When my oncologist first told me that radiation therapy would be part of my cancer treatment plan I felt a mixture of relief and fear.
Relief because there was a plan.
Fear because I had absolutely no idea what radiation therapy would involve.
My imagination immediately ran wild. I pictured huge machines. I worried about pain. I wondered whether I would be radioactive afterwards. I worried about side effects and whether I would be able to cope with daily treatments.
If you are preparing to start radiation therapy you may be having some of those same thoughts right now.
I want to share what I learned from my own experience because there are many practical things that can make the process less overwhelming. Whilst every person’s diagnosis and treatment plan is unique, there are certain realities that many of us experience.
This guide is not medical advice. Always follow the guidance of your oncology team. My goal is simply to help you feel more informed, more prepared and hopefully a little less frightened.
One of the first things I did was ask questions.
I quickly realised that much of my anxiety came from not understanding what radiation therapy actually does.
Radiation therapy uses carefully targeted radiation to damage cancer cells and prevent them from growing and dividing. Depending on the type of cancer, it may be used alone or alongside surgery ,chemotherapy, immunotherapy or hormone therapy.
The treatment itself is painless which surprised me. The machine makes noises and moves around you but you do not feel the radiation entering your body.
Knowing this beforehand will help calm many of your fears.
The emotional preparation was almost harder than the practical preparation.
There is something daunting about walking into a cancer centre for the first time. Even if you have already undergone surgery or chemotherapy, radiation therapy feels like another significant step in the journey.
I found it helpful to acknowledge my fears instead of trying to ignore them.
Some of my worries included:
Speaking openly with my oncology team helped tremendously. Many of my fears became smaller when I opened up completely about them and they were discussed honestly.
I also found comfort in talking to other cancer patients who had completed radiation therapy. Their experiences reassured me that whilst treatment could be challenging, it was manageable.
Before my first treatment I attended what is often called a simulation or planning session. This appointment is extremely important because it helps the radiation team map out exactly where treatment will be delivered.
The process may involve:
I was not expecting this appointment to take as long as it did but the staff explained that precision is critical because the goal is to target the cancer cells whilst protecting healthy tissue as much as possible.
The planning session gave me confidence because I could see the level of care and attention involved.
I took a notebook to appointments with all my questions ready and wrote down answers.
Questions I found useful included:
Writing down answers prevented me from forgetting important information once I got home.
One thing I underestimated was how much daily appointments would affect my routine. Radiation therapy often takes place five days a week for several weeks which was the case for me.
Although each appointment may only last a short time, travelling to and from the treatment centre can become tiring.
Before treatment started I tried to simplify my schedule.
I gave myself permission to focus on treatment and recovery so removing unnecessary pressure made a huge difference.
This may sound like a small detail but comfortable clothing became very important.
I recommend loose-fitting garments, especially for when the treatment area becomes sensitive. You don’t want anything harsh on your skin
I found these items particularly useful:
Comfort quickly becomes more important than fashion during cancer treatment trust me.
Skin care was one of the topics discussed most often during my treatment and with good reason.
When radiation therapy begins, many patients are surprised by how normal everything feels. The treatment itself is painless and during the first week or two there may be very few noticeable side effects.
I remember thinking that perhaps I would get through treatment without any significant skin problems.
Unfortunately that was not my experience.
As the treatments continued, the skin in the treatment area gradually became more sensitive. What started as mild redness, eventually felt similar to severe sunburn. The area became tender sore and increasingly uncomfortable.
Radiation affects healthy cells as well as cancer cells and the effects often build up over time. This means that side effects may become more noticeable towards the end of treatment and sometimes even for a short period after treatment has finished.
My oncology team provided specific guidance about skin care and I followed their instructions carefully.
Some of the recommendations included:
Every treatment centre has its own protocols so always follow the advice of your oncology team. Looking after your skin from the very beginning may help reduce discomfort later in the treatment process.
I was nervous before my first appointment. Very nervous in fact.
What helped me was creating a simple routine.
And I reminded myself that thousands of people successfully undergo radiation therapy every day.
After the first session much of my anxiety disappeared because the experience was not nearly as frightening as I had imagined.
Fear definitely grows larger in the unknown.
This was a side affect that took me by surprise as it did not really make sense to me.
When I asked my oncology team they explained to me that it is primarily caused by your body expending extra energy to repair healthy cells that get damaged during treatment. This process triggers an immune response which elevates stress hormones.
