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Side effects of total body irradiation (TBI)

Radiotherapy to the whole body is called total body irradiation or TBI. You might have TBI alongside high dose chemotherapy drugs as part of your preparation for a stem cell or bone marrow transplant.

Side effects

During the treatment and for some time afterwards you are likely to have:

  • sickness – you have anti sickness medicine to help prevent and treat this
  • tiredness – you might feel particularly tired about 6 to 12 weeks after your treatment and this could become severe for a couple of weeks
  • diarrhoea – tell you medical team if you have diarrhoea
  • a dry and sore mouth – your nurse will give you drinks, mouthwashes and painkillers to help
  • loss of taste and appetite
  • sensitive skin – your skin may go pink, darken and be itchy and more sensitive to the sun
  • complete head and body hair loss - this is usually temporary and will grow back gradually when treatment has finished

TBI and chemotherapy causes your blood levels to become low. So you are more at risk of infection, anaemia (low red blood levels) and bleeding. For example, bleeding gums and nose bleeds. You have treatment with antibiotics, blood transfusions and platelet transfusions if you need them.

Due to a high risk of infection, you may be looked after in a single room (isolation) in hospital.

Long term side effects

TBI can have long term effects. It can make your skin sensitive and you will need to be extra careful in the sun for several months after treatment. Talk to your specialist about exact precautions you should take to protect your skin in the sun.

There are other long term effects that can be more permanent. 

Lung changes

TBI can cause changes in the lung such as thickening or scarring of the tissue (fibrosis). This can cause breathlessness, coughing or wheezing. You will have regular tests to check how well your lungs are working and may need antibiotics to prevent infection. Breathing exercises can help.

Clouding of the lens of the eye (cataracts)

It is possible that you might develop cataracts several years after treatment. This means the lens inside your eye clouds over and it becomes increasingly difficult to see. This is less common now as you have radiotherapy over a few days. 

Your doctor will refer you to an eye specialist (ophthalmologist) if you develop a cataract. Cataracts are fairly easy to treat with surgery. The eye specialist removes the clouded lens and puts a man made one in its place.

Fertility problems

Unfortunately, you are usually unable to become pregnant or father a child after TBI and high dose chemotherapy.

In women, the treatment is likely to cause an early menopause. Sometimes it is possible for women to freeze their eggs or embryos before cancer treatment. But it takes time to stimulate your ovaries to collect the eggs. Your doctor may not want you to delay starting cancer treatment.

Men may be able to bank sperm before starting any treatment.

Ask your doctor and nurse if you're not sure about anything. They can explain what your options are. 

Underactive thyroid

The thyroid gland produces hormones that regulate our body metabolism. Low levels of these hormones can cause weight gain, tiredness, constipation and dry skin. You will have blood tests to check your hormone levels. If they are low, you can take thyroid hormone tablets.

A second cancer

Bone marrow and stem cell transplants can increase your risk of getting a second cancer. This is a worrying thought but it is important to remember that it is a very small risk. And it is less of a risk to your health than if the leukaemia, lymphoma or myeloma was not treated.

Last reviewed: 
27 Aug 2018
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