain or tumors that have spread to your brain from another part of your body . Your doctor will decide whether youll receive partial or whole brain radiation. Youll have either external beam radiation therapy or stereotactic radiosurgery depending on your treatment plan.
During external beam radiation, a treatment machine will aim beams of radiation directly to the tumor. The beam passes through your body and destroys cancer cells in its path. You wont see or feel the radiation.
Stereotactic radiosurgery can be used in some tumors and is even more precise. It targets a small area in your brain with high doses of radiation and delivers lower doses of radiation to the normal tissue around it. Youre able to receive higher doses to the tumor at each treatment session, which shortens the overall course of treatment.
Radiation therapy takes time to work. It takes days or weeks of treatment before cancer cells start to die, and they keep dying for weeks or months after radiation therapy.
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When Do You Have Physical Energy
I had my radiation treatments at 2:45 in the afternoon. I quickly discovered that I had more physical energy in the mornings. I would try to prioritize my day to get the most important things done in the morning. If I had lessons that I needed to go over with the boys, it was best that I did it when I had the physical energy to work with them. This was not after my treatments in the afternoon.
If you have your treatment in the morning, your energy cycle might be different. Perhaps you get more physical energy in the evenings. I would encourage you to note the time of day that you feel like you have more energy. Then, plan the most important things when you might feel the best.
Take Charge Of Your Stress
Managing stress can play an important role in fighting fatigue. Here are some suggestions that may help.
- Adjust your expectations. For example, if you have a list of 10 things you want to accomplish today, pare it down to two and leave the rest for other days. A sense of accomplishment goes a long way toward easing stress.
- Help others understand and support you. Family and friends can be helpful if they can put themselves in your shoes and understand what fatigue means to you. Cancer support groups can be a source of strength, too. Other people with the disease may understand what you’re going through.
- Relaxation techniques like deep breathing or visualization can lower stress, too. Or just do low-key things that are fun for you: read, listen to music, or knit, for example.
Let your doctor know if your stress seems out of control. They can help you feel better.
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Ways To Save Up Your Energy
Medicines Other Than Chemotherapy May Add To Fatigue
Patients may take medicines for pain or conditions other than the cancer that cause drowsiness. Opioids, antidepressants, and antihistamines have this side effect. If these medicines are taken at the same time, fatigue may be worse.
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Mouth And Throat Changes
Radiation therapy to the head and neck can cause mouth changes. Radiation not only kills cancer cells but can also harm healthy cells in the glands that make saliva and the moist lining of your mouth. You may have:
- Mouth sores
- Loss/change in taste
- Thickened saliva
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, such as dry mouth, may get better but never go away.
Mouth Care After Radiation
Radiation therapy to the neck or chest can cause the lining of your throat to become swollen and sore. 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 getting radiation therapy. You may notice throat changes in 23 weeks after starting radiation. These will likely get better 46 weeks after you have finished treatment.
Nutrition During Head, Neck or Chest Radiation
Feeling Tired Because Of Sleeping Problems Anxiety Or Depression
Tiredness, depression, anxiety and problems sleeping often appear together in some people. Researchers think there is a link between cancer tiredness and depression. Sleeping problems, anxiety or depression may make your tiredness worse. But extreme tiredness can also cause emotional distress in some people.
A short course of sleeping tablets might help. It can help to get you back into your sleeping pattern. Your doctor might suggest anti depressants if depression is causing you sleeping problems. You need to take these for a few months to get the most out of them. Most anti depressants take a few weeks to start to work. Talk to your doctor or nurse if you feel depressed.
Sleeping problems, depression and tiredness can be difficult to cope with. But there are things you can do and people that can help.
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How Is Cancer Fatigue Diagnosed
Your healthcare provider will assess your symptoms. You may be asked to complete a questionnaire or rate your fatigue level. Your provider may ask you to keep a journal to track your level of fatigue and factors that might contribute to fatigue.
Blood tests can check for anemia, signs of infection or other problems that cause fatigue.
What About Tiredness That Becomes A Severe Burden
A final aspect of the cancer fatigue conversation comes up when those receiving treatment begin to experience dramatic changes in the severity and frequency of fatigue. When fatigue becomes persistent and interferes with your ability to perform basic daily function, tell your doctor. More importantly, if fatigue reaches an extreme point and causes confusion, dizziness, loss of balance, severe shortness of breath or leaves you bedridden for more than 24 hours, contact your care team immediately. While it is normal to sleep more than typical after a radiotherapy session, these symptoms greatly increase your risk of injury and could lead to the worsening of your overall health.
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Day Of Your Simulation
What to expect
A member of your radiation therapy team will check you in. Youll be asked to state and spell your full name and birth date many times. This is for your safety and part of our standard identification process. Patients with the same or similar names may be having care on the same day as you.
Youll be greeted by your radiation therapist. Theyll take a photograph of your face. This picture will be used to identify you throughout your treatment.
Your therapist will then explain the simulation to you. If you havent already signed a consent form, your radiation oncologist will review everything with you, and ask for your signature.
During your simulation
For your simulation, you may need to get undressed and change into a gown. You should keep your shoes on. If you wear a head covering, such as a wig, turban, or cap, you may have to remove it. Your therapists will help you lie down on a table and make every effort to ensure your comfort and privacy.
Although the table will have a sheet on it, its hard and has no cushion. If you havent taken pain medication and think you may need it, tell your therapists before your simulation begins. Also, the room is usually cool. If you feel uncomfortable at any time, let your therapists know.
To help pass the time, your therapists can play music for you. You may bring a CD of your own from home, if you wish.
Figure 1. Mask for your radiation
Figure 2. Chin strap for your radiation
Cancer Fatigue Is Different From Fatigue That Healthy People Feel
When a healthy person is tired from day-to-day activities, their fatigue can be relieved with sleep and rest. Cancer fatigue is different. People with cancer get tired after less activity than people who do not have cancer. Also, cancer fatigue is not completely relieved by sleep and rest, interferes with daily activities, and may last for a long time. Fatigue usually decreases after cancer treatment ends, but some people may still feel fatigue for months or years.
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What Reduces The Severity Of Tiredness
The level of tiredness a person experiences relates closely to other activities during treatment. What a person eats, how much they sleep, their level of pain and mental stress affect the body and result in fatigue. Those with a cancer diagnosis and receiving treatment, including radiotherapy, should follow the advice of their board-certified radiation therapy oncologist to combat fatigue. Some common methods for reducing fatigue include:
How Long Side Effects May Last
Radiation therapy can cause side effects during and just after treatment. These are called short-term or acute effects. It can also cause long-term or late effects months or years down the track. Most side effects go away after treatment. But sometimes radiation therapy can cause long term or late effects months or years down the track.
During treatment, tell your radiation therapy team about any side effects, as side effects can usually be controlled with the right care and medicine.
Learn more about:
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What Are The Complications Of Cancer Fatigue
Persistent fatigue can interfere with your ability to participate in lifes activities. You may miss out on time with family and friends. It can affect your ability to concentrate and think clearly. Some people are too exhausted to continue working.
As many as 1 in 4 people with cancer develop depression. Sometimes, its hard to determine if fatigue leads to depression or vice versa.
What Should I Do If I Have Fatigue
- Exercise: Try to do some exercise ask your doctor for advice about the best exercise for you.
- Rest: Build rest periods into your day and save your energy for doing the things that are most important to you. If you are going somewhere special, have a rest before you go out.
- Get help: Ask for help at work or at home, especially with cooking, housework or childcare.
- Eat well: Try to eat a well-balanced diet. Eat little and often if your appetite is poor. You could read our booklet Diet and Cancer for tips to help you eat well.
- Avoid stress: Talk to friends and family about any worries you have and take time to enjoy yourself. Counselling may help if youre finding it hard to cope.
- Relaxation therapies may help, such as visualisation, yoga and meditation. Your local cancer support centre may have sessions where you can learn these techniques. Free guided meditation videos are available online.
- Sleep: If you are not sleeping well, try relaxation techniques and avoid stimulants like caffeine and alcohol before bedtime.
- Complementary therapies: Try complementary therapies like meditation, acupuncture or massage. Check with your doctor or nurse first some therapies might not be suitable for people with certain cancers or having certain treatments.
- Keep a diary of your energy levels: Use the diary pages below to take note of the times when you feel most and least tired. This can help you to plan your activities. Your doctor may also find your fatigue diary useful.
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Questions To Ask The Health Care Team
What physical side effects are likely based on my specific radiation therapy treatment plan? When will they likely begin?
How can these side effects be prevented or managed?
How can I take care of the affected skin during my treatment period?
Who should I tell when a side effect appears or gets worse?
Are there specific side effects I should tell the doctor about right away?
Who can I talk with if I’m feeling anxious or upset about having this treatment?
If I’m having side effects that affect my nutrition, can you recommend an oncology dietitian?
What are other ways I can take care of myself during the treatment period?
Are there any restrictions on exercising or other physical activity during this treatment?
Could this treatment affect my sex life? If so, how and for how long?
Could this treatment affect my ability to become pregnant or have a child? If so, should I talk with a fertility specialist before cancer treatment begins?
What are the potential long-term effects of this type of radiation therapy?
If I’m worried about managing the financial costs of cancer care, who can help me?
Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?
After radiation therapy is completed, what will my follow-up care plan be?
Why is follow-up care important for managing side effects of treatment?