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Coping With Radiation Treatment
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Radiation: What Is It and How Does It Work?
Half of us who are diagnosed with cancer will be treated with radiation therapy. Radiation is used for three things: to shrink or "de-bulk" a tumor thereby making it more accessible for surgery, to "cure" early stage cancer, and to provide a better quality of life through "palliative treatment" by reducing tumor pressure, bleeding and pain.
Radiation therapy works by damaging a cancer cell's DNA (the cell's genetic blueprint of how to function) thereby preventing it from dividing, spreading, and surviving. Radiation therapy is considered curative for cancer of the larynx and Hodgkin' disease. It is also curative, when combined with surgery and chemotherapy, in such cancers as head and neck, ovarian and childhood-based tumors. It is also used to prevent the "spread" of disease in brain and lung cancer.
There are two kinds of radiation treatment. There is External Radiation Therapy, where you go to the hospital and receive external radiation beams from a machine called a linear accelerator. With external beam radiation, the doctor will often mark your treatment area by "tattooing" your skin—outlining in semi-permanent ink, where the radiation technician should aim the beam of radiation. "Hyperfractionated Radiation Therapy," is another form of external radiation therapy where your treatment is divided into even smaller doses that you receive several different times a day in order to reduce the likelihood and severity of side-effects.
The second type of radiation is Internal Radiation Therapy. This is where you have small radioactive substances or "seeds" placed near or into your tumor itself. When internal radiation is used, it is often chosen in order to deliver a highly localized intense dosage of radiation to kill off any remaining cancer cells without damaging normal cells. Internal radiation is commonly used for head, neck, breast, uterus, thyroid and prostate cancers. "Interstitial radiation," "intracavitary radiation," and/or "brachytherapy," are other names for internal radiation therapy.
Fears of Radiation: Side-Effects, Radioactivity and Having To Say Goodbye
As with chemotherapy, the possible side effects stemming from radiation will vary greatly. And as with chemo, most of the side effects you may experience WILL go away with time. Two possible exceptions to this may be your ability to focus on sustained intellectual tasks and the possibility of developing "secondary" cancers years later that were caused by your radiation treatments.
Psychiatrists like Memorial Sloan-Kettering's Jimmie Holland point out that many of us harbor fears regarding radiation. Some of our fears stem from historical events such as the bombing of Hiroshima during World War II, as well as media coverage of the radiation leaks at nuclear power plants, such as Three Mile Island in the United States, and Chernobyl, in the former Soviet Union. It truly takes a powerful soul—one with the Samurai's Fudo—to overcome such fears.
If you are being treated with radiation therapy, the possible side-effects that you may experience include weight loss, nausea, vomiting, fatigue, a sore throat, diarrhea, sexual or fertility problems, skin rashes, burns, pain, hair loss, and low white blood cell, red blood cell and platelet counts.
The severity of your side effects will be depend on how much radiation you receive, where on your body you receive it and for how long of a period of time. As a patient receiving radiation, you will be faced with a number of emotional and social stressors. These stressors are common and will tend to undermine the personal power of your inner soul and being. They include the fear that your cancer will kill you, fear that the radiation won't get all of your cancer, fear you will become radioactive, and fear that you won't be able to withstand the effects of skin irritation, loss of appetite, diarrhea, nausea, and/or hair loss.
It is also common for you to feel angry and depressed at how bad your treatment makes you feel and the impact it has had on your lifestyle. And surprisingly, when radiation is over, and you lose your routine of going for radiation every day for weeks and being actively supported by a large treatment team, you may actually feel worse than when you started radiation. This is the start of what I call the post-treatment abyss.
Strategies to Cope With Radiation Anxiety and Side Effects: Empowering Your Personal Soul
As with chemotherapy, if you experience difficulty eating due to a lack of appetite, mouth sores, or nausea, many oncologists and radiologists recommend that you only eat when you are hungry, that you eat several small meals, that you use soft lighting and quiet music at table settings, and that you vary your diet. In addition, the National Cancer Institute has these recommendations for those of you who are undergoing radiation treatment, and who want to combat weight loss, fatigue and soreness. They are:
- Mix canned cream soups with milk for meals
- Drink egg nog, milkshakes or liquid supplements
- Add cream sauce or melted cheese to meals
- Avoid spices and coarse food such as raw vegetables
- Don't smoke or drink alcohol
- Drink cool liquids between meals
- Eat foods with mild aromas
- Clean your mouth and teeth often
- Do not use commercial mouthwash; the alcohol content has a drying effect on the mouth
- Use a fluoride toothpaste that contains no abrasives
- Floss gently between teeth daily
- And, rinse your mouth well with a salt and baking soda solution
If you experience skin rash, burning, redness, pain, or tenderness from your radiation treatments, besides informing your physician, we recommend that you avoid void wearing tight clothes, not scrubbing your radiated skin during bathing, and not using soaps or adhesive tape or very hot or cold water on your treated areas. Use only lukewarm water for bathing, as well as using a PABA sunscreen with a minimal of 15 protection, which should help areas of your skin that are red, burned or in pain.
Our Recommendations For Getting Through Radiation
Your radiologist or radiation oncologist should provide you with an orientation that consists of a complete tour of their facility, as well as meeting your treatment team, seeing the radiation machines, and receiving a video presentation of how the machines work. Research has shown that when patients undergo this type of orientation, they do better emotionally and physically with their radiation treatments compared to those patients who don't participate in such an orientation. This orientation should be followed with a question and answer session, so that you can ask such vitally important questions as why do you need radiation therapy, what are the benefits of radiation therapy, what are the risks of radiation therapy, what dose will you be getting, how will the treatment be given, how long will your treatments last, what are the possible side effects, and are there any other treatment, besides radiation, for your type of cancer?
In addition, your radiation oncologist should provide you with the names, phone numbers and addresses of those psychologists who are versed in teaching such relaxation and stress management procedures as hypnosis, biofeedback, progressive muscle relaxation, autogenic therapy, and cognitive behavior therapy**(see the sections on coping with surgery and chemotherapy for more details).
I also recommend you use a special soul-empowering coping technique called "The 3 P's," which stand for "Predict, Prepare and Practice." Write down your predictions regarding all the possible scenarios that you may experience in reaction to your radiation treatment. Include the best-case scenario involving minimal side effects, an alternate scenario involving moderate side effects and a worse-case scenario involving severe side effects.
Then, write down all of the things you need (physically, socially, emotionally and spiritually), to successfully cope with these possible scenarios. Who do you need to take you to and from your treatments? Who will cover for you at home with your chores? What medicines or foods do you need to prepare? Where's the quietest room of the house for you to get undisturbed rest? Which meditation tapes or music CD's do you need? Who can you "lean on" if you need to cry and vent?
Then, I recommend that you practice fire drill "walk throughs" of each of your prepared responses to these three scenarios that you came up with. By doing the "Three P's" (Predicting, Preparing and Practicing), you will reduce your anxiety and depression while increasing your mood and independence.
And finally, as mentioned before in the surgery and chemotherapy chapters, this again is an excellent opportunity to use your SANITYMatrix™ and its Transformational Grid with the 14 Pods of Healing. This will go a long way in helping you bring down your anxiety or depression while at the same time, pumping yourself up in coping with possible radiation-induced fatigue, in a focused and centered manner. As in the previous three chapters, I am including a blank SANITYMatrix™ for you to use in your efforts to cope with your radiation treatments and to insure the best possible treatment outcome for you and your family.
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