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What Are The Side Effects Of Internal Radiation

If Youre Having Radiation Therapy To The Pelvis

Cancer Treatment: IMRT (Radiation Therapy)

Radiation therapy to the pelvis can cause side effects such as:

  • Bladder problems
  • Fertility problems
  • Changes in your sex life

You might also have some of the same problems people get from radiation to the abdomen, such as nausea, vomiting, diarrhea, or constipation.

Bladder problems

Radiation to the pelvis can cause problems with urination, including:

  • Pain or burning sensations
  • Blood in the urine
  • An urge to urinate often

Most of these problems get better over time, but radiation therapy can cause longer-term side effects as well:

  • Radiation cystitis. If the radiation damages the lining of the bladder, radiation cystitis can be a long-term problem that causes blood in the urine or pain when passing urine.
  • Urinary incontinence. Radiation treatments for certain cancers, such as prostate and bladder cancer, may make you unable to control your urine or have leakage or dribbling. There are different types and degrees of incontinence, but it can be treated. Even if incontinence cant be corrected completely, it can still be helped. See Bladder and Bowel Incontinence to learn more. This side effect is most often a problem for men being treated for prostate cancer, but some of the information might also be helpful for women dealing with treatment-related incontinence.

Nursing Allied Health And Interprofessional Team Interventions

Nursing interventions and patient education play an essential role in reducing the side effects of radiotherapy. Specific strategies that can be useful include:

  • Identification of patients at risk of complications and initiation of appropriate therapy .
  • Oral hygiene instruction for all patients receiving head and neck irradiation. Consultation with a dentist and treatment of periodontal disease before radiotherapy can minimize the risk of jaw osteoradionecrosis. Use of bland rinses, cryotherapy, mucosal protective agents, antiseptic mouthwashes, topical analgesics, and anti-inflammatory agents or growth factors as necessary. Regular assessment and monitoring of high-risk patients can reduce long-term sequela in these patients and improve the overall quality of life. Dietary modifications that alleviate symptoms include avoiding spicy or acidic foods, caffeine, alcoholic beverages, alcohol-containing mouthwashes, and sharp foods .
  • Nutritional assessment and dietary consult can improve the healing of damaged tissues. It is especially important in patients with cancer cachexia compounded by radiotherapy-associated fatigue, loss of appetite, alterations in taste sensations, and mucositis.
  • Wound care interventions for skin ulcers with hydrocolloid dressings and regular cleaning and hyperbaric oxygen therapy for refractory cases.
  • Vaginitis douches with dilute hydrogen peroxide use for cleaning and prevention of infection following pelvic irradiation.
  • Will I Be Radioactive During Or After Internal Radiation Treatment

    With internal radiation therapy, your body may give off a small amount of radiation for a short time.

    If you have a temporary implant, youll be asked to stay in the hospital and might have to limit visitors during treatment. You also may be asked to stay a certain distance away from them. Pregnant women and children might not be allowed to visit you. Depending on the type of implant, once it is removed, your body will likely no longer give off radiation.

    Over a few weeks to months, permanent implants will slowly stop giving off radiation. The radiation usually doesnt travel much farther than the area being treated, so the chances that others could be exposed to radiation is very small. Still, your health care team might ask you to take certain precautions such as staying away from small children and pregnant women, especially right after you get the implants.

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    Treatment Areas And Possible Side Effects

    Part of the body being treated Possible side effects

    Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is over. But sometimes people may have side effects that do not improve. Other side effects may show up months or years after radiation therapy is over. These are called late effects. Whether you might have late effects, and what they might be, depends on the part of your body that was treated, other cancer treatments you’ve had, genetics, and other factors, such as smoking.Ask your doctor or nurse which late effects you should watch for. See the section on Late Effects to learn more.

    • Reviewed:January 11, 2022

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    Enhancing Healthcare Team Outcomes

    Effects of Radiation

    Radiotherapy is the single most effective non-surgical treatment of cancer. In terms of overall cost, radiotherapy consumes only 5% of total spending for cancer care while forming a significant part of the treatment plan for almost 40% of patients and is responsible for a cure in about 16%. There has been huge progress in the field to improve effectiveness and minimize side effects. Some techniques that can be used to reduce side effects are:

  • Stereotactic Surgery and Stereotactic Body Radiation Therapy : Single fraction treatment or multifunctional administration of high dose radiation to particular target areas from multiple directions to maximize dose delivery at highly specific points helps reduce exposure to surrounding normal tissues. Commonly utilized in intracranial, spinal, or extracranial sites in sensitive tissues .
  • Brachytherapy: Radiation source is placed inside the tissue or next to the target area and slowly emits radiation, which is active only for a short distance. Commonly utilized for prostate cancer and gynecological malignancies.
  • Fractionation: Delivers radiation in multiple fractions allows time for normal tissues to repair before the next dose of radiation. Experimental evidence suggests that fraction size is the dominant factor in determining late effects. Therefore, hyperfractionated radiotherapy – where the number of fractions is increased, and the dose per session is reduced can reduce late complications without affecting local tumor control.
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    How Long Does The Implant Stay In The Body

    The implants may be temporary or permanent. If the implants will be removed but then put in again later, the catheter is often left in until the treatment is finished. The catheter is then removed when the implants are taken out for the last time. The way you will receive brachytherapy depends on a number of factors, including where the tumor is, the stage of the cancer, and your overall health.

    Does Radiation Have More Or Fewer Side Effects Than Chemotherapy

    Many of the side effects of chemotherapy and radiation are similar. Both treatments work to kill cancer cells. Both also damage healthy cells in the process.

    Radiation can be a more targeted therapy. In some cases, there are fewer side effects than chemotherapy.

    The type and severity of side effects from either treatment will also depend on the:

    • area of the body undergoing treatment

    For many people, both radiation and chemotherapy may be part of the treatment plan.

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    Does Radiation Therapy Hurt

    External radiation therapy won’t hurt. You won’t see or smell the radiation, however you may hear a buzzing sound when the machine is on. You will NOT be radioactive. It is safe to be in contact with other people, including pregnant women and children, when you are having treatment and afterwards.

    During internal radiation therapy you may experience a little discomfort from the implant, however you should not have any severe pain or feel ill. While your radioactive implant is in place, it may send some radiation outside your body. There will be limits on visitors while your implant is in place.

    Why Does Radiation Therapy Cause Side Effects

    I had radiation for breast cancer

    In this type of treatment, high doses of radiation therapy are used to destroy cancer cells. Side effects come from damage to healthy cells and tissues near the treatment area.

    There have been major research advances in radiation therapy over recent years that have made it more precise. This has reduced this treatment’s side effects compared to radiation therapy techniques used in the past.

    Some people experience few or no side effects from radiation therapy. Other people experience more severe side effects. Reactions to radiation therapy often start during the second or third week of treatment. Or, they may last for several weeks after the final treatment. Some side effects may be long term. Talk with your treatment team about what you can expect.

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    How Long Do Implants Stay In Place

    The length of time an implant is left in place depends on the type of brachytherapy you are getting. Some implants are permanent, while others are taken out after a few minutes or days. The type of implant you get will depend on the kind of cancer, where it is in your body, your general health, and other treatments you have had. If an implant is permanent, the radiation fades over time and at some point won’t give off any more radiation.

    Can I Have Radiation Therapy If I Am Pregnant

    If you are pregnant, you will probably not be able to have radiation therapy, as radiation can harm a developing baby. It’s important that you don’t become pregnant during treatment. Men who have radiation therapy should avoid getting their partner pregnant during treatment and for about six months afterwards, as radiation can damage sperm. Your doctor will be able to give you more information about radiation therapy and pregnancy.

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    Risks And Side Effects Of Brachytherapy

    Brachytherapy can cause short-term and long-term effects that may affect your physical and emotional wellbeing.

    We know that the thought of treatment having a long-term impact can be worrying. If you want to know more about what to expect or how to manage any effects, we are here for you.

    Advances Of Radiation Therapy

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    Despite possible long-term side effects of radiation treatment, it’s essential to point out that radiation therapy has come a long since it was introduced in 1903, especially in recent years. With more precise dosing and newer methods of delivery, older studies may overestimate the risks.

    At the same time, as people are living longer with cancer, the long-term effects of radiation will become increasingly important. It’s estimated that 50% of people diagnosed with cancer will receive radiation therapy at some point in their journey.

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    Limiting Cancer Risk From Radiation In The Environment

    EPA bases its regulatory limits and nonregulatory guidelines for public exposure to low level ionizing radiation on the linear no-threshold model. The LNT model assumes that the risk of cancer due to a low-dose exposure is proportional to dose, with no threshold. In other words, cutting the dose in half cuts the risk in half.

    The use of the LNT model for radiation protection purposes has been repeatedly recommended by authoritative scientific advisory bodies, including the National Academy of Sciences and the National Council on Radiation Protection and Measurements. There is evidence to support LNT from laboratory data and from studies of cancer in people exposed to radiation. 2,3,4,5

    How Is Brachytherapy Implanted

    The care team will typically insert brachytherapy into the patients body through a catheter or an applicator, depending on the cancer type, using one of the following techniques:

    • Intracavitary brachytherapy: The care team places the radiation source directly in a body cavity, or a cavity that the surgical team creates. For instance, the radiation may be placed in the rectum to treat rectal cancer.
    • Interstitial brachytherapy: The care team places the radiation source directly in or near the tumor rather than in a body cavity. For instance, the radiation may be placed next to a tumor in the breast to treat breast cancer.
    • Episcleral brachytherapy: The care team attaches the radiation source to the patient’s eye to treat ophthalmic tumors.

