Head & Neck Radiation: Side Effects 1

MD Anderson Cancer Center
Date: May 2012

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>> Now let's talk about the side effects of radiation treatment.  It is important to understand that radiation only affects the tissues being treated.  Side effects start mild and slowly get worse throughout your radiation treatment.  Please note how severe these side effects are can vary from person to person, even with the patients who get the same areas treated. 

These are some of the most common side effects related to radiation treatment.  We will go through each of these so that you understand when they begin, how they will change throughout treatment, how to manage them, and the recovery time for each.  Some of these side effects can be physically and emotionally overwhelming.  You will get through it and we are here to help along the way. 

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Skin care is very important during radiation treatment.  Your skin will become dry during the 1st or 2nd week of treatment.  By the 2nd to 3rd week, your skin will look like it has a mild sunburn.  During the 4th week and throughout the reminder of your treatment the skin can break down, peel, and become moist.  After you complete your radiation treatment, it may take about 3 to 5 weeks for the skin to completely heal. 

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Follow these tips to help care for your skin:  Bathe with warm water and use moisturizing soaps; do not use hot water.  Use your hands to wash the skin of the treatment area; don't use a wash cloth or a sponge because this may irritate the skin.  Lightly pat the skin dry with a towel; don't rub.  Rubbing creates friction and can cause the skin to break down more quickly.  It's important to keep your skin moist by using recommended lotions, creams, gels, or ointments.  Start using these products on the first day of your treatment.  Wash your hands before applying these ointments to your skin.  Avoid any skin products that contain alcohol or perfumes.  Shave with an electric razor; do not use a razor blade, shaving cream, or aftershave.  Do not wear any makeup in the treatment area because this may cause more skin irritation.  Don't use a heating pad or ice pack on your skin; these can damage your skin.  Avoid direct sunlight, hot tubs, and swimming pools.  Wear clothes that are soft and loose fitting.  If the skin breaks down, drainage may leak from the site.  If this occurs, come to the head and neck radiation clinic and we'll show you how to take care of your skin.  This usually includes soaking the skin two to three times a day and applying wound dressings to help absorb the drainage.  After radiation is complete and your skin is healed, your skin will be permanently sensitive to the sun's rays and may burn more quickly.  So we recommend using a Sunscreen with a SPF of 45 or higher to protect the skin from the sun. 

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Any hair in the treatment area with radiation can stop growing after about four to six weeks of treatment.  This hair loss is usually permanent. 

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If any part of your tongue is in a treatment area, you'll have taste changes throughout the treatment.  This usually occurs during the 1st or 2nd week of treatment.  Foods tend to have a bland, metallic, or unpleasant taste.  When you've finished your treatment, your sense of taste will start to return in about one to two months and may continue to improve up to a year.  Some patients get more taste back than others. 

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Now let's talk about saliva; saliva a responsible for cleaning the mouth and teeth.  It predigests foods as we chew and lubricates foods to make swallowing easier.  Unfortunately if any of your saliva glands are in the radiation treatment area, the radiation affects the saliva glands and prevents them from doing their job.  During the 1st or 2nd week of radiation, you may produce less saliva.  This can make chewing and swallowing solid food more difficult.  During the 3rd and the 4th week, the saliva and the secretions that line the throat will become thick and sticky.  Small amounts of blood may be present and this is normal.  The thick secretions can make it difficult to swallow, drink, eat, and even sleep.  The saliva will remain thick and sticky throughout your treatment.