Managing side effects

We cannot prevent side effects, but we can help you to manage them. We use the most modern radiotherapy techniques available to reduce the side effects as much as possible. However, some side effects are unavoidable. We will support you and help you to manage these side effects, with advice and medicines where necessary.

Pain in the breast

You might have some discomfort in your breast, such as sharp pains, heaviness and swelling. These side effects will gradually settle after treatment has finished.

Tiredness

You might feel tired during treatment. Try to rest, eat regularly, and do a small amount of light exercise (such as walking). Ask your friends and family to help you with daily activities.

Looking after your skin

Radiotherapy commonly causes inflammation (swelling), redness and itching 1 to 2 weeks after treatment begins. This can sometimes affect the entire treatment area. We have advice about how you can reduce the chances of skin reactions.

Washing your skin

It is important to keep the treatment area clean. Shower or bathe using slightly warm water and your usual soap or shower gel. Use a soft towel to gently pat your skin dry and do not rub it.

Moisturising

Moisturising the treatment area can help your skin. You can continue to use your usual moisturiser or, if you need to buy one, we recommend one without sodium lauryl sulphate (SLS). During treatment, use the moisturiser sparingly, 2 times a day, or more often if your skin is very itchy. Check your skin each day before applying creams. Dressings will be given for broken skin.

Do not use moisturisers on broken skin.

Hot water bottles

Do not use a hot-water bottle on your chest during your treatment as it will irritate your skin.

Deodorant

You can continue to use your usual deodorant, unless your skin becomes sore or irritated.

Hydrocortisone cream 1%

This is a steroid cream that helps with inflammation. It can be prescribed by your doctor if the itchiness becomes a problem. Check your skin each day before applying creams. Your doctor will give you wound dressing for any broken skin.

Do not use the hydrocortisone cream on broken skin.

Shaving

Do not wet-shave under your arm on the treatment side. If you really need to shave, you can use a dry, electric razor. Do not use any hair removal creams or wax on or near the treatment area.

Clothing

Wear comfortable clothes. If you usually wear a bra, it is better to wear a loose one. Nursing bras or camisoles might feel more comfortable.

Swimming

Reduce the number of times you swim in chlorinated water (usually found in swimming pools) as this can dry out your skin. After swimming, shower to remove chlorine. You should stop swimming if the skin becomes sore.

Sun

The skin in the treatment area will be more sensitive during radiotherapy and should not be exposed to the sun. You need to protect the skin in this area for at least 1 year after treatment, using a high-factor sun cream.

How to get more medicines

After being prescribed medicines at the hospital, take the white copy of your prescription to your GP who can continue to prescribe these for you. Anyone with a cancer diagnosis is entitled to free prescriptions.

If you do not already have a medical exemption card, you can get an application form from:

• your GP
• the cