Patient Information

Frequently Asked Questions

How does radiation therapy work?
What are the benefits and goals of radiation therapy?
Are there risks involved?
How is radiation therapy given?
Who administers radiation treatments?
Is radiation therapy expensive?
Are the side effects the same for every patient?
Will side effects from treatment limit my activities?
What causes fatigue?
How are skin problems treated?
What can be done about hair loss?
What if I experience problems eating?
What side effects occur with radiation therapy to the breast and chest?
What side effects occur with radiation therapy to the head and neck region?
What side effects occur with radiation therapy to the pelvis?
What side effects occur with radiation therapy to the stomach and abdomen?
Does radiation treatment affect my emotions?
What does follow-up mean?
Who provides care after therapy?
What if pain is a problem?
How can I help myself after radiation therapy?
When should I call the doctor?
What questions should I ask about follow up care?
What about returning to work?

How does radiation therapy work?

Radiation therapy works by damaging the DNA (genes) of tumor cells. DNA damage stops tumor cells from dividing, growing and spreading. Radiotherapy is a useful tool for treating cancer because cancer cells grow and divide more rapidly than most normal cells around them.

Although some normal cells are affected by radiation, most normal cells appear to recover more fully from the effects of radiation than do cancer cells. Your radiation oncologist will carefully limit the intensity of treatments and the area being treated so that the cancer will be affected more than the normal tissues.

What are the benefits and goals of radiation therapy?

Radiotherapy is an effective means of treating many types of cancers in almost any part of the body. Nearly two-thirds of all cancer patients receive radiation during the course of their disease, and the number of cancer patients who have been cured is rising every day.

For many patients, radiation is the only treatment needed. Thousands of patients are free of cancer after having radiation therapy alone or in combination with surgery, chemotherapy or both.

Your doctors may choose to use radiation before surgery to shrink your tumor. Or radiation may be used after surgery to sterilize microscopic tumor cells potentially left behind. Your doctor may use radiation along with chemotherapy.

Even if cure of your cancer is not possible, radiotherapy may still be indicated to bring relief from symptoms caused by the tumor. Many patients find that the quality of their lives is greatly improved when radiation is given to shrink tumors and reduce pressure, bleeding, pain or other distressing symptoms. This is called palliative radiation therapy.

Are there risks involved?

Like all other treatments of cancer, there are risks for patients who undergo radiation therapy. Radiation used to damage or destroy cancer cells may also hurt normal cells. When this happens, patients may experience side effects.

The risk of side effects, however, is less than the potential benefits of killing cancer cells. Your radiation oncologist will not advise you to undergo treatment unless its potential benefits (control of disease and relief of symptoms) are greater than its potential risks.

How is radiation therapy given?

Radiotherapy can be delivered using one of two approaches: external or internal radiotherapy. Some patients, however, may require both forms.

Most patients who receive treatment undergo external beam radiotherapy. Such treatment is typically delivered as an outpatient visits once daily (Monday through Friday) over several weeks. In some cases, your doctor may choose to deliver several treatments per day. In external therapy, a machine known as a linear accelerator (linac) is used to direct high-energy x-rays or particles (electrons) at the cancer.

When internal radiation therapy, also known as brachytherapy, is indicated, a radioactive substance, or source, is used. Another name for internal radiation therapy is an “implant”. During the implant procedure, a radioactive source is placed either next to (intracavitary implant) or within (interstitial implant) the tumor.

To aid in the delivery of the treatment, a small plastic or metal apparatus may be temporarily inserted into the body which holds the radioactive source in its proper place.

Two primary methods are used to deliver brachytherapy: low-dose-rate (LDR) and high-dose-rate (HDR) techniques. For much of the last century, patients were treated with LDR brachytherapy which delivered treatment slowly over several days. LDR required the patient to be admitted to the hospital and typically placed at strict bedrest.

Today, patients undergoing brachytherapy are treated predominantly with HDR techniques administered over a few minutes on an outpatient basis. At UCSD, HDR is the treatment of choice for all patients undergoing brachytherapy.

Who administers radiation treatments?

A doctor who has had special training in using radiation to treat disease, known as a Radiation Oncologist, will prescribe the type and amount of treatment that is required in your individual case.

