Ask the Expert

How can you feel your best when undergoing radiation therapy for a brain tumour?

Radiation therapy involves the use of high energy x-rays to kill tumour cells. Although patients generally feel quite well on treatment, here are some typical side effects with advice on how to deal with each one:

Headache and nausea
As tumour cells are killed, brain swelling may occur, resulting in headache and nausea. Your doctor may prescribe a steroid medication to reduce the swelling. This medication is very effective but can cause a number of side effects, especially if used for long periods. It should not be stopped abruptly, so speak to your health care team about how and when to discontinue it. You may also benefit from medications used to treat nausea.

Hair loss, hearing and skin changes
Hair loss will occur where radiation beams are directed and may be temporary or permanent, depending on the dose delivered. If you are interested in wearing a wig and would like to match your natural colour and style, shop for one before the hair begins to fall out, usually in the 2nd or 3rd week of treatment. The scalp may become tender and red, like a sunburn. Use a mild shampoo with lukewarm water and avoid dyes, hair dryers and curling irons. If you develop itching or flaking skin, your radiation therapists will advise you about the use of appropriate creams. Oozing skin or pain should be promptly reported. Cover your head and ears to protect your skin from sun, wind and extreme temperatures. Hearing may be reduced by a buildup of wax in the ear. A few drops of mineral oil in the ear canal will help soften the wax and allow it to be dislodged. Avoid putting anything else into the ear.

Fatigue
Fatigue usually occurs midway through treatment. Activity and exercise may help to prevent or decrease fatigue, but you should also allow for rest periods in the day. Plan your day so that your most demanding activities occur when your energy is likely to be best. If possible, delegate some responsibilities to family and friends. Rarely, extreme sleepiness and fatigue may occur, accompanied by loss of appetite and nausea. This should be reported to your health care team.

Bleeding and infections
If you are taking chemotherapy with radiation, remember to have your blood drawn regularly, and monitor for signs suggesting that your blood cells have been affected by the treatment. Of greatest concern is the effect on white blood cells (that fight infection), and platelets (that prevent excessive bleeding). Report signs of infection, especially a fever greater than 38.5º C (101º F), or go to your local emergency room. Also report the appearance of bruises, red spots or unusual bleeding.

It is important to let your health care team know how you’re doing so that they can offer you guidance and support throughout your treatment.