Side effects of radiotherapy for pleural mesothelioma
You are unlikely to get side effects from having radiotherapy to your scar, or from radiotherapy to control your symptoms.
You may have side effects if you have a few weeks of radiotherapy treatment after surgery for early pleural mesothelioma. The most common side effects are reddening of the skin and loss of hair in the treatment area.
The side effects you may have
Side effects tend to start a week after the radiotherapy begins. They gradually get worse during the treatment and for a couple of weeks after the treatment ends. But they usually begin to improve after around 2 weeks or so.
These side effects vary from person to person. You may not have all of the effects mentioned.
Side effects can include:
Your skin might go red or darker in the treatment area. You might also get slight redness or darkening on the other side of your body. This is where the radiotherapy beams leave the body.
The red or darker areas can feel sore. This may start after your radiotherapy treatment is completed. Your radiographers may give you creams to soothe your skin. The soreness usually goes away within 2 to 4 weeks of ending the treatment. But your skin might always be slightly darker in that area.
Radiotherapy causes tiredness.
Tiredness starts during your course of treatment. It usually lasts for about a week after your treatment has finished and then gradually gets better.
You might also feel weak and lack energy. Staying active can help.
You may lose some body hair in the treatment area.
Some of the side effects you may have depend on which part of your chest is being treated. If it is:
- your lower chest, you may feel sick or have diarrhoea
- your upper chest, you may develop a dry sore throat
These side effects are usually controllable with anti sickness or anti diarrhoea medicines. Ask your radiotherapy doctor for these if you need them. Any side effects tend to get worse towards the end of your treatment. Then they gradually clear up after it has finished.
While you are having radiotherapy, your radiographer or a physiotherapist may ask you to do particular exercises. These exercises help to prevent stiffness and aching in your chest and shoulder, which some people get after their treatment ends.
Radiotherapy can cause many different side effects, such as tiredness. The side effects you get will depend on the area you're having treatment to but there are some general side effects you might experience regardless of where your cancer is. This video is about the side effects you might have when having radiotherapy to the chest.
On screen text: Difficulty swallowing
Martin (Radiographer): Radiotherapy can irritate the lining of your oesophagus, also known as your food pipe, which can cause soreness and swelling and make it more difficult to swallow.
David: After about two weeks it started to get more difficult to swallow. The more it progressed, the worse it got and ended up couldn't eat anything solid at all so it was virtually down to liquids.
Laurel: I wasn't physically able to swallow anything whatsoever and that was quite challenging because I was thirsty and I was hungry, but, you know, nothing was happening.
Martin (Radiographer): Eating foods which are softer and easier to swallow can be helpful. Things such as soup and porridge or mashed potatoes.
Laurel: Yoghurt or custard were easier because I don't need to chew on anything.
David: Soups, trifles, tiramisus. It's down to trial and error and keep trying to eat what you can because you really have to keep your body up to scratch.
Martin (Radiographer): I'd recommend avoiding very spicy foods and avoiding foods which are very hot or very cold.
Laurel: Spicy food, definitely avoid the peppers and stuff like that.
Martin (Radiographer): For chest radiotherapy, we would recommend that you avoid alcohol as this can cause more irritation in the area we're treating.
Laurel: I had a dietitian and either on the phone or they'd pop in.
David: So they noticed that my weight was coming down so they got a dietitian in and she prescribed all these protein drinks.
Martin (Radiographer): You can replace the calories by swapping foods for high calorie alternatives, or your dietitian can recommend high calorie drinks and food supplements. If you're experiencing pain or heartburn during treatment, speak to your team and they can prescribe medication that can help with that.
On screen text:
- Try different foods to find out which are easiest to swallow
- Avoid eating foods that may irritate your throat
- Avoid smoking and alcohol, particularly spirits
- You might need high calorie drinks to boost your calorie intake
- Drink lots of water
- Let your team know if you need painkillers
- Ask to see a dietician
On screen text: Feeling or being sick
Laurel: Yes, being sick was one of the worst things happening.
David: I was just constantly being sick. I would have my porridge in the morning, wait a couple of minutes and it would be up again so it was just one of these things.
Martin (Radiographer): What you eat and drink can affect how sick you feel during treatment. You can drink fizzy drinks and eat ginger, which can help reduce sickness and we'd recommend avoiding fatty foods or big heavy meals, which can make you feel more sick.
Laurel: But I didn't realise, okay, you can get medication for the anti-sickness until the medical team realises that's what was needed. It's helped me slowing not being sick as often as I would have done because a lot of things I would just be gagging.
Martin (Radiographer): If you are having problems eating and drinking during your treatment, there are dieticians available which can help you.
On screen text:
- Your doctor can prescribe anti sickness medication
- Relaxation techniques such as mindfulness and visualisation might help
- Avoid certain foods
- Eating a few hours before treatment can help
- Drink lots of liquid, taking small sips slowly throughout the day
- See a dietician for advice – there is help available
On screen text: Shortness of breath
Martin (Radiographer): Having radiotherapy to the chest can affect your breathing. This may come on about two weeks after treatment begins and will continue throughout the rest of treatment. Once you've finished treatment, the breathlessness may continue for a couple of weeks, but then recovers after that. Depending on your diagnosis and treatment you may experience long term breathing problems and your doctor will discuss that with you before you start treatment.
David: So I've been constantly shortness of breath and I take inhalers twice a day now. I just have to be careful in what I do. I can walk for miles on the flat but as soon as an incline, that's when I start to get short of breath. I go out walking or cycling everyday, so that's just a constant to try and keep it going.
Martin (Radiographer): If you are experiencing shortness of breath, we would recommend speaking to your team as soon as you notice it, just to make sure there isn't something else going on, such as an infection or blood clots.
On screen text:
- Shortness of breath can happen during and after radiotherapy
- It usually improves after treatment finishes
- It can continue long term
- Always let your specialist or radiographer know if you are short of breath
If you're experiencing a side effect that hasn't been covered in this video, you can find more information on the Cancer Research UK website.
On screen text: For more information go to: cruk.org/radiotherapy/side-effects