Radiation Oncology, however, is a team approach and many professionals are involved in the planning and delivery of your treatment. Your radiation team includes:

A Medical Physicist, who makes sure that the equipment is working properly and that the right dose of radiation is delivered;
A Dosimetrist, who works closely with your Radiation Oncologist and Medical Physicist to develop your treatment plan;
A Radiation Oncology Nurse, who provides nursing care and helps you learn about treatment and how to manage side effects;
A Radiation Therapist, who sets you up everyday on the treatment table and operates the radiation equipment under the supervision of your Radiation Oncologist and Medical Physicist;
A Social Worker, who addresses any social or psychological needs that may arise prior to, during or after your treatment.

Click here to learn more about the different professionals involved in the Radiation Therapy treatment process.

Is radiation therapy expensive?

Treatment of cancer with radiation therapy can be costly. It requires very complex equipment and the services of many health care professionals. The exact cost of your radiation therapy will depend on the type and number of treatments you need. Fortunately, most health insurance policies, including Medicare, cover charges for radiation therapy.

Prior to treatment, a financial specialist at UCSD will contact your insurance provider to obtain authorization of the treatment you require. If you have any questions or concerns regarding financial issues, please bring them to the attention of your Radiation Oncologist, Nurse and/or Social Worker.

Are the side effects the same for every patient?

Side effects of radiation treatment vary from patient to patient. You may have no side effects or only a few mild ones during your treatment. Or you may have more serious side effects. The side effects that you experience depend mostly on the treatment dose and the part of the body treated.

Your general health may also affect how your body reacts to radiation and whether you develop side effects. Before beginning treatment, your Radiation Oncologist and Radiation Nurse will discuss the side effects that you may experience, how long they might last, and how serious they might be.

There are two main types of side effects: acute and chronic. Acute, or short-term, side effects occur during the treatment and are usually gone completely within a few weeks of finishing treatment. Chronic, or long-term, side effects may take months or years to develop and may be permanent.

The most common side effects include fatigue and skin irritation. Fatigue may result from treatment to any site in the body. Skin irritation may not occur, particularly if tumors deep inside the body are treated. However, if it does, it is limited to the area treated.

Side effects in general are related to the area treated. For example, hair loss may occur when undergoing treatment to the head. Diarrhea may occur when undergoing treatment to the abdomen or pelvis.

Fortunately, most side effects will go away in time. In the meantime, there are ways to reduce the discomfort they cause. If you have a side effect that is particularly severe, your Radiation Oncologist may prescribe some medications or a break in your treatment you’re receiving.

Be sure to tell you Radiation Oncologist, Radiation Nurse, or Radiation Therapist about any side effects that you notice. They can help you treat the problems.

Will side effects from treatment limit my activities?

Not necessarily. It will depend on what side effects you develop and how severe they are. Many patients are able to return to work, do light house keeping, and enjoy leisure activities while they are receiving radiation therapy.

Other patients find that they need to rest more than usual and therefore can’t do as much. You should try to do the things you enjoy as long as you don’t become too tired.

Your Radiation Oncologist may suggest that you limit activities that might irritate the area being treated. In most cases, you can have sexual relations if you wish.

Your desire for physical intimacy may be lower because radiation therapy may cause you to feel more tired than usual. Other treatments you may be receiving, including chemotherapy or hormones, may also reduce your sexual desire.

What causes fatigue?

The cause of fatigue due to radiotherapy is not well understood. During treatment, the body uses a lot of energy healing itself. Stress related to your illness, daily travel for treatment, and the effects of radiation on normal cells all may contribute to fatigue.

Most patients undergoing treatment begin to feel tired after a few weeks. Feelings of weakness or weariness will generally go away gradually after your treatment is complete.

You can help yourself during radiation therapy by not overexerting yourself. If you feel tired, limit your activities and use your leisure time in a restful way. Do not feel that you have to do all the things you normally do. Try to get more sleep at night, and rest during the day whenever possible.

If you have been working a full-time job, you may want to continue doing so during treatment. Although treatment visits are time-consuming, you can ask your treatment to be scheduled with your workday in mind. Inform the Radiation Nurse and/or Social Worker if your boss or employee requests a letter regarding reduced hours or time off.

