Radiation to the Bone

Side effects experienced from radiation treatment to the bone will vary from mild to moderate according to the area of bone that is being treated. Approximately two weeks after your first radiation treatment, you may experience some mild side effects. They may continue throughout the treatment period and gradually disappear after you have completed treatment. Your radiation oncologist will discuss which symptoms you are likely to experience, when you will notice them and how long they will last. To help minimize side effects, please follow these instructions carefully, and communicate any discomfort to your radiation oncologist or nurse.

Skin reactions

The skin exposed to radiation may become dry and itchy, or tanned and reddened. These symptoms will subside within a few weeks after completing therapy. With radiation to the bone, the skin reaction is usually very mild. Keeping your skin clean and dry will help. To cleanse properly, use lukewarm water and a mild soap, such as Dove, Basis Neutrogena or Aveno Oatmeal Soap. Wash the area gently and pat it dry with a soft towel. Do not scrub, rub or massage.

Avoid lotions and deodorants

Consult your nurse, therapist or radiation oncologist before applying any creams, ointments, lotions, powders or deodorants to the treatment area. These products often contain metals and alcohol, which can decrease the skin-sparing effect of today's radiation equipment and may result in increased skin irritation.

Pain control

The pain you have been feeling in the treatment area may decrease after several treatments or temporarily increase. The increase in pain may be due to swelling in the bone, a side effect of the radiation. Please notify your radiation oncologist or nurse of any pain increase and they will assist you in adjusting your pain medication. Do not be alarmed if the pain is not completely gone at the end of your treatment period. Radiation effects can continue working on the treated area for several weeks.

Medications

(May apply if receiving treatment to the spine.)

While you are receiving treatment, you may be taking a medication called Decadron (dexamethasone). It decreases swelling and inflammation caused by the tumor. Decadron may cause increases in your appetite, urination, fluid retention (swelling), leg cramps, difficulty sleeping and mood changes. These side effects are temporary, but should be reported to your radiation oncologist or nurse.

Your radiation oncologist will decrease your Decadron dosage over a period of weeks during the treatment course. Do not decrease this medication without first being instructed by your radiation oncologist or nurse. Make sure you do not run out of this medication. Your doctor will refill your prescription when you have a few tablets left.

Ambulation and exercise

(May apply if receiving treatment to the spine, pelvic girdle or long bones.)

Ask your doctor or nurse to instruct you on any precautions you may need to take regarding exercise and walking. If you need assistive devices such as a cane or walker, your nurse will help you in obtaining these items.

Sore throat/difficulty swallowing

(May apply if receiving treatment to the lower cervical or thoracic spine.)

If your lower neck or upper back area is being treated, swallowing food may become uncomfortable or painful. Discuss this with your radiation oncologist or nurse. Medication is available to ease this discomfort. The nurse or your dietitian will help you maintain your weight by finding foods that are easier to swallow and give you adequate nutrition.   See additional information in “Having Problems Swallowing?”

Nausea and heartburn

(May apply if receiving treatment to the thoracic or lumbar spine.)

If your mid-back area is being treated, you may experience mild nausea and/or heartburn during the treatment period. Small, frequent meals consisting of bland foods will provide some relief. In addition, anti-nausea medication may be prescribed. It is important to let the nurse or therapist know about any nausea or heartburn before each treatment session. The nurse or dietitian will assist you in finding foods that will cause less nausea and heartburn. See additional information in “Coping with Nausea and Vomiting”.

Bowel

(May apply if receiving treatment to the lumbar spine or pelvic girdle.)

If your pelvis or lower back are being treated, there may be a potential for diarrhea. You may be asked to take Psyllium Fiber (Metamucil) regularly to help prevent the diarrhea. If you have loose bowel movements or diarrhea, let your radiation oncologist or nurse know as soon as this occurs. Medication can be prescribed to keep the diarrhea under control. The nurse or your dietitian will assist you with a diet that will help prevent the diarrhea.  See additional information in “Having Problems with Diarrhea?”

Rectal/vaginal discomfort

(May apply if receiving treatment to the hips or parts of the pelvic girdle.)

If one of your hips or part of your pelvis is being treated, you may experience some discomfort in your rectum such as itching, burning or pain during a bowel movement. Female patients may also experience itching or burning sensations in the vagina. If these symptoms occur, medications are available for both, so please notify your radiation oncologist or nurse.

Sexual activity

Sexual desire or performance may change during your treatment. These changes vary greatly from one person to another. Please discuss your concerns with your radiation oncologist or nurse.

Fatigue

You may notice that you become increasingly tired during the last weeks of your treatment course. This is not unusual. Pace your activities and plan frequent rest periods to avoid becoming overtired. See additional information in “Simple Ways to Relieve Fatigue”.

Counseling

We understand the special needs and concerns you and your family are experiencing. Your radiation oncologist, nurse and other members of your treatment team can help answer your questions. If necessary, your radiation oncologist may refer you to a counselor, who can also talk with you, recommend appropriate support groups and refer you to the right community agencies.