Fatigue can also be compounded by anemia (low red blood cell counts), as well as the emotional stress of the daily treatments.
Of all the side effects I experienced, fatigue was probably the most significant.
Many people assume tiredness appears immediately but for me it developed gradually. At first I felt relatively normal, but after several weeks I noticed my energy levels declining.
Fatigue during radiation therapy is not ordinary tiredness and resting became a necessary part of my recovery strategy rather than an occasional luxury.
I learned to listen carefully to my body.
Some days required activity. Other days required rest.
Both were equally valid.
Eating well became more important than ever as treatment places additional demands on the body and good nutrition supports recovery.
My healthcare team encouraged me to focus on:
Some days were fine but there were days when my appetite was low. On those days small snacks throughout the day were easier than having a full meal.
If you have concerns about eating or weight changes ask your healthcare team for guidance. Many cancer centres have dietitians available to assist patients.
This was probably the part of radiation therapy that caught me most off guard.
The actual treatment sessions remained painless throughout my course of radiation therapy but the treatment area itself became increasingly uncomfortable as the weeks passed.
For some patients the skin may simply become pink and sensitive. For others it can feel like a severe sunburn with soreness, itching, burning or peeling skin.
Depending on the location being treated, there can also be discomfort when clothing rubs against the skin or when trying to sleep.
A few things helped me cope:
I quickly abandoned anything tight scratchy or restrictive.
Soft cotton clothing became my best friend. Loose-fitting garments reduced friction and made everyday activities more comfortable.
Kaftans were not really my vibe but quickly became my go to.
Pain and fatigue often go hand in hand during radiation therapy. Giving my body permission to slow down helped both physically and emotionally. Allowing myself to simply rest in a comfortable position provided much sort after relief.
If the skin becomes painful, speak to your radiation team immediately.
Do not suffer in silence.
Many treatment centres can recommend specialised creams, dressings, gels or other treatments designed specifically for radiation-related skin reactions.
I found that keeping the treated area cool and avoiding overheating helped reduce discomfort. I would to lie on the bed with a fan gently blowing on the affected area which really helped.
Always ask your healthcare team what cooling methods are appropriate for your specific treatment area.
Whilst drinking water will not prevent skin reactions, it will supports overall wellbeing and recovery during treatment.
Other options are herbal teas. Not only were they a welcome change from water, but I found the warmth from the tea was soothing.
There is a tendency amongst cancer patients to minimise what they are experiencing.
I know I did.
If redness, soreness, blistering, peeling or pain becomes significant, tell your oncology team straight away. They deal with these side effects every day and can often suggest ways to improve comfort.
One thing I wish someone had told me beforehand is that skin reactions often continue developing for a short period after treatment ends. I expected everything to improve immediately after my final session, but recovery took longer than I expected.
Knowing this in advance would have saved me some worry.
Keep reminding yourself that the discomfort will eventually improve and the skin will gradually heal, but patience and perseverance is required.
If you experience painful skin reactions during radiation therapy, please remember that you are not failing and you are not being weak. Many patients experience similar challenges and support is available.
If pain meds are offered, take them. If they are not offered, ask for them.
You are trying to cope with so much as it is so there is no point in trying to be a hero.
I am naturally independent so accepting help did not come easily, but radiation therapy taught me that support is not a weakness. Family and friends often want to help but do not know what you need from them.
Practical assistance might include:
Even the smallest of gestures can ease the burden during treatment.
Radiation therapy affects more than the body. There were days when I felt optimistic and strong. Then there were other days when anxiety crept in unexpectedly.
What helped me most included:
Sometimes I would simply ask for an hour or two of absolute alone time with no interruptions. This allowed me time to think, cry, not think, not have to communicate and just be one with myself for a short time.
Mental wellbeing deserves just as much attention as physical wellbeing.
Before treatment began I made several small adjustments at home.
These simple preparations reduced stress once treatment was underway.
Most importantly I discovered that I was stronger than I realised.
Many cancer patients underestimate their resilience.
You do not need to be fearless to get through radiation therapy. You simply need to keep showing up one day at a time.
If I could sit down with someone beginning treatment tomorrow this is what I would say.
Radiation therapy may feel intimidating right now but knowledge and preparation can make the road ahead feel much more manageable.
You are stronger than you think.
One appointment at a time.
One week at a time.
One step at a time.
That is how we get through it.