Some patients prefer to take a few weeks off from work while they are receiving radiation therapy. Others work a reduced number of hours. You may want to speak frankly with your employer about your needs and wishes during this time. You may be able to agree on a part-time schedule, or perhaps you can do some work from home.

Whether you’re going to work or not, it’s a good idea to ask family members or friends to help with the daily chores, shopping, child care or driving. Neighbors may be able to help by picking up groceries for you when they do their own shopping.

You could also ask someone to drive you to and from your treatment visits if you feel very tired. However, the great majority of patients undergoing radiation do not experience fatigue preventing them from driving.

How are skin problems treated?

You may notice that your skin in the treatment area may begin to look reddened, irritated, sunburned, or tanned. After a few weeks, you may have dry skin from therapy. Ask you Radiation Nurse for advice on relieving itching or discomfort. Skin irritation may be particularly severe in areas where they are skin folds.

It is important to notify your Radiation Oncologist or Radiation Nurse if such reactions occur. They can give you suggestions on how these symptoms can be treated.

During treatment, you will need to be very gentle with the skin in the treatment area. Avoid irritating the treated skin unnecessarily. When you bathe, use only lukewarm water and mild soap. Don’t wear tight clothing. It is important not to rub, scrub, or scratch any sensitive spots. Also avoid putting anything on the skin that is very hot or very cold, such as heating pads or ice packs.

Don’t use any creams, ointments, lotions or home remedies in the treatment area while you are being treated (unless approved by your doctor or nurse). Many skin products can leave a coating on the skin that can actually worsen the effects of radiation.

Avoid exposing the treated area to the sun for prolonged periods during treatment and for at least a year after your treatment is completed. If you expect to be in the sun for a prolonged period of time, you will need to be very careful. Wear protective clothing (such as a hat with a broad brim and a shirt with long sleeves) and use sun screen. Ask your doctor or nurse about using sun-blocking lotions.

Fortunately, the majority of skin reactions to radiation therapy go away a few weeks after treatment is finished. In some cases, though, the treated skin will remain darker than it was before.

What can be done about hair loss?

Radiation treatment may cause hair loss, also known as alopecia, but only in the area being treated. For example, if you are receiving treatment to your hip, you will not lose hair from your head. However, radiation to your head may cause you to lose some or all the hair on your scalp.

Many patients undergoing radiotherapy find that their hair grows back again after the treatment is finished, but accepting the loss of hair can be a hard adjustment. The amount of hair that grows back will depend on how much radiation you received.

Other types of treatment, such as chemotherapy, also may affect how your hair grows back. Sometimes when hair re-grows, it may be different, e.g. lighter, finer or even curlier.

Although your scalp may be tender after the hair is lost, you may want to cover your head with a hat or scarf while you’re under treatment. Also, you should wear a protective cap or scarf when you’re in the sun. If you prefer a wig or toupee, be sure the lining does not irritate your scalp.

A hairpiece that you need because of cancer therapy is a tax-deductible expense and may be covered in part by your health insurance provider. If you plan to buy a wig, it’s a good idea to select it early in you treatment so that you can match the color and style to your own hair.

What if I experience problems eating?

Many side effects can cause problems with eating and/or digesting food, but you always should try to eat enough to help damaged tissues heal. It is very important not to lose weight during radiation therapy.

Try to eat small meals often and eat a variety of different foods. Your Radiation Oncologist or Nurse can tell you whether your treatment calls for a special diet.

If you experience pain when you chew or swallow, your doctor may advise you to a liquid dietary supplement. Many of these products, available at your neighborhood drugstore, are made in a variety of flavors. They are tasty when used alone, or they can be combined with other foods, such as fruit, or added to milkshakes.

Some of the companies that make diet supplements have produced recipe booklets to help you increase your nutrient intake.

You may lose interest in food during your treatment. Some people just don’t feel like eating because of the stress from their illness and treatment or because the treatment changes the taste of certain foods. Even if you are not hungry, it is important to make every effort to keep your protein and calories intake high.

Doctors have found that patients who eat well can better handle both their cancer and the side effects of treatment.

The list below includes suggestions are ways to perk up your appetite during treatment:

Eat when you are hungry, even if it is not mealtime
Eat several small meals during the day rather than 3 large ones
Use soft lighting, quiet music, brightly colored table settings or whatever helps you feel good while eating
Vary your diet and try new recipes
If you enjoy company while eating, try to have means with family and/or friends, or turn on the radio or television
Ask your doctor or nurse whether you can have a glass of wine or beer with your meal to increase your appetite. Keep in mind that in some cases, alcohol may not be allowed because of the chance that it will worsen the side effects of therapy. This may be especially true if you are receiving radiation therapy for cancer of the head and neck region
When you feel up to it, make some simple meals in batches and freeze them to eat later
Keep healthy snacks close by for nibbling when you get the urge
If other people offer to cook for you, let them. Don’t be shy about telling them what you’d like to eat
If you live alone, you might want to arrange for “Meals on Wheels” to bring food to you. Ask your Radiation Nurse or Social Worker for information on this service
If you are able to eat only small amounts of food, you can increase the calories per serving by
- Adding butter or margarine if you like the flavor
- Mix canned cream soups with mild or half-and-half rather than water
- Drink eggnogs, milkshakes or prepared liquid supplements between meals
- Add cream sauce or melted cheese to your favorite vegetable
- Some people find that they can handle large amounts of liquids even when they don’t feel like eating solid foods. If this is the case for you, try to get the most of each glassful by having drinks enriched with powdered mild, yogurt, honey, or prepared liquids supplements.

Does radiation treatment affect my emotions?

Nearly all patients who receive treatment for cancer feel some degree of emotional upset. It’s not unusual to feel depressed, afraid, angry, frustrated, alone, or helpless. Radiation may affect these emotions indirectly through fatigue or changes in your hormonal balance, but the treatment itself does not directly cause mental distress.

Many patients help themselves by talking about their feelings with a close friend, family member, chaplain, nurse, social worker, or psychologists with whom they feel at ease. You may want to ask you nurse or social worker about meditation or relaxation exercises that you could help you unwind and feel better.

American Cancer Society nationwide programs may also provide additional support. Groups such as the United Ostomy Association and the Lost Chord Club offer opportunities to meet with others who share your same problems and concerns. Local and National Programs exist for nearly every disease site. Remember to ask you Social Worker for support groups held at the UCSD Cancer Center.

What side effects occur with radiation therapy to the head and neck region?

Some patients who are having radiation to the head and neck have redness and irritation in the mouth, dry mouth, difficulty swallowing, changes in taste, or nausea. Try not to let these symptoms keep you from eating during treatment.

Other problems that may occur during treatment include the loss of your sense of taste, earaches, and swelling or drooping of the skin under the chin. There may be changes in your skin texture. You also may notice that your jaw feels stiff and that it is more difficult to open your mouth widely. Jaw exercises may help this problem. Remember to report all side effects to your Radiation Oncologist and Nurse and ask what you should do about them.

If you are receiving radiation therapy to the head or neck, you need to take especially good care of your teeth, gums, mouth, and throat. Side effects from treatment to these areas most often involve the mouth, which may be sore and dry. Here are a few tips that may help you manage mouth problems:

Avoid spices and coarse foods such as raw vegetables, dry crackers, and nuts
Don't smoke, chew tobacco, or drink alcohol
Stay away from sugary snacks that promote tooth decay
Clean your mouth and teeth often, using the method your dentist or doctor recommends
Do not use acommercial mouthwash; the alcohol content has a drying effect on mouth tissues

Radiation treatment for head and neck cancer can increase your chances of getting cavities. Mouth care designed to prevent problems will be a very important part of your treatment.

Before starting radiation, you should be seen by a dentist who has experience with radiation therapy patients. Your dentist may need to consult with your radiation oncologist about any dental work you need before your treatments begin.

Soreness in your mouth or throat may appear in the second or third week of external radiation therapy. It is likely to end a month or so after your treatment is complete. You may have trouble swallowing during this time because your mouth feels dry. Your doctor or dentist can prescribe medicine for mouth discomfort and advise you about methods to relieve other mouth problems.

If you wear dentures you may notice that they no longer fit well. This may happen if the radiation causes swelling in your gums. It's important not to let your dentures cause gum sores that may become infected. You may need to stop wearing your dentures until your radiation therapy is over.

Although newer radiation techniques such as IMRT reduce the risk of dry mouth, it is still possible that you may still experience some dryness. If this is a problem for you, it's helpful to sip cool drinks often throughout the day. Water probably is your best choice. In the morning, fill up a large cup or glass with ice, add water, and carry it with you so you have something to drink during the day. Keep a glass of cool water at your bedside at night, too.

Some patients say that drinking carbonated beverages helps relieve dry mouth. Sugar-free candy or gum also may help. Avoid tobacco and alcoholic drinks because they will dry and irritate your mouth tissues even more. Moisten food with gravies and sauces to make eating easier. If these measures are not enough, ask your dentist about artificial saliva.

Soreness or dryness in your mouth or throat can make it hard to eat. However, there are several ways to ease your discomfort:

Choose foods that taste good to you and are easy to eat
Try changing the consistency of foods by adding fluids and using sauces and gravies to make them softer
Avoid highly spiced foods and textures that are dry and rough, such as crackers
Eat small meals, and eat more frequently than usual
Cut your food into small, bite-sized pieces
Ask your doctor for special liquid medicines that can help you eat and swallow more easily by reducing the pain in your throat
Ask your doctor about liquid food supplements. These can help you meet your energy needs
Try to drink extra fluids. This will help keep mucus and other secretions thin and manageable
If your sense of taste changes during radiation therapy, try different methods of food preparation

What side effects occur with radiation therapy to the breast and chest?

Radiation treatment to the chest may cause several changes. You will notice some of these changes yourself, and your treatment team will keep an eye on these and others. For example, you may find that it is hard to swallow or that swallowing hurts. You may develop a cough. Or you may develop a fever, notice a change in the color or amount of mucus when you cough, or feel short of breath.

It is important to let your treatment team know right away if you have any of these symptoms. Your doctor also may check your blood counts regularly, especially if the radiation treatment area on your body is large. Just keep in mind that your doctor and nurse will be alert for these changes and will help you deal with them.

If you are receiving radiotherapy after a lumpectomy or mastectomy, it's a good idea to go without wearing a bra whenever possible. If this is not possible, wear a soft cotton bra without underwires. This will help reduce the irritation to your skin in the treatment area.

You may have several other side effects if you are receiving radiation therapy for breast cancer. For example, you may notice a lump in your throat or develop a dry cough. Or, your shoulder may feel stiff; if so, ask your doctor or nurse about exercises to keep your arm moving freely.

Other side effects that may appear are breast soreness and swelling from fluid buildup in the treated area. These side effects, as well as skin reddening or tanning, most likely will disappear in 4 to 6 weeks. If fluid buildup continues to be a problem, your doctor will tell you what steps to take.

Women who have radiation therapy after a lumpectomy may notice other changes in the breast after the therapy. These long-term side effects may continue for a year or longer after treatment. The redness of the skin will fade, and you may notice that your skin is slightly darker, just as when a sun burn fades to a suntan. The skin pores may be enlarged and more noticeable.

Some women report increased sensitivity of the skin on the breast; others have decreased feeling. The skin and the fatty tissue of the breast may feel thicker, and you may notice that your breast is firmer than it was before your radiation treatment. Sometimes the size of your breast changes -it may become larger because of fluid buildup or smaller because of the development of fibrous tissue. Many women have little or no change in size.

After 10 to 12 months, no further changes are likely to be caused by the radiation therapy. If you see new changes in breast size, shape, appearance, or texture after this time, report them to your doctor at once.

What side effects occur with radiation therapy to the stomach and abdomen?

If you are having radiation treatment to the stomach or some portion of the abdomen, you may have to deal with an upset stomach, nausea, or diarrhea. Your doctor can prescribe medicines to relieve these problems. Do not take any home remedies during your treatment unless you first check with your doctor or nurse.

Some patients undergoing radiation to the stomach or abdomen report feeling queasy for several hours after radiation therapy. If you have this problem, do not eat for several hours before your treatment time. You may be able to handle the treatment better on an empty stomach.

After your treatment, you may find it helpful to wait 1 to 2 hours before eating again. If the problem persists, ask your doctor to prescribe a medicine to prevent nausea. If such medications are prescribed, try to take them when your doctor suggests, even if you sometimes feel that they are not needed.

If your stomach feels upset just before your treatment, try a bland snack such as toast or crackers and apple juice before your appointment. This type of side effect may be related to your emotions and concerns about treatment. Try to unwind a bit before you have your treatment. Reading a book, writing letters, or working a crossword puzzle may help you relax.

Here are some tips to help an unsettled stomach:

Stick to any special diet that your doctor or dietitian gives you
Eat small meals
Eat often and try to eat and drink slowly
Avoid foods that are fried or are high in fat
Drink cool liquids between meals
Eat foods that have only a mild aroma and those that can be served cool or at room temperature
For a severe upset stomach, try a clear liquid diet (broth and juices) or bland foods that are easy to digest, such as dry toast and gelatin

Radiation therapy to the stomach and abdominal region may result in diarrhea. Diarrhea most often begins in the third or fourth week of radiation therapy. Your doctor may suggest you change your diet, prescribe medicine for you, or give you special instructions to help with the problem. Tell the doctor or nurse if these changes are not controlling your diarrhea.

The following changes in your diet also may help:

Try a clear liquid diet (water, weak tea, apple juice, clear broth, plain gelatin) as soon as diarrhea starts or when you feel that it's going to start
Ask your doctor or nurse to advise you about liquids that won't make your diarrhea worse. Apple juice, peach nectar, weak tea, and clear broth are frequent suggestions.
Avoid foods that are high in fiber or can cause cramps or a gassy feeling such as raw fruits and vegetables, coffee, beans, cabbage, whole grain breads and cereals, sweets, and spicy foods.
Eat frequent small meals
Avoid milk and milk products if they irritate your bowels
When the diarrhea starts to improve, try eating small amounts of low-fiber foods such as rice, bananas, applesauce, mashed potatoes, low-fat cottage cheese, and dry toast
Be sure your diet includes foods that are high in potassium (bananas, potatoes, apricots), an important mineral that you may lose through diarrhea.

Diet planning is a very important part of radiation treatment of the stomach and abdomen. Keep in mind that these problems will be reduced greatly when treatment is over. In the meantime, try to pack the highest possible food value into even small meals so that you will have enough calories and vital nutrients.

What side effects occur with radiation therapy to the pelvis?

If you are having radiation therapy to any part of the pelvis (the area between your hips), you might have one or more of the digestive problems already described. You also may have some irritation to your bladder. This can cause discomfort or frequent urination. Drinking fluids can help relieve some of your discomfort. Your doctor can prescribe some medicine to deal with these problems.

There are also certain side effects that occur only in the reproductive organs. The effects of radiation therapy on sexual and reproductive functions depend on which organs are treated. Some of the more common side effects for both men and women do not last long after treatment. Others may be long-term or permanent. Before your treatment begins, ask your doctor about possible side effects and how long they might last.

Scientists are still studying how radiation treatment affects fertility. If you are a woman in your childbearing years, you should discuss birth control measures with your doctor. It is not a good idea to become pregnant during radiation therapy.

Radiation may injure the fetus. In addition, pregnancy, childbirth, and caring for a very young child can add to the physical and emotional stress of having cancer. If you are pregnant before beginning radiation therapy, special steps should be taken to protect the fetus from radiation.

Depending on the radiation dose, women having radiation therapy in the pelvic area may stop menstruating and may have other symptoms of menopause. Treatment also can result in vaginal itching, burning, and dryness. You should report these symptoms to your doctor or nurse, who can suggest treatment.

For men, radiation therapy to an area that includes the testicles can reduce both the number of sperm and their effectiveness. This does not mean that conception cannot occur, however. If you're having this type of treatment, discuss your concerns and your birth control measures with your doctor. If you want to father a child and are concerned about reduced fertility, you can look into the option of banking your sperm before treatment.

During treatment to the pelvis, some women are advised not to have intercourse. Others may find that intercourse is painful. You most likely will be able to resume having sex within a few weeks after your treatment ends.

Some shrinking of vaginal tissues occurs during radiation therapy. After your therapy is finished, your doctor will advise you about sexual intercourse and how to use a dilator, a device that gently stretches the tissues of the vagina.

A new form of therapy was recently introduced to improve sexual function in the irradiated patient known as the Eros Clitoral Therapy Device.

With most types of radiation therapy, neither men nor women are likely to suffer any change in their ability to enjoy sex. Both sexes, however, may notice a decrease in their level of desire. This is more likely to be due to the stress of having cancer than to the effects of radiation therapy. This effect most likely will go away when the treatment ends, so it should not become a major concern.

What does follow-up mean?

Once your course of radiation therapy is finished, it is important to have regular exams to check the results of your treatment. No matter what type of cancer you've had, you will need regular checkups and perhaps lab tests and x-rays.

The radiation oncologist will want to see you at least once after your treatment ends. The doctor who referred you for radiation therapy will schedule follow-up visits as needed. Follow-up care, in addition to checking the results of your treatment, might also include more cancer treatment, rehabilitation, and counseling. Taking good care of yourself is also a part of following through after radiation treatments.

Who provides care after therapy?

Most patients return to the radiation oncologist for regular follow-up visits. Others are referred back to their original doctor, to a surgeon, or to a medical oncologist, a doctor who is trained to give chemotherapy (treatment with anticancer drugs). Your follow-up care will depend on the kind of cancer you have and on other treatments that you had or may need.

What if pain is a problem?

A few patients need help to manage pain if it continues after radiation therapy. You should not use a heating pad or warm compress to relieve pain in any area treated with radiation. Mild pain medicine may be enough for some people. If you have severe pain, ask the doctor about prescription drugs or other methods of relief. Be as specific as possible when telling the doctor about your pain so you can get the best treatment for it. If you are unable to get relief from pain, you may want to talk with a doctor who is a pain specialist.

Because pain can be worse when you are afraid or worried, it may help to try relaxation exercises. Other methods such as hypnosis, biofeedback, and acupuncture may be useful for some cancer patients.

How can I help myself after radiation therapy?

Patients who have had radiation therapy need to continue some of the special care used during treatment at least for a short while. For instance, you may have skin problems for several weeks after your treatments end. You should continue to be gentle with skin in the treatment area until all signs of irritation are gone. Don't try to scrub off the marks in your treatment area. They will fade and wear away.

You may find that you still need extra rest while your healthy tissues are rebuilding. Keep taking naps as needed and try to get more sleep at night. You may need some time to test your strength, little by little, so you may not want to resume a full schedule of activities right away.

When should I call the doctor?

After treatment for cancer, you're likely to be more aware of your body and to notice even slight changes in how you feel from day to day. The doctor will want you to report any unusual symptoms. If you have any of the problems listed below, tell your doctor at once:

A pain that doesn't go away, especially if it's always in the same place
Lumps, bumps, or swelling
Nausea, vomiting, diarrhea, or loss of appetite
Unexplained weight loss
A fever or cough that doesn't go away
Unusual rashes, bruises, or bleeding.
Any other signs mentioned by your doctor or nurse

What questions should I ask about follow up care?

The following are some of the questions that you may want to ask your Radiation Oncologist after you have finished treatment:

How often do I need to return for checkups?
Why do I need more x-rays, scans, blood tests, and so on? What will these tests tell us?
Will I need chemotherapy, surgery, or other treatments?
How will you know if I'm cured of cancer? What are the chances that it will come back?
How soon can I go back to my regular activities? Work? Sexual activity? Sports?
Do I need to take any special precautions?
Do I need a special diet?
Should I exercise?

What about returning to work?

A very common question after completing Radiation Therapy is regarding returning to work. Many people continue to work during therapy, but if you have stopped working, you can return to your job as soon as you feel up to it, even while your radiation therapy is continuing.

If your job requires lifting or heavy physical activity, you may need to change your activities until you have regained your strength.

When you are ready to return to work, it is important to learn about your rights regarding your job and health insurance. If you have any questions about employment issues, contact the Cancer Information Service or the American Cancer Society . They can help you find local agencies that respond to problems cancer survivors sometimes face regarding employment and insurance rights.

This material was taken in part from the booklet Radiation Therapy and You published by the National Institutes of Health.

Answers to additional frequently asked questions regarding radiation therapy can be found on the ASTRO website.