Feeling good during radiation therapy. Radiation therapy (radiotherapy). What is it and what is its essence? Indications, types and methods of radiation therapy. Consequences after radiation therapy of the brain

After the course radiotherapy patients develop radiation sickness, which has a depressing effect on many vital important features organism.

The development of radiation sickness is due to the fact that healthy tissue cells are affected by ionizing radiation along with tumor cells.

Ionizing radiation has the ability to accumulate in the body.

early and emerging later signs radiation sickness - pain, nausea and vomiting, swelling, fever, intoxication, cystitis, etc. - are caused by negative impact on active cells of the body of ionizing radiation. Epithelial cells most susceptible to damage gastrointestinal tract, nervous tissue, immune system, bone marrow, genital organs.

The intensity of the manifestations of radiation sickness varies depending on the radiation exposure and the characteristics of the patient's body. What should cancer patients do to prevent complications after radiation therapy and to improve their well-being?

Radiation sickness has several stages, with each subsequent stage of the disease characterized by an increase in symptoms and a deterioration in the patient's condition. So, if at first a person is only worried about general weakness, loss of appetite and dyspeptic symptoms, then over time, with the development of the disease, he feels a pronounced asthenization (weakening) of the body, suppression of immunity and neuroendocrine regulation.

Serious damage can develop after radiation therapy skin- so-called. radiation burns requiring rehabilitation. Radiation burns often go away on their own, but in some cases they are so severe that they may require special medical attention.

Radiation therapy can also provoke inflammatory processes that easily turn into complications such as exudative epidermitis, esophagitis, pulmonitis, and perichondritis. Sometimes complications affect the mucous membranes of organs located close to the site of exposure to the rays.

In addition, radiation therapy can have a serious impact on the hematopoietic process in the body. So, the composition of the blood may change, in particular, anemia develops when the amount of hemoglobin in the blood falls below the permissible limit.

It should be noted that high-tech modern equipment minimizes possible complications.

During the recovery period, it is necessary to periodically check the results of therapy, take necessary tests regularly undergo a follow-up examination by an oncologist.

The specialist will establish the cause of the violations in time, give the necessary recommendations, prescribe the necessary drugs for treatment.

For example, erythropoietin-based drugs, as well as iron supplements, vitamin B12, and folic acid, will help increase the amount of hemoglobin in the blood.

A serious reaction of the body to radiation therapy procedures can be depression, manifested incl. and increased irritability. It is necessary during this period to find positive emotions in life, to tune in to an optimistic mood. Very important in this difficult and responsible period of life is the support of loved ones.

Currently, an increasing number of patients who have undergone a course of radiation therapy successfully cope with the disease and return to a normal full life. However, it must be remembered that even if a person has recovered after a period of 2-3 years, one should not refuse regular examinations by a doctor in order to detect possible relapses, as well as courses of supportive and restorative therapy and spa treatment.

The use of phytotherapy to restore the body

Some patients recover fairly quickly after radiation therapy with rest and a balanced diet. In another part of patients, after treatment, there may be serious complications caused by general intoxication body and requiring medical assistance.

To speed up the recovery processes of the body, traditional medicine can also be of great help. An experienced phytotherapeutist will select herbs and their preparations that will help cleanse the body of radionuclides, improve the blood formula, strengthen the immune system and have a positive effect on the patient's well-being.

Use of lungwort

Experts recommend using lungwort preparations after radiation therapy.

The plant contains the richest complex of trace elements that contribute to the restoration and improvement of the blood formula.

In addition, taking plant preparations helps to stimulate and strengthen the immune system, increase the adaptogenic functions of the body, improve the psycho-emotional state, and get rid of emotional exhaustion.

For patients who have undergone radiation therapy, phytotherapists recommend using water infusion and alcohol tincture of the plant. There are no contraindications to lungwort preparations, but they should be used with caution in intestinal atony and increased blood clotting. Do not take plant preparations on an empty stomach - this can provoke nausea.

To prepare the infusion 2 tbsp. spoons of chopped herbs are poured with a glass of boiling water, insisted for 3-4 hours, filtered. Consume 1/4 cup 3-4 times a day, with a small amount of honey. Outwardly, the infusion can be used for douching the rectum or vagina.

Alcohol tincture is prepared as follows: raw chopped grass is placed in a 1 liter jar, filling 0.5 volumes (if the raw materials are dry, fill 0.3 volumes of the jar), pour vodka to the top, close and put for 14 days in a dark place. Filter out. Use the drug 1 teaspoon 3-4 times a day, with a little water.

Use of Rhodiola Rosea and Eleutherococcus

The use of adaptogen plants such as Rhodiola rosea and Eleutherococcus is very effective for the recovery of patients who are undergoing radiation therapy. The drugs weaken the toxic effects of radiation on the body and improve the blood count. Experts also point to antitumor properties plant data.

As medical preparations use alcohol tinctures of Rhodiola and Eleutherococcus. It is important to note that the stimulating effect of these drugs on hematopoiesis begins from the 5-6th day from the start of the use of drugs, and a pronounced therapeutic effect is observed by the 10-12th day. Therefore, it is better to start taking plant preparations 5-6 days before the start of irradiation.

An alcohol tincture of Rhodiola rosea is prepared as follows: 50 g of pre-crushed rhizomes are poured into 0.5 liters of vodka and placed for 2 weeks in a dark place, after which it is filtered. Take 20-30 drops 2-3 times a day half an hour before meals (the last dose should be no later than 4 hours before bedtime). For persons prone to high blood pressure, the drug begins with 5 drops three times a day. In the absence of negative effects, the dose is increased to 10 drops.

Alcohol tincture of Eleutherococcus drink 20-40 drops twice a day before meals. The course of treatment with drugs is 30 days. After a short break, the course of treatment can be repeated if necessary.

The use of herbs

For the rehabilitation of patients who are severely weakened after a course of radiation therapy, phytotherapists recommend using special healing fees herbs.

Healing infusions prepared from such collections supply the depleted body with vitamins, increase immunity, effectively remove toxins, and ensure the stable functioning of all organs and body systems.

Collection with such components as: birch (buds), immortelle (flowers), common oregano (grass), angelica officinalis (root), St. -and-stepmother ordinary (leaves), peppermint (leaves), medicinal dandelion (root), large plantain (leaves), motherwort (leaves), chamomile (flowers), common pine (buds), common yarrow (grass), thyme (herb), celandine (herb), medicinal sage (herb).

All components of the collection are taken in equal weight quantities, crushed and mixed. 14 art. spoons of the collection pour 3 liters of boiling water, cover with a lid, wrap tightly and let it brew for at least 8 hours. Next, the infusion is filtered through several layers of gauze, poured into a jar and stored in the refrigerator. The shelf life of the product is 5 days. Use the infusion 2 times a day: on an empty stomach (an hour before the first meal) and during the day (but not before bedtime). single dose- 1 glass of infusion. The infusion has no side effects, it can be used for a long time.

Use of bergenia and nettle

To improve the blood count, especially with a decrease in platelets, herbalists recommend using preparations of bergenia root and nettle leaves.

To prepare a decoction of bergenia root, pour 10 g of raw materials with a glass of boiling water, keep for 30 minutes in a water bath, insist for an hour, filter. Take 1-2 tbsp. spoon three times a day before meals.

To prepare a decoction of nettle 1 tbsp. a spoonful of fresh crushed leaves of the plant is poured into a glass of hot water, brought to a boil, boiled for 8-10 minutes. Remove from heat, let it brew for an hour, filter. Take 2-3 tbsp. spoons 3-4 times a day before meals.

