Q&A on Radiation Effects

By Carol L. Kornmehl, MD
Attending Radiation Oncologist,
The Valley Hospital, Ridgewood, New Jersey

Will I be radioactive?

A: The way external beam radiation therapy is delivered can be compared to a light bulb. The radiation beam is either on or off. While you are receiving external beam radiation therapy, there is radioactivity in the room. Once the beam shuts off, there is no further radioactivity.

If you undergo brachytherapy, however, and if your sources of radiation are permanent, you are radioactive until your implanted radioactive sources decay to background level. If you have a temporary implant or insertion, you are radioactive until the sources are removed.

May I go in the sun?

A: I do not recommend sunbathing for anybody, because of the risk of skin cancer. However, sun exposure is inevitable when anyone walks outdoors. I recommend using sun block with at least SPF 30 on sun-exposed surfaces. If your irradiated area can be covered by wearing opaque, protective clothing, it is prudent to do so, because a sunburn on irradiated skin can complicate matters.

May I go swimming?

A: Yes. If you go swimming during a course of radiation therapy, be sure that when you come out of the water and dry yourself you apply moisturizer to the irradiated skin. If you experience ulceration of the irradiated skin, do not swim until the skin heals.

Will you do X-rays during the treatment?

A: Unless you have a specific symptom that warrants an X-ray, imaging studies are generally not ordered. Your radiation oncologist usually orders studies only if the findings might change what he or she would otherwise do.

What happens if I miss a treatment?

A: It’s ideal to go through your treatment course without missing any days. In reality, however, people often do miss a day because of a holiday, vacation, inclement weather, illness, or machinery malfunction. As long as the treatment break is not prolonged, there is no consequence from missing a treatment. You do not need to start all over again; you simply continue where you left off.

Is there any special diet that I should follow?

A: During the course of radiation therapy, you can continue your normal diet. If you report any symptoms that warrant making modifications in your diet, your radiation oncologist will let you know. If your appetite is poor, the best thing is to eat many small portions frequently rather than three main meals a day. There is no restriction on eating before a radiation treatment.

Will I get sick?

A: Radiation therapy affects only the body sites being treated. If your stomach and intestinal area are not in the treatment field, you will not experience any nausea, vomiting, or diarrhea from radiation therapy.

Will I get burned?

A: Most tumors are treated with high-energy radiation therapy beams, which spare the skin. When more superficial beams are used for radiation treatment that’s intended to treat the skin or the tissue just under the skin, a burn might occur.

When will I stop feeling so tired?

A: If fatigue is caused solely by radiation therapy, it should resolve within six months after you complete radiation therapy.

However, multiple factors can compound radiation therapy-induced fatigue. These include travel to receive radiation treatments, sleep deprivation, emotional distress, chemotherapy, medications, fluid and mineral imbalances, nutrition problems, anemia, hypothyroidism, diminished production of cortisol (a hormone produced in the body that gives people a sense of well-being), and miscellaneous factors.

If you feel fatigued, you need not push yourself to do unnecessary activities. Exercise actually improves fatigue, but be sure to discuss physical exercise with your physician before you embark on a program. Yoga and tai chi are always excellent choices.

I have no side effects. Does this mean that radiation therapy is not working?

A: No. Complications are not necessary in order to benefit from radiation therapy. In fact, many patients experience no side effects during radiation therapy and still achieve the desired, beneficial effect.

Reprinted with permission from The Best News About Radiation Therapy: How to Cope and Survive by Carol L. Kornmehl, MD.