Early Side effects (during/soon after treatment)
General – Fatigue is common in the second half of treatment and is very variable between patients. Fatigue may persist for several weeks after treatment.
Local –The acute side effects to the skin will be discussed here. However additional acute side effects may be relevant to you depending on what part of the body is being treated, the type of radiation being used and what tissues or organs are in the path of the radiation therapy.
Your Radiation Oncologist will explain what additional side effects are relevant to you based on what area of the body is being treated. For example, radiation to the skin on the face, scalp, groin, etc will have different tissues and organs nearby and therefore other possible acute side effects are specific to the area treated.
Skin reddening and irritation– The skin can become increasingly red and itchy during treatment. The peak of the skin reaction occurs 7-14 days after the treatment is completed. Skin blistering and peeling can also occur. Occasionally there may discomfort but strong pain medications are rarely required.
Loss of hair (alopecia)– Hair may fall out during or after radiation treatment. If hair loss occurs, it may be temporary or permanent.
What can help reduce acute side effects to the skin?
Resting as needed can help with fatigue. During treatment your Radiation Oncology team will provide advice on creams and dressings based on the degree of your skin reaction. Special creams can be used for itchy skin and if pain or discomfort occurs, pain medications can be prescribed. It is advised to keep the treatment area protected from the wind and sun. For sun protection during and immediately after treatment do not apply sunscreen to the skin receiving radiation. Instead wear a wide brimmed hat or loose-fitting protective clothing over the skin for sun protection.
Late or long-term side effects (Side effects well after treatment)
Late side effects may occur a few months to years after treatment. They are more uncommon than early side effects. Depending on the problem it may occur once and then go or may be more persistent over the long term or may come and go over time. The late side effects to the skin will be discussed here. However additional late side effects may be relevant to you depending on what part of the body is being treated, the type of radiation being used and what tissues or organs are beneath the skin being treated.
Your Radiation Oncologist will explain what additional late side effects are relevant to you based on what area of the body is being treated. For example, radiation to the skin on the face, scalp, groin, etc will have different tissues and organs nearby and therefore other possible late side effects are specific to the area treated.
Skin and underneath soft tissue changes – If permanent skin changes develop after treatment, they are mainly cosmetic and can be minimised. Occasionally the skin can be a little lighter or darker in the region that has received radiation. Tiny blood vessels under the skin may be come swollen and more prominent (telangiectasias) over time. Skin may become thinner and more easily injured with time. The tissues under the skin can become firmer and feel tighter.
Skin ulceration – This is a rare side effect of radiation treatment to the skin (usually less than 1%).
Radiation induced cancers – Second cancers occurring as a result of radiation therapy are an extremely rare side effect of radiation therapy, occurring more than 10-15 years after radiation therapy.
What can be done to minimise and treat late side effects?
To reduce the severity of late skin effects it is important to follow the detailed advice from your Radiation Oncologists & radiation therapy nursing staff regarding topical creams, dressings (if necessary) and general skin care.
Even after the acute skin reaction has resolved, the skin that has received radiation will always be more sensitive to the sun and more susceptible to slower healing. It is important to wear sunscreen with SPF 30 or higher to any previously treated skin if it is exposed while in the sun. In addition to sunscreen, a wide brimmed hat or protective clothing is a good idea. Makeup can be used to conceal skin paleness & telangiectasia. Massage and physiotherapy treatments can help soft tissue firmness. In the rare instance that a non-healing skin ulcer develops after radiation treatment, surgery can be performed to repair the skin.