In the cold season, you can use an infusion made from dry nettle leaves. 10 g of dry raw materials are poured with a glass of boiling water, insisted in a thermos for 20-30 minutes, filtered. Use healing infusion in small portions during the day, before meals.

Recall that any independent medical measures must be agreed with the attending physician without fail.

The topic of side effects and complications is one of the most important in medicine. “Do no harm” is the main commandment of the doctor’s activity at all times. A modern concept might look like this: the risk of disability and death from complications of treatment should not exceed similar risks from this disease.

There is no doubt that such a complex and dangerous type of treatment as radiation therapy, despite its high efficiency in oncology, fraught high risks side effects.

Classical radiosensitivity factors of cells and tissues.

proliferative activity of a cell or tissue
degree of differentiation
cell cycle phase
partial pressure of oxygen in tissues
functional stress or pathological processes in tissues

Law of Bergonier and Tribondo- radiosensitivity of tissues and cells is directly proportional to proliferative activity and inversely proportional to the degree of differentiation.

Phases of the cell cycle.

The maximum radiosensitivity is observed in the phase of mitosis, then in the postsynthetic and presynthetic periods. The maximum radioresistance is observed in the interphase and synthetic period. Thus, the radiosensitivity of a tissue is determined by the pool of cells proliferating in it.

The factors of radiosensitivity also include the partial pressure of oxygen in the tissue, the state of functional stress or the presence of pathological processes.

Taking into account radiosensitivity factors, let's list the most radiosensitive cells and tissues, although some of them do not obey the above laws:

- bone marrow stem cells

- epithelium

- germinal epithelium

– lymphocytes

- lens of the eye

Long-term effects of irradiation.

We must not forget that during irradiation, even in small doses in biological systems morphogenetic changes are possible. Long-term effects of exposure are divided into two types:

- deterministic effects

— stochastic effects

Deterministic Effects– are characterized by the presence of a radiation dose threshold, below which they are not observed. They appear in the form obvious pathology(radiation sickness, burns, cataracts, leukopenia, infertility, etc.).

Stochastic (probabilistic, random) effects– there is no dose threshold for the occurrence of these effects. Have a long latency period(years). They are non-specific.

To date, two types of stochastic effects have been proven:

malignant transformation as a result of mutations in the somatic cell genome

2. inherited birth defects in offspring with mutations in the germ cell genome

To date, the world scientific community has adopted non-threshold hypothesisbiological action ionizing radiation. Based on this hypothesis, at any level of absorbed dose, theoretically there is always the possibility of biological consequences. As the dose increases, the likelihood of consequences increases linearly with the absorbed dose.

In addition to the classical factors of radiosensitivity of cells and tissues, in order to understand the mechanisms of the biological action of ionizing radiation, it is necessary to state the theory "The character of cell population organization in various tissues".

According to the nature of the organization of the cell population, two types of tissues are distinguished:

Hierarchical fabrics. H-systems (hierarchial cell population). These are fast update systems.
Sequential Functional Fabrics. F-systems (flexible cell lineage). Slow update systems.
Tissues incapable of cellular renewal

H-systems consist of a hierarchy of cells from stem to functional. That. these tissues contain a large pool of dividing cells. These include: Bone marrow, epithelial tissues, germ cell epithelium.

F-systems consist of a homogeneous population of functionally competent cells that are predominantly in the interphase. These systems include: vascular endothelium, fibroblasts, cells of the parenchyma of the liver, lungs, kidneys.

In addition to H- and F-systems, tissues are isolated that are incapable of cell renewal in an adult organism ( nervous tissue and muscular).

When exposed to ionizing radiation on tissues with different organizational and cellular structure, they react differently in time and morphologically. This knowledge makes it possible to predict the type, time and severity of possible radiation-induced pathological processes.

So, in H-systems, early or acute radiation reactions predominate, which are associated with stopping the division of the most poorly differentiated stem cells, which normally provide the processes of reparative tissue regeneration.

For F-systems, distant biological consequences exposures associated with microcirculation disorders, slow parenchymal emptying and tissue fibrosis.

Stochastic radiobiological effects are typical for tissues incapable of cell renewal after irradiation in any doses.

Side effects of radiation therapy:

general (asthenic and intoxication syndrome, myelo- and immunosuppression)
local: radiation reactions and radiation damage.

The likelihood and severity of common side effects during radiotherapy depends on:

volume of irradiated tissues (spot, local, regional, subtotal, total irradiation)
irradiation zones (limbs, pelvis, mediastinum, abdominal cavity, celiac plexus, brain)
total absorbed dose.
general somatic condition of the patient

Beam reactions- this is reactive changes normal tissues under the influence of ionizing radiation that occur during the course of radiation therapy and last no more than 100 days (3 months) after its completion, which are reversible.

The main mechanism of pathogenesis: a temporary block of reparative regeneration.

Radiation reactions are typical for tissues with rapid renewal (H-systems: bone marrow, epithelial tissues). 100 days is deadline to repair sublethal damage to the genome. Radiation reactions occur in 100% of cases during the passage of radiation therapy.

A prime example is radiation dermatitis. Clinical manifestations occur after 10-15 sessions of radiation therapy. Most pronounced in the areas of folds (neck, axillary areas, perineum). The skin of the abdomen is highly radiosensitive. It is characterized by 4 degrees.

Another, no less clinically significant, manifestation of radiation reactions is radiation mucositis. It also has 4 levels. Most pronounced in radiation therapy of tumors of the oral cavity and abdominal cavity. It appears in the form radiation stomatitis and enteritis. Despite the temporary nature of these phenomena, but they can be so pronounced that they require stopping or stopping treatment, as well as significant medical correction.

The epithelium of the rectum Bladder, esophagus and stomach have a lower proliferation rate than in the oral cavity or small intestine. In this connection, radiation reactions may also be less pronounced.

The severity and likelihood of radiation reactions depends on the following factors:

irradiation zones
volume of irradiated tissues
total dose and radiation therapy fractionation regimen
initial state of reparation processes

The task of the radiotherapist: upon reaching the 2-3 degree of radiation reaction, stop treatment in order to preserve the reserve pool of stem cells (surviving cells of the basal layer that have gone into interphase), which will provide further repair of the epithelium.

Diseases such as diabetes, systemic atherosclerosis, immunodeficiency states, prolonged use of corticosteroid hormones and NSAIDs, hypotrophic status of the patient, decompensation of any somatic pathology, numerous courses of chemotherapy significantly disrupt reparative processes in tissues.

That. The role of therapeutic specialties related to oncology is enormous in terms of preparing the patient for radiation therapy, as well as in the post-radiation period. Tasks: correction and compensation of somatic pathology (diabetes mellitus, broncho-obstructive pulmonary diseases, systemic atherosclerosis, ischemic heart disease, circulatory failure), correction of reparative processes (nutritive support, correction of myelo and immunodeficiencies).

Summary: radiation reactions occur in 100% of patients undergoing radiation therapy, should be temporary, can be significantly clinically pronounced, disrupting the patient's quality of life.

radiation damage is a degenerative-dystrophic change in normal tissues, which is persistent and irreversible, occurring in remote period(peak frequency 1-2 years after radiotherapy). Radiation damage is mainly characteristic of systems with a slow update. The frequency of occurrence should be no more than 5%.

The main pathogenetic mechanism: damage to microcirculation vessels with an outcome in chronic ischemia and the development of processes of fibrosis of the parenchyma of the organ.

Vascular endothelium belongs to slowly renewing F-systems, although a hierarchy of cells is structurally traced. In this connection, the endothelium reacts to irradiation late (after 4-6 months).

Possible changes in the endothelium:

1. uncontrolled hyperplasia of endothelial cells with subsequent occlusion of the vessel lumen

2. cellular devastation with desolation and thrombosis of the vessel.

Thus, a site develops in the parenchyma of the organ. chronic ischemia, which disrupts trophism and restoration of parenchymal cells, and also provokes collagen synthesis and rapid tissue sclerosis.

The vascular pathogenesis of radiation damage is the most studied, but is not the leading one for all tissues. The following are known pathogenetic mechanisms:

- under the influence of radiation, a change is possible antigenic structure biopolymers and cell membranes, which can induce autoimmune processes (AIT and hypothyroidism after neck irradiation, dilated cardiomyopathy)

- the death of pneumocytes of the 2nd order can lead to a decrease in the synthesis of surfactant, the collapse of the walls of the alveoli, the development of bronchiolitis and alveolitis.

- high doses of ionizing radiation can cause demyelination of nerve fibers, gradual depletion of the pool of Schwann cells and oligodendroglia cells. These processes underlie damage to the structures of the central and peripheral nervous system, including the neuro-automatic system of the heart muscle.

— reduction of the pool and functional activity fibroblasts leads to incomplete resorption and "obsolescence" of the structure of collagen fibers, which leads to loss of elasticity and excessive development of connective tissue.

Primary fibrosis processes compress microcirculation vessels and prevent neoangiogenesis, which exacerbates trophic disorders and triggers a pathogenic circle.

The probability of occurrence and severity of radiation damage depends on:

single and total dose of exposure, fractionation mode (large-fraction irradiation methods are always more dangerous with the risk of developing damage than classic version radiotherapy)
the amount of exposure to a particular organ
the presence of other pathological processes in the irradiated tissue

Based on the requirements of the European Community of Oncoradiology, the frequency of detection of radiation injuries should not exceed 5%, there should not be radiation injuries of grade 3 or higher.

The average frequency of radiation damage in the Russian Federation, which is published in official publications, is about 20%, but some authors talk about a frequency of at least 40%. Statistical study of this phenomenon is difficult due to the long time period after radiation therapy, the slowly progressive nature of the course, and the low awareness of physicians in matters of radiobiology and medical radiology.

Possible nosologies as a consequence of radiation damage.

With total brain irradiation in acute period the following phenomena are possible: headaches, nausea, vomiting, anorexia, asthenic syndrome, cerebral edema. And in the long-term period after such a variant of radiation therapy, most patients have a decrease in memory, mental and cognitive disorders, headaches, and also in 20% of cases the development of dementia. The extreme degree of radiation damage to the brain with local high-dose irradiation is radionecrosis.

The spinal cord very often enters the radiation field with any type of radiation therapy. In the remote period, the formation of radiation myelitis is possible: paresthesia, impaired superficial and deep sensitivity, motor and pelvic disorders.

The structures of the eye have high radiosensitivity: radiation cataract, atrophy of the retina and optic nerve.

Inner ear: sclerosis of the otolith apparatus with progressive hearing loss.

With long-term irradiation of head and neck tumors, patients may experience chronic xerostomia due to sclerosis. salivary glands, chronic periodontal disease with tooth loss.

Irradiation of the thyroid gland in the long term can provoke AIT with progressive hypothyroidism.

The respiratory parenchyma of the lungs is highly radiosensitive, which predetermines the possibility of both acute radiation pneumonitis (often masked as infectious pneumonia) and the development of radiation pneumosclerosis 6-12 months after the end of the course of radiation therapy, which leads to a decrease in respiratory volumes.

The mesothelium of the pleura, pericardium and peritoneum is a highly radiosensitive tissue. In the acute period, it can react to irradiation in the form of fluid tracing, and in the long-term period, in the form of an adhesive process.

The main pathological processes during irradiation of the kidney parenchyma are observed in the proximal and distal parts of the convoluted tubules, as well as in the vessels of the microcirculation. The main pathological process is nephrosclerosis with a decrease in function.

Radiation damage to the dermis, ligamentous-articular apparatus and striated muscles follows the path of vascular pathogenesis, followed by fibrosis and sclerosis of the tissue. Severe degree of damage - ankylosis of the joint, radiation ulcer of the skin.

Cardiological toxicity of anticancer treatment is a very common and topical problem today. The mediastinal region is very often included in the therapeutic irradiated volumes (breast cancer, lymphomas, lung cancer, esophagus cancer). This is one of the most formidable side effects that affects both the quality of life of patients and survival rates.

Primary cardiac risk: age over 50, arterial hypertension, overweight, hyperlipidemia, atherosclerosis, smoking, diabetes.

In addition to the presence of risk factors, most modern cytostatics (even cyclophosphamide and 5-FU) have cardiotoxicity (in its various variants).

Even with high-precision radiation equipment, it is impossible to limit the mediastinum from radiation as much as possible, due to a decrease in the radicalism of treatment and tumor control.

Radiation-related heart disease:

- acute effusion pericarditis (with outcome in chronic exudative, or adhesive pericarditis), hypotonic syndrome. Observed in the early period after and during the course of radiation therapy.

- angina pectoris and myocardial infarction (due to endarteritis of the coronary vessels). This is a late side effect, with a maximum frequency at 3-5 years of follow-up.

- diffuse interstitial myocardial fibrosis with an outcome in restrictive cardiomyopathy, in rhythm disorders (sinus tachycardia, various options atrial fibrillation, blockades). Fibrosis can lead to valvular disorders (stenosis and regurgitation of the mitral and aortic valves)

— dilated cardiomyopathy as an outcome of autoimmune processes in the myocardium

- fibrosis of the large lung volume can lead to an increase in blood pressure pulmonary artery with subsequent development cor pulmonale

- venous obstruction lymphatic vessels mediastinum after irradiation can provoke chronic exudative pleurisy and pericarditis or chylothorax.

As shown clinical observations and studies, the total dose at which these pathological processes are possible is 30-40 Gy (in reality, the SOD used is from 46 to 70 Gy). And if we add to this the presence of primary cardiac problems, the behavior of massive cytostatic therapy, anesthesia, stress, then the probability turns into inevitability.

Before starting treatment (including before chemotherapy), it is recommended: ECG, cardiac ultrasound (LVEF, diastolic values), type-B natriuretic peptide, troponin.

Contraindication for cardiotoxic interventions(radiotherapy to the mediastinal region or cardiotoxic chemotherapy) are: baseline LVEF less than 50%, or decrease in LVEF by 20% from baseline, even normal level, even in the absence clinical signs heart failure. Also a contraindication is sub- and decompensation of the pathology of the cardiopulmonary system.

However, radiotherapy is a highly effective antitumor treatment, the frequency of use in treatment regimens or how independent method, is growing. Accumulating clinical and radiobiological experience with sources of ionizing radiation. The main direction in the development of radiation therapy is to minimize the impact of ionizing radiation on normal tissues, with a more accurate and high-dose effect on a malignant tumor.

Most cancer patients go through a radiation therapy procedure. Its main goal is to destroy cancer cells, to suppress their ability to reproduce. Despite the fact that radiation techniques have improved significantly over the past decade, healthy tissues located near the tumor still suffer. This method can not be called completely safe for health. However, its effect in terms of reducing and destroying the tumor in most cases covers the negative consequences.

What are the consequences of radiation therapy?

The consequences of exposure to radiation depend on its type, the depth of penetration into tissues, and individual reactions of a person. The stronger and longer exposure, the more noticeable will be the reaction of the body. The most common complications occur in patients undergoing long-term treatment. The side effects of radiation therapy are not always severe, some patients tolerate such treatment quite easily. In some cases, the consequences develop immediately after the session, in others only after discharge from the hospital, because the therapeutic effect is realized even after the end of the course of radiation therapy.

Complications after radiotherapy:

skin reactions,
Pain, swelling of tissues at the site of exposure,
Shortness of breath and cough
Reactions from the mucous membranes,
fatigue,
Mood and sleep disorders
Nausea, vomiting, gastrointestinal disturbances,
Hair loss.

Most common skin reactions

After irradiation, the skin loses its resistance to mechanical stress, becomes more tender and sensitive, requires more careful attitude and meticulous care.

The skin in the irradiated area changes color, discomfort, burning, pain are felt in this place. The skin's response to radiation is similar to sunburn but it develops gradually. The skin becomes drier and more sensitive to touch. It is possible to form blisters that open, exposing a weeping, painful area of \u200b\u200bthe skin. In the absence of treatment and proper care, such areas of the skin become the entrance gate for infection. In these places, ulcers can form. Non-healing ulcers after radiation therapy develop in severe cases when patients have particularly sensitive skin, reduced immunity or they suffer from diabetes.

As a rule, skin reactions appear 10-15 days after the start of treatment and disappear 4-5 weeks after the end of the irradiation procedures.

Degrees of skin damage as a result of radiation therapy:

Grade 1 - Slight redness
Grade 2 - redness, accompanied by peeling or swelling,
Grade 3 - extensive redness with wet peeling and severe swelling.

The treatment of burns after radiation therapy depends on the degree of skin damage. In the first degree, it is enough to maintain daily skin hygiene and apply a moisturizer after the irradiation procedure. In the second and third stages, when itching occurs, a cream containing corticosteroids can be prescribed, which will significantly improve the condition of the skin. However, its use should be limited in time (no more than 7 days). To prevent infection from entering the wound, bandages are applied to it. If signs of infection appear, then antibacterial dressings with active silver ions or iodine should be applied.

Signs of infection of a radiation wound:

Increased pain
sharp swelling,
increased redness,
Increase in the amount of fluid in the wound
The appearance of an unpleasant odor.

High temperature after radiation therapy may be due to infection in the wound. In this case, it is necessary to additional examinations to determine the nature of the infection.

Reactions from the respiratory system

Shortness of breath, shortness of breath, cough after radiation therapy develop when the effect is applied to the area chest such as in breast cancer. Radiation damage to the lungs manifests itself within three months after exposure. As a rule, the cough is unproductive (that is, it does not bring relief). If an infection joins, then it is possible to increase the temperature and worsen general condition. Treatment radiation injuries lungs is limited by several methods:

Electro- and phonophoresis,
magnetotherapy,
inhalation therapy,
Massage,
Breathing exercises.

In each specific case, the methods are selected individually, taking into account the nature of changes in the respiratory organs and the nature of the tumor for which radiation is performed.

Mucosal damage

With extensive irradiation of the abdominal cavity and small pelvis, the mucous membranes of the intestines, stomach, and bladder may suffer. In this regard, the work of these organs is deteriorating. Irradiation of the ENT organs can lead to stomatitis, dryness and sore throat, pain in this area.

Fatigue

Many cancer patients report fatigue as a side effect of radiation therapy. This is a rather unpleasant state of affairs. The fact is that it does not go away after sleep or rest. The patient has a feeling that he lacks energy. All this happens not only because of the effect of radiation on the body, but also because of emotional experiences, changes in lifestyle and nutrition.

In order to alleviate the condition, at least slightly reduce the feeling of fatigue, you need to try to follow the regimen, sleep enough time, do what you can exercise. You don't have to do hard work. You may need to ask friends or loved ones for help and support.

Recovery after treatment

How to recover after radiation therapy? This question is asked by almost all patients. At the end of the course of treatment, the body after a while restores its strength, improves the functioning of the organs that have suffered. If you help him, then the recovery period will pass faster.

Usually, after a course of radiation therapy, special drugs are prescribed. Strictly follow all the recommendations of the doctor, take medicines, following the scheme proposed by the doctor.

Even if you want to lie down all the time, find the strength in yourself to move, do not let the body stagnate. Movement will invigorate. Lungs will do simple exercises, walks. As much time as possible should be on fresh air.

The liquid will help the body get rid of toxins and harmful substances formed as a result of treatment. You should drink about 3 liters of fluid. It can be normal or mineral water, juices. Carbonated drinks should be avoided.

To keep your body as free of toxins as possible, stop smoking and drinking alcohol. Drinking alcohol in small doses (usually red wine) may be indicated only in some cases. Then it is recommended by the attending physician.

Proper nutrition will help the body to "recover" faster. Food should be natural, without preservatives and artificial additives. No smoked meats, pickles should not be in the diet. More vegetables and greenery.
Avoid being in the sun.

Wear loose, soft clothing to avoid chafing the radiation site.

See your doctor regularly. Be sure to tell him about cases when something has changed in his state of health, pain has begun to bother him or the temperature has risen.

Treatment of oncological diseases for many patients becomes a real test due to serious side effects. However, there comes a day when a person feels relieved. He understands that the disease recedes, and life is getting better.

Radiation therapy for cancer

What is radiation therapy?

Radiation therapy (X-ray therapy, telegamma therapy, electron therapy, neutron therapy, etc.) is an application special kind the energy of electromagnetic radiation or beams of elementary nuclear particles capable of killing tumor cells or restraining their growth and division.

Some healthy cells that enter the radiation area are also damaged, but most of them are able to recover. Tumor cells divide faster than surrounding healthy cells. Therefore, radiation affects them more detrimentally. It is these differences that determine the effectiveness of radiation therapy for cancer.

What types of cancer are treated with radiation therapy?

Radiation therapy is used to treat various kinds cancer. Currently, more than half of patients suffering from one type of cancer or another are successfully treated with radiation.

Irradiation can be used as an independent method of treatment. Sometimes RT is done before surgery to shrink the tumor or after it to kill any remaining cancer cells. Quite often, doctors use radiation in conjunction with anticancer drugs (chemotherapy) to destroy a tumor.

Even in those patients who cannot be removed the tumor, RT can reduce its size, relieve pain and improve the general condition.

Radiation therapy equipment

To conduct RT, special complex devices are used that allow you to direct the flow of therapeutic energy to the tumor. These devices differ in principle of operation and are used for different purposes. Some of them are used to treat superficial cancers (skin cancer), others are more effective in treating tumors that are located deep in the body.

Which of the devices is better to use for the decision will be decided by your doctor.

The radiation source can be brought to the diseased area in several ways.

If source:

located at a distance from the patient's body, irradiation is called remote;
placed in any cavity - intracavitary;
injected directly into the diseased area in the form of a liquid, wire, needles, probes - interstitial.

Stages of radiation therapy

Three stages are conditionally distinguished during LT:

pre-beam;
ray;
post-beam.

Each of these stages has its own characteristics that determine the rules of your behavior. Their observance will improve the results of treatment and reduce the frequency of side effects.

The process of conducting radiation therapy

1. Preparation for treatment

During this period, there are additional research in order to clarify the localization and assessment of the state of healthy tissues surrounding the pathological focus.

Before starting a course of radiation therapy, radiation doses are carefully calculated and its methods are determined, with the help of which it is possible to achieve maximum destruction of tumor cells and protection of healthy tissues in the areas of the body to be treated.

What dose of radiation you need, how to carry it out and how many sessions you need for this, your doctor will decide.

A whole group of highly qualified specialists - physicists, dosimetrists, mathematicians - helps to carry out these complex calculations. Sometimes it takes several days to make a decision. This procedure is called planning.

During the simulation (planning) you will be asked to lie quietly on the table until the doctor determines the radiation field using a special X-ray machine. There may be several such areas. Irradiation fields are marked with dots or lines (marking), using special ink for this. This marking must remain on the skin until the end of the treatment. Therefore, while taking a shower, try not to wash it off. If lines and dots begin to fade, tell your doctor. Don't draw the dots yourself.

Already in the pre-beam period:

iodine tinctures and other irritants should not be used on areas of the skin that will be exposed to radiation;
should not sunbathe;
in the presence of diaper rash, rashes on the skin, it is necessary to indicate them to the attending physician. He will prescribe the appropriate treatment (powders, ointments, aerosols);
if radiation therapy will be carried out to treat a tumor of the maxillofacial region, preliminary sanitation of the oral cavity is necessary (treatment or removal of carious teeth). This is the most important measure for the prevention of radiation complications in the oral cavity.

2. How is the treatment session

This marking must remain on the skin until the end of the treatment. Therefore, while taking a shower, try not to wash it off. If lines and dots begin to fade, tell your doctor. Don't draw the dots yourself.

If radiation therapy will be carried out to treat a tumor of the maxillofacial region, preliminary sanitation of the oral cavity is necessary (treatment or removal of carious teeth). This is the most important measure for the prevention of radiation complications in the oral cavity.

Radiation therapy: how is the treatment

1. Choice of treatment regimen by radiotherapy

Typically, radiation therapy sessions are performed 5 times a week. Sometimes in order to protect normal tissues in the radiation area daily dose divided into 2-3 sessions. A two-day break at the end of the week allows healthy tissues to recover.

The decision on the total dose of radiation and the number of sessions is made by the radiologist based on the size of the tumor and the location of the tumor, its type, your general condition and other types of treatment.

2. How is the treatment session

You will be asked to lie down on a treatment table or sit in a special chair. According to the fields marked earlier on the skin, the irradiation zones will be precisely determined. Therefore, you must not move during exposure. You need to lie calmly, without much tension, breathing should be natural and even. You will be in the office for 15-30 minutes.

Before turning on the unit, the medical staff moves to another room and watches you on TV or through a window. You can communicate with him through the loudspeaker.

Some parts of radiotherapy machines may move and make noise during operation. Don't worry - the whole process is under control.

The radiation itself is painless. If you feel unwell during the exposure, inform your doctor immediately without taking any independent action. The unit can be turned off at any time.

Perhaps, already at the beginning of treatment, you will feel a decrease in pain (if any). However, as a rule, the greatest therapeutic effect of radiation therapy occurs after the completion of the course of treatment.

To get good therapeutic effect It is very important that you complete all scheduled treatment sessions.

How to behave during radiation therapy

The sensation usually resolves 4-6 weeks after treatment is completed. However, it should not be avoided at all. physical activity, which raises defensive forces body and resistance to harmful effects. You can get recommendations on the selection and dosage of physical activity from your doctor and exercise therapist.

During treatment, you should follow some rules

Eat well. Try to stick balanced diet(ratio of proteins, fats and carbohydrates 1:1:4). Together with food, it is necessary to take 2.5-3 liters of liquid per day (fruit juices, mineral water, tea with milk).
Refuse, at least for the period of treatment, from bad habits(smoking, drinking).
Do not wear tight-fitting clothing on exposed areas of the body. Items made of synthetic fabrics and wool are highly undesirable. Loose old cotton clothing is preferred. Exposed areas of the skin should be kept as open as possible.
Be outdoors more often.
Take good care of your skin. Irradiated skin sometimes looks tanned or darkened. By the end of treatment, in some cases, the irradiated areas of the body may be excessively moistened (especially in the folds). This largely depends on your individual sensitivity to radiation. Tell your doctor or nurse about any changes you notice. They will make appropriate recommendations.
Do not use soap, lotions, deodorants, ointments, cosmetics, perfumes, talcum powder, or other similar products on the exposed body area without consulting a doctor.
Do not rub or scratch the exposed skin area. Do not put warm or cold objects on it (heater, ice).
When going outside, protect the exposed part of the skin from the sun (light clothing, wide-brimmed hat).

What awaits the patient after irradiation?

Side effect of radiation

Radiation therapy, like any other type of treatment, can be accompanied by general and local (in the area of tissue exposure to radiation) side effects. These phenomena can be acute (short-term, occur during treatment) and chronic (develops several weeks or even years after the end of treatment).

The side effect of radiotherapy is most often manifested in tissues and organs that have been directly exposed to radiation. Most of the side effects that develop during treatment are relatively mild and are treated with medication or through proper nutrition. They usually disappear within three weeks after the end of radiation therapy. Many patients have no side effects at all.

During the treatment, the doctor monitors your condition and the effect of radiation on body functions. If you develop any unusual symptoms during treatment (cough, sweating, fever, unusual pain), be sure to tell your doctor or nurse.

Common side effect of radiotherapy

Emotional condition

Nearly all patients undergoing cancer treatment experience some degree of emotional stress. Most often there is a feeling of depression, fear, melancholy, loneliness, sometimes aggression. As the general condition improves, these emotional disturbances become dull. Communicate more often with family members, close friends. Don't lock yourself in. Try to take part in the lives of the people around you, help them and do not refuse their help. Talk to a psychotherapist. Perhaps he will recommend some acceptable methods of stress relief.

Fatigue

The feeling of fatigue usually begins to be felt a few weeks after the start of treatment. It is associated with a significant physical load on the body during radiation therapy and stress. Therefore, during the period of radiation therapy, you should slightly reduce your overall activity, especially if you are used to working at a busy pace. However, do not completely withdraw from household chores, take part in family life. Do more things that you like, read more, watch TV, listen to music. But only until you feel tired.

If you do not want other people to know about your treatment, you can take a leave of absence for the period of treatment. If you continue to work, talk to your supervisor - he may change your work schedule. Don't be afraid to ask your family and friends for help. They will surely understand your condition and provide necessary support. After completion of treatment, the feeling of fatigue gradually disappears.

Blood changes

When irradiating large areas of the body in the blood, the number of leukocytes, platelets and erythrocytes may temporarily decrease. The doctor monitors the function of hematopoiesis according to a blood test. Sometimes, with pronounced changes, a break in treatment is made for one week. AT rare cases prescribe medications.

Loss of appetite

Radiotherapy usually does not cause nausea or vomiting. However, there may be a decrease in appetite. You must understand that in order to repair damaged tissues, you should eat enough food. Even if there is no feeling of hunger, it is necessary to make an effort and provide high-calorie food With high content proteins. It will allow you to better cope with side effects and improve the results of cancer treatment.

A few nutritional tips for radiation therapy:

Eat a variety of foods often, but in small portions. Eat when you feel like it, regardless of the daily routine.
Increase the calorie content of food - add more butter if you like its smell and taste.
Use a variety of sauces to increase your appetite.
In between meals, use kefir, a mixture of milk with butter and sugar, yogurt.
Drink more liquids, juices are better.
Always keep a small supply of foods you like (that are approved for storage in the clinic where you are being treated) and eat them when you have a craving for something to eat.
While eating, try to create conditions that increase your mood (turn on the TV, radio, listen to your favorite music while eating).
Ask your doctor if you can drink a glass of beer with your meal to increase your appetite.
If you have any medical condition that requires you to follow a particular diet, talk to your doctor about how to diversify your diet.

Side effects on the skin

To prevent too pronounced skin reaction, you can use vegetable and animal oils (Children's cream, Velvet, aloe emulsion), which should be applied to the skin after a radiation therapy session.

Before the session, it is necessary to wash off the remnants of the cream. warm water. However, the skin should be lubricated with appropriate ointments and creams not from the first days of irradiation, but later, when the skin begins to turn red. Sometimes, with a pronounced radiation reaction of the skin, a short break in treatment is made.

More detailed information information about skin care can be obtained from your doctor.

Side effects on the mouth and throat

If you receive radiation to the maxillofacial area or neck, in some cases, the mucous membrane of the gums, mouth and throat may become red and inflamed, dry mouth and pain when swallowing may appear. Usually these phenomena develop on the 2-3rd week of treatment.

In most cases, they go away on their own one month after the completion of radiation therapy.

You can alleviate your condition by following the recommendations below:

Avoid smoking and alcohol during treatment, as they also cause irritation and dryness of the oral mucosa.
Rinse your mouth at least 6 times a day (after sleep, after each meal, at night). The solution used should be at room temperature or refrigerated. What solutions are best to rinse the mouth, you can ask your doctor.
Twice a day, gently, without pressing hard, brush your teeth with a soft toothbrush or cotton swab(Rinse thoroughly after use and store dry.)
Consult with your dentist regarding the selection of the right toothpaste. It should not be sharp and irritate the mucous membrane.
If you use prostheses, remove them before your radiation therapy session. In case of rubbing gums with prostheses, it is better to temporarily stop using them altogether.
Avoid acidic, spicy foods.
Try to eat soft foods (baby food, purees, cereals, puddings, jellies, etc.). Soak hard and dry food in water.

Side effects on the mammary gland

During radiation therapy for a breast tumor, the most common side effect are skin changes (see section "Side effects on the skin"). In addition to following the above recommendations for skin care, you should refuse to wear a bra for the period of treatment. If you are uncomfortable without it, use a soft bra.

In some cases, these deformations of the shape of the gland can persist for the rest of life. For more information about the nature of changes in the shape and size of the breast, you can find out from your doctor.

Radiation therapy can lead to poor movement in the shoulder. Consult with an exercise therapy specialist what exercises should be done to prevent this complication.

In some patients, radiation therapy can lead to swelling of the arm on the side of the treated gland. This edema can develop even 10 or more years after the completion of treatment. Therefore, it is necessary to carefully monitor the condition of the hand and adhere to some rules of conduct:

Avoid heavy lifting (no more than 6-7 kg), vigorous movements that require excessive effort (pushing, pulling), carrying a bag over your shoulder on the side of the irradiated breast.
Don't let me measure arterial pressure, as well as injecting (taking blood) into the arm on the irradiation side.
Do not wear tight-fitting jewelry or clothing on this arm. In case of accidental damage to the skin of the hand, treat the wound with alcohol (but not alcohol tincture of iodine!) And seal the wound with a bactericidal plaster or apply a bandage.
Protect your hand from direct sunlight.
Maintain your optimal weight through a balanced diet with low content salt and high in fiber.
If you even experience occasional swelling of your arm that goes away after a night's sleep, contact your doctor immediately.

Side effects on the chest

During the course of radiation therapy, you may find it difficult to swallow due to radiation inflammation of the esophageal mucosa. You can make eating easier by eating more often, in smaller portions, thinning thick foods and cutting solid foods into pieces. Before eating, you can swallow a small piece of butter to make it easier to swallow.

You may develop a dry cough, a fever, a change in the color of sputum, and shortness of breath. If you notice these symptoms, tell your doctor immediately. He will prescribe a special drug treatment.

Side effect on the rectum

In order to prevent or reduce the severity of these phenomena, it is necessary to prevent constipation from the first days of treatment. This can be easily achieved by organizing an appropriate diet. It is necessary to additionally include in the diet kefir, fruits, raw carrots, stewed cabbage, prunes infusion, tomato and grape juice.

Side effects on the bladder

Radiation therapy sometimes causes inflammation of the lining of the bladder. This may lead to frequent painful urination, increase in body temperature. Occasionally, the urine becomes reddish in color. If you notice these symptoms, tell your doctor. These complications require special drug treatment.

How to behave after the completion of radiation therapy (post-radiation period)

After completing a course of radiotherapy, it is very important to periodically check the results of your treatment. You should have regular check-ups with your radiologist or the doctor who referred you for treatment. The time of the first follow-up examination will be determined by the attending physician upon discharge.

The schedule of further observation will be made by the doctor of the polyclinic or dispensary. The same specialists, if necessary, will prescribe you further treatment or rehabilitation.

Symptoms in which you should consult a doctor without waiting for the next follow-up examination:

the occurrence of pain that does not go away on its own within a few days;
nausea, diarrhea, loss of appetite;
fever, cough;
the appearance of a tumor, swelling, unusual rashes on the skin;
development of limb edema on the irradiation side.

Care for irradiated skin

After completion of treatment, it is necessary to protect the irradiated skin from injuries and sunlight for at least a year. Be sure to lubricate the irradiated skin areas 2-3 times a day nourishing cream even when she healed after treatment. Do not treat the skin irritants.

Ask your doctor which cream is best to use. Do not try to erase the designations left after irradiation, they will gradually disappear on their own. Give preference to the shower, rather than taking a bath. Do not use cold or hot water. When taking a shower, do not rub the exposed skin with a washcloth. If irritation of the irradiated skin persists for a long time, consult a doctor. He will prescribe the appropriate treatment for you.

Remember: slight pain in an irradiated place is a common and fairly common occurrence. If it occurs, you can take mild painkillers. In case of severe pain, a doctor's consultation is necessary.

Relationships with relatives and friends

During radiation therapy, your body does not become radioactive. It should also be clearly understood that cancer is not contagious. Therefore, do not be afraid to communicate with other people, friends and relatives during and after treatment.

If necessary, you can invite the closest people for a joint conversation with your doctor.

intimate relationship

In most cases, radiation therapy does not have a pronounced effect on sexual activity. The decrease in interest in intimate relationships is mainly due to the general physical weakness that occurs during this treatment and stress. So don't avoid intimate relationships, which are important part a fulfilling life.

Professional activity

If your work is associated with strenuous physical activity or occupational hazards, you should think about changing the working conditions or profession.

Leisure

Make it a rule to take daily walks in the fresh air (walks in the park, in the forest). Communicate more with friends and family. With the knowledge of your attending physician, consult a physiotherapist and a psychotherapist. They will help you choose the right physical activity(improving gymnastics) and suggest ways to overcome stress.

Conclusion

We hope that this information will help you get rid of unnecessary nervous tension, it is easier to undergo a course of radiation therapy, to understand what awaits you after it. All this contributes to your recovery.

For more information on matters related to your health, please contact your doctor.

Treatment results. Photos before and after

According to CT data, the patient was inoperable before treatment, and after preoperative chemoradiotherapy, she was subsequently successfully operated on.

Tumor of the rectum. CT before treatment

When performing radiation therapy of the pelvic organs, IMRT allows you to achieve a uniform dose distribution of the irradiation zone and significantly reduce the dose to the bladder, small intestine. Thus, conditions are created to reduce toxicity and improve the tolerability of the treatment.

Cancer of the anal canal. CT before treatment

When conducting chemoradiotherapy for anal cancer, the VMAT technique allows achieving a highly conformal isodose distribution, improving treatment tolerance (avoiding the development of reactions from the intestines - diarrhea, bladder - cystitis, genital organs).

CT after chemoradiotherapy

Postoperative radiation therapy for breast cancer using the IMRT method reduces the risk of damage to the heart and lung tissue.

Radiation therapy (X-ray therapy, telegamma therapy, electron therapy, neutron therapy, etc.) is the use of a special type of energy of electromagnetic radiation or beams of elementary nuclear particles that can kill tumor cells or restrain their growth and division. Some healthy cells that enter the radiation area are also damaged, but most of them are able to recover. Tumor cells divide faster than surrounding healthy cells. Therefore, radiation affects them more detrimentally. It is these differences that determine the effectiveness of radiation therapy for cancer.

Radiation therapy is used to treat a variety of types of cancer. Currently, more than half of patients suffering from one type of cancer or another are successfully treated with radiation.

Even in those patients who cannot be removed the tumor, RT can reduce its size, relieve pain and improve the general condition.

Periods of Radiation Therapy

When conducting RT, three periods are conditionally distinguished: pre-beam, beam and post-beam. Each of these periods has its own characteristics that determine the rules of your behavior. Their observance will improve the results of treatment and reduce the frequency of side effects.

Prebeam period

During this period, additional studies are carried out in order to clarify the localization and assess the state of healthy tissues surrounding the pathological focus. Before starting a course of radiation therapy, radiation doses are carefully calculated and its methods are determined, with the help of which it is possible to achieve maximum destruction of tumor cells and protection of healthy tissues in the areas of the body to be treated. What dose of radiation you need, how to carry it out and how many sessions you need for this will be decided by your doctor. A whole group of highly qualified specialists - physicists, dosimetrists, mathematicians - helps to carry out these complex calculations. Sometimes it takes several days to make a decision. This procedure is called planning.

You will be asked to lie quietly on the table until the radiologist uses a special X-ray machine to determine the radiation field. There may be several such areas. Irradiation fields are designated by dots or lines (marking), using special ink for this. This marking must remain on the skin until the end of the treatment. Therefore, while taking a shower, try not to wash it off. If lines and dots begin to fade, tell your doctor. Don't draw the dots yourself.

Already in the pre-radiation period, tinctures of iodine and other irritants should not be used on areas of the skin that will be exposed to radiation. Should not sunbathe. In the presence of diaper rash, rashes on the skin, it is necessary to indicate them to the attending physician. He will prescribe the appropriate treatment (powders, ointments, aerosols). If radiation therapy will be carried out to treat a tumor of the maxillofacial region, preliminary sanitation of the oral cavity is necessary (treatment or removal of carious teeth).

This is the most important measure for the prevention of radiation complications in the oral cavity.

Beam period

How Radiation Therapy Is Done

Usually the course of treatment lasts 4-7 weeks. In some cases, when radiation therapy is performed before surgery in order to reduce the size of the tumor or to alleviate the patient's condition, the duration of the course is 2-3 weeks. Typically, radiation therapy sessions are performed 5 times a week. Sometimes, in order to protect normal tissues in the irradiation zone, the daily dose is divided into 2-3 sessions. A two-day break at the end of the week allows healthy tissues to recover. The decision on the total dose of radiation and the number of sessions is made by the radiologist based on the size of the tumor and the location of the tumor, its type, your general condition and other types of treatment.

How is the treatment session going?

You will be asked to lie down on a treatment table or sit in a special chair. According to the fields marked earlier on the skin, the irradiation zones will be precisely determined. Healthy tissues in the affected area will be protected by special pads (blocks). Therefore, you must not move during exposure. You need to lie calmly, without much tension, breathing should be natural and even. You will be in the office for 15-30 minutes, but the duration of the treatment itself does not exceed 1-5 minutes.

Before turning on the unit, the medical staff moves to another room and watches you on TV or through a window. You can communicate with him through the loudspeaker.

Some parts of radiotherapy machines may move and make noise during operation. Don't worry - the whole process is under control.

The radiation itself is painless. If you feel unwell during the exposure, inform your doctor immediately without taking any independent action. The unit can be turned off at any time.

To obtain a good therapeutic effect, it is very important that you complete all the prescribed treatment sessions.

How to behave during radiation therapy

The body's response to radiation therapy varies from person to person. However, in any case, the process of radiation therapy is a significant burden on the body. Therefore, during treatment, you may develop a feeling of fatigue. In this regard, you should rest more. Go to bed when you feel the need to. The sensation usually resolves 4-6 weeks after treatment is completed. However, physical activity, which increases the body's defenses and resistance to harmful influences, should not be completely avoided. You can get recommendations on the selection and dosage of physical activity from your doctor and exercise therapist.

During treatment, you should follow some rules:

Eat well. Try to stick to a balanced diet (ratio of proteins, fats and carbohydrates 1:1:4). Together with food, it is necessary to take 2.5-3 liters of liquid per day (fruit juices, mineral water, tea with milk).
Refuse, at least for the period of treatment, from bad habits (smoking, drinking alcohol).
Do not wear tight-fitting clothing on exposed areas of the body. Items made of synthetic fabrics and wool are highly undesirable. Loose old cotton clothing is preferred. Exposed areas of the skin should be kept as open as possible.
Be outdoors more often.
Take good care of your skin. Irradiated skin sometimes looks tanned or darkened. By the end of treatment, in some cases, the irradiated areas of the body may be excessively moistened (especially in the folds). This largely depends on your individual sensitivity to radiation. Tell your doctor or nurse about any changes you notice. They will give appropriate recommendations.
Do not use soap, lotions, deodorants, ointments, cosmetics, perfumes, talcum powder, or other similar products on the exposed body area without consulting a doctor.
Do not rub or scratch the exposed skin area. Do not put warm or cold objects on it (heater, ice).
When going outside, protect the exposed part of the skin from the sun (light clothing, wide-brimmed hat).

Side effect of radiation

Common side effect of radiotherapy

Emotional condition

Almost all patients undergoing treatment for cancer experience some degree of emotional stress. Most often there is a feeling of depression, fear, melancholy, loneliness, sometimes aggression. As the general condition improves, these emotional disturbances become dulled.

Communicate more often with family members, close friends. Don't lock yourself in. Try to take part in the lives of the people around you, help them and do not refuse their help. Talk to a psychotherapist. Perhaps he will recommend some acceptable methods of stress relief.

Fatigue

If you do not want other people to know about your treatment, you can take a leave of absence for the period of treatment. If you continue to work, talk to your supervisor, they may change your work schedule. Don't be afraid to ask your family and friends for help. They will certainly understand your condition and provide the necessary support.

After completion of treatment, the feeling of fatigue gradually disappears.

Blood changes

Loss of appetite

Radiotherapy usually does not cause nausea or vomiting. However, there may be a decrease in appetite. You must understand that in order to repair damaged tissues, you should eat enough food. Even if there is no feeling of hunger, it is necessary to make an effort and provide a high-calorie, high-protein diet. It will allow you to better cope with side effects and improve the results of cancer treatment.

A few nutritional tips for radiation therapy:

Eat a variety of foods often, but in small portions. Eat when you feel like it, regardless of the daily routine.
Increase the calorie content of food - add more butter if you like its smell and taste.
Use a variety of sauces to increase your appetite.
In between meals, use kefir, a mixture of milk with butter and sugar, yogurt.
Drink more liquids, juices are better.
Always have a small supply of foods you like (which are approved for storage in the clinic in which treatment is carried out) and eat them when you have a desire to eat something.
While eating, try to create conditions that enhance your mood (turn on the TV, radio, listen to your favorite music while eating).
Ask your doctor if you can drink a glass of beer with your meal to increase your appetite.
If you have any medical condition that requires you to follow a particular diet, talk to your doctor about how to diversify your diet.

Local side effects of radiation therapy

Side effects on the skin

The reaction of the skin to radiation is manifested by its redness in the area of exposure. In many ways, the development of this phenomenon is determined by your individual sensitivity to radiation. Usually redness appears on the 2-3rd week of treatment. After the completion of radiation therapy, the skin in these places becomes a little dark, as if tanned. To prevent too pronounced skin reaction, you can use vegetable and animal oils (Children's cream, Velvet, aloe emulsion), which should be applied to the skin after a radiation therapy session. Before the session, it is necessary to wash off the remaining cream with warm water. However, the skin should be lubricated with appropriate ointments and creams not from the first days of irradiation, but later, when the skin begins to turn red. Sometimes, with a pronounced radiation reaction of the skin, a short break in treatment is made.

For more information about skin care, contact your healthcare provider.

Side effects on the mouth and throat

You can alleviate your condition by following the recommendations below:

Avoid smoking and alcohol during treatment, as they also cause irritation and dryness of the oral mucosa.
Rinse your mouth at least 6 times a day (after sleep, after each meal, at night). The solution used should be at room temperature or refrigerated. What solutions are best to rinse the mouth, you can ask your doctor.
Twice a day, gently, without pressing hard, brush your teeth with a soft toothbrush or cotton swab (rinse the brush thoroughly after use and store dry).
Consult with your dentist regarding the selection of the right toothpaste. It should not be sharp and irritate the mucous membrane.
If you use prostheses, remove them before your radiation therapy session. In case of rubbing gums with prostheses, it is better to temporarily stop using them altogether.
Avoid acidic, spicy foods.
Try to eat soft foods (baby food, purees, cereals, puddings, jellies, etc.). Soak hard and dry food in water.

Side effects on the mammary gland

When performing radiation therapy for a breast tumor, the most common side effect is skin changes (see section "Side Effects on the Skin"). In addition to following the above recommendations for skin care, you should refuse to wear a bra for the period of treatment. If you are uncomfortable without it, use a soft bra.

Under the influence of radiation therapy in the area of the breast, pain and swelling may occur, which will disappear or gradually decrease after the treatment is completed. The irradiated mammary gland can sometimes increase (due to fluid accumulation) or decrease (due to tissue fibrosis). In some cases, these deformations of the shape of the gland can persist for the rest of life. For more information about the nature of changes in the shape and size of the breast, you can find out from your doctor.

Radiation therapy can lead to poor movement in the shoulder. Consult with an exercise therapy specialist what exercises should be done to prevent this complication.

Avoid heavy lifting (no more than 6-7 kg), vigorous movements that require excessive effort (pushing, pulling), carrying a bag over your shoulder on the side of the irradiated breast.
Do not allow blood pressure measurements or injections (drawing blood) into the arm on the radiation side.
Do not wear tight-fitting jewelry or clothing on this arm.
In case of accidental damage to the skin of the hand, treat the wound with alcohol (but not alcohol tincture of iodine!) And seal the wound with a bactericidal plaster or apply a bandage.
Protect your hand from direct sunlight.
Maintain your optimal weight by eating a balanced, low-salt, high-fiber diet.

If you even experience occasional swelling of your arm that goes away after a night's sleep, contact your doctor immediately.

Side effects on the chest

During the course of radiation therapy, you may find it difficult to swallow due to radiation inflammation of the mucosa of the esophagus. You can make eating easier by eating more often, in smaller portions, thinning thick foods and cutting solid foods into pieces. Before eating, you can swallow a small piece of butter to make it easier to swallow.

You may develop a dry cough, a fever, a change in the color of sputum, and shortness of breath. If you notice these symptoms, tell your doctor immediately. He will prescribe a special drug treatment.

Side effect on the rectum

This may occur during radiation therapy for cancer of the rectum or other pelvic organs. With radiation damage to the intestinal mucosa, pain and bloody discharge may appear, especially with difficult stools. In order to prevent or reduce the severity of these phenomena, it is necessary to prevent constipation from the first days of treatment. This can be easily achieved by organizing an appropriate diet. It is necessary to additionally include kefir, fruits, raw carrots, stewed cabbage, prunes infusion, tomato and grape juice in the diet. If, despite following the recommendations, you have a stool retention for more than 1-2 days, be sure to inform your doctor about this.

Side effects on the bladder

Radiation therapy sometimes causes inflammation of the lining of the bladder. This can lead to frequent painful urination, an increase in body temperature. Occasionally, the urine becomes reddish in color. If you notice these symptoms, tell your doctor. These complications require special drug treatment.

How to behave after the completion of radiation therapy (post-radiation period)

At the end of a course of radiotherapy, it is very important to periodically check the results of your treatment. You should have regular check-ups with the radiologist or doctor who referred you for treatment. The time of the first follow-up examination will be determined by the attending physician upon discharge. The schedule for further follow-up will be drawn up by a doctor at a polyclinic or dispensary. The same specialists, if necessary, will prescribe you further treatment or rehabilitation.

Symptoms in which you should consult a doctor without waiting for the next follow-up examination:

the occurrence of pain that does not go away on its own within a few days;
nausea, diarrhea, loss of appetite;
fever, cough;
the appearance of a tumor, swelling, unusual rashes on the skin;
development of limb edema on the irradiation side.

Care for irradiated skin

After completion of treatment, it is necessary to protect the irradiated skin from injuries and sunlight for at least a year. Be sure to lubricate the irradiated skin with a nourishing cream 2-3 times a day, even when it has healed after treatment. Do not treat the skin with irritants. Ask your doctor which cream is best to use. Do not try to erase the designations left after irradiation, they will gradually disappear on their own. Give preference to the shower, rather than taking a bath. Do not use cold or hot water. When taking a shower, do not rub the exposed skin with a washcloth.

If irritation of the irradiated skin persists for a long time, consult a doctor. He will prescribe the appropriate treatment for you.

Remember: slight pain in the irradiated area is common and fairly common. If it occurs, you can take mild painkillers. In case of severe pain, a doctor's consultation is necessary.

Relationships with relatives and friends

intimate relationship

In most cases, radiation therapy does not have a pronounced effect on sexual activity. The decrease in interest in intimate relationships is mainly due to the general physical weakness that occurs during this treatment and stress. Therefore, do not avoid intimate relationships, which are an important part of a fulfilling life.

Professional activity

In outpatient radiotherapy, some patients do not stop working at all during the course of treatment. If you did not work during treatment, you can return to your professional activities as soon as you feel that your condition allows you to do so. If your work is associated with strenuous physical activity or occupational hazards, you should think about changing the working conditions or profession.

Leisure

Pay more attention to rest. Over time, you will restore your strength, so do not return to physical activity in full at once. Visit theaters, exhibitions. This will allow you to distract from unpleasant thoughts. Make it a rule to take daily walks in the fresh air (walks in the park, in the forest). Communicate more with friends and family. With the knowledge of your attending physician, consult a physiotherapist and a psychotherapist. They will help you choose an adequate physical activity (improving gymnastics) and suggest ways to overcome stress.

Conclusion

We hope that this information will help you get rid of excessive nervous tension, make it easier to undergo a course of radiation therapy, and understand what awaits you after it. All this contributes to your recovery. For more information on matters related to your health, please contact your doctor.