    After the catheter or applicator has been placed, its used to deliver the radiation source. Typically, devices such as pellets, seeds, ribbons, wires, needles, capsules, balloons and tubes are used to carry the radioactive material. These implants remain in place for a set period of time depending on the cancer type, other treatments, the type of radiation source, the cancers location and the patients overall health status.

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    Cancer Of The Bladder Or Lower Bowel

    A small number of men develop bladder cancer or cancer of the lower bowel after radiotherapy for prostate cancer.

    Your doctor will discuss this with you and you will have regular checks after your treatment ends. The checks aim to pick up cancer early when the chance of successful treatment is high.

    Urinary And Bladder Changes

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    Radiation therapy to the pelvis can cause urinary and bladder problems by irritating the healthy cells of the bladder wall and urinary tract. These changes may start 35 weeks after radiation therapy begins. Most problems go away 28 weeks after treatment is over. You may experience:

    • Burning or pain when you begin to urinate or after you urinate
    • Trouble starting to urinate
    • Bladder spasms, which are like painful muscle cramps

    Ways to manage include:

    • Drink lots of fluids. Aim for 68 cups of fluids each day, or enough that your urine is clear to light yellow in color.
    • Avoid coffee, black tea, alcohol, spices and all tobacco products.
    • Talk with your doctor or nurse if you think you have urinary or bladder problems. You may need to provide a urine sample to check for infection.
    • Talk with your doctor or nurse if you have incontinence. He/she may refer you to a physical therapist to assess your problem. The therapist may recommend exercises to help you improve your bladder control.
    • Your doctor may prescribe medications to help you urinate, reduce burning or pain, and ease bladder spasms.

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    How To Alleviate Side Effects

    Before RT begins, a doctor will describe the adverse effects that a person may experience during and after the treatment.

    If any side effects arise during treatment, inform the doctor as soon as possible some effects indicate that the treatment program should be changed or that the person should be taking radioprotective drugs. Other side effects may improve with lifestyle changes and home care. Below, we look at ways of managing some side effects of RT.

    Radioprotective Drugs For Reducing Side Effects

    One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.

    Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.

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    Mouth And Throat Changes

    To manage mouth and throat pain or sensitivity, try:

    • avoiding foods that are hard, crunchy, spicy, or acidic
    • eating soft foods

    The strategies below can help with managing bowel and bladder issues resulting from RT:

    • drinking plenty of clear liquids each day to prevent dehydration and constipation
    • eating foods rich in potassium and sodium to maintain the bodys electrolyte balance
    • eating smaller meals throughout the day to improve digestion
    • eating yogurt, bananas, and other high-fiber foods to prevent diarrhea
    • avoiding hard-to-digest foods and beverages, such as dairy products, alcohol, and fried foods

    Radiation Therapy And Risk Of A Second Cancer

    RadTown Radiation Exposure: Teacher Information

    Radiation therapy can damage cells around the area being treated and slightly increase your risk of developing another cancer. suggests radiation therapy for prostate cancer increases your risk of rectal cancer or acute myeloid leukemia.

    Its thought that the risk of a second cancer becomes higher with increasing dosages of radiation.

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    What Is The Procedure For Treatment

    Vaginal Vault brachytherapy

    An example of how an applicator might look is shown below. Please note there are many different kinds of applicators available and each institution will have its own type.

    The applicator is then attached by cables to a shielded container where the radiation source is kept when not being used. The treatment staff will leave the room while the radiation therapy is being delivered. The patient is asked to lie still during the procedure. During the treatment, the radioactive source leaves the shielded container, travels to the tube/applicator in the patient to deliver the treatment before returning to the shielded container.

    When the machine is on the patient may hear the cable and source moving but the treatment itself is not painful and you will not see or feel anything.

    There is a camera and microphone in the treatment room, for communication between the treatment staff and the patient if needed. You can also call out or wave your hands, and the staff will stop the treatment and come back into the room to attend to you.

    After the treatment is completed, the applicator is removed and you will be able to go home. The whole procedure usually takes around 20 minutes.

    What Happens After A Temporary Implant Is Removed

    In most cases, anesthesia is not needed when the applicator and/or implant is removed. Its usually done right in your hospital room. The treated area may be sore or tender for some time after treatment, but most people can return to normal activities quickly. Keep in mind that your body is recovering from radiation treatments, and you may need extra sleep or rest breaks over the next few days.

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