Palliative care: Understanding side effects of radiotherapy
Palliative cancer treatment is the term used to describe supportive care, improving quality of life and controlling symptoms relating to cancer.
For some people, the word ‘palliative’ can be very frightening and have negative associations. Try to remember that palliative cancer treatment is about improving quality of life and controlling symptoms relating to cancer. It cannot remove the cancer but can improve the management of symptoms you may be experiencing and in many cases be life extending.
Many people can live a long time with a cancer diagnosis, palliative cancer treatment plays a big role in the relief of symptoms, ensuring the quality of life left is lived well.
Usually, the side effects from palliative radiotherapy are less severe, because lower doses of radiation are used than when delivering curative radiotherapy. Before your radiotherapy begins, your clinical oncologist should explain what side effects you might have and how to manage them. These will vary depending on:
- which part of your body is being treated
- the number of treatments
- the dose given
You will likely have side effects not listed below as this is a general list. Any side effects you experience will be linked to the area of the body being treated and will depend on the symptoms you are experiencing due to your cancer. They may also be caused by a different part of your cancer treatment. Research and support for side effects and late effects of radiotherapy is growing.
Joining a support group can be a positive way to share your experiences, feel less alone, and help you come to terms with the emotional and physical impact of treatment and your diagnosis. Ask your treatment or clinical team if you need more support.
How likely am I to have side or late effects?
Before treatment you will discuss and sign a consent form with your clinical oncologist or therapeutic radiographer. They will tell you what your chances are of getting early or late side effects.
When you consent to treatment, you are saying you understand that you have a chance of getting early and late side effects. Your team will use words like Expected, Common, Less Common and Rare.
| Wording on the consent form | % chance of side or late effect | How many patients will get this? |
| Expected | 50 to 100% | Between half and all patients |
| Common | 10 to 50% | Up to half of all patients |
| Less common | Less than 10% | Fewer than one in ten patients |
| Rare | Less than 1% | Fewer than one in 100 patients |
Possible general side effects
- Feeling very tired (fatigue): You might feel very tired during and after your treatment. It’s important to get plenty of rest but sometimes you will still feel really tired, even with lots of sleep. Some tiredness can be caused by having cancer and having cancer treatment and some can be caused by travelling to and from hospital every day for treatment.
- Pain: It is often the case that any symptoms you are being treated for i.e. pain may get worse during treatment before you feel any relief or benefit. This is normal and can affect people differently. Some people may experience this in the weeks after treatment too.
- Skin reactions: You might notice a change in colour, swelling, itching or changes in the texture of your skin where you’re treated. For people with lighter skin tones these changes can be pink, red or darker than the surrounding area. People with brown and black skin tones might have colour changes such as maroon, purple, yellow or grey pigment changes. The skin can also look darker than the surrounding area. These changes usually improve after treatment.
- Hair loss: you might lose hair in the area where you are treated. Often, this grows back over time, but not always.
- Sickness: Sometimes you might feel sick (nausea) or be sick. This is more common if treatment is near your brain or stomach.
What to do about side effects
- Drinking fluids: Drinking plenty of fluids such as water and squash can help with fatigue and tiredness caused by your treatment. It can also help flush out toxins in your body caused by treatment. You can try diluted juice if you don’t like water.
- Skin reactions: Your treatment team can suggest creams to soothe your skin. Sometimes, extra care is needed if the skin breaks down in the treatment area. Wear loose clothing and protect the treatment area from direct sun exposure.
- Keeping active: If possible gentle movement can help you feel better, both during and after treatment. Your treatment team can tell you what is safe for you to do.
- Resting: Get lots of sleep and take breaks if you feel tired.
- Sickness: Your doctor or treatment team might give you a tablet called an antiemetic to help reduce sickness this is sometimes taken before radiotherapy treatment is given.
- Alcohol use: Please follow the NHS guidelines on safe drinking levels and any instructions you get from your team on what is right for you, your diagnosis and your treatment. If in doubt, please ask your team.
- Stop smoking: If you are looking to stop or reduce smoking, there are services available to help you. Please see the links at the bottom of this page for more information.
Always talk to your treatment team about any side effects you have. There may be ways they can help you reduce or manage symptoms.
For side effects specific to the area you are having treatment on go to the different cancer sites here and select the area of the body relevant to you. Remember when looking at these pages it is less likely you will have many of the side effects listed, as the treatment you receive will be much gentler because you are having a lower dose of radiotherapy.
Further information
Macmillan Cancer Support | The UK’s leading cancer care charity
Pelvic Radiation Disease Association
Learn more about radiation skin reactions here:
Learn more about managing cancer fatigue:
Managing and treating cancer fatigue | Cancer Research UK
Cancer-related fatigue | NHS inform
Advice and support on reducing alcohol use:
Drink less – Better Health – NHS (www.nhs.uk)
NHS stop smoking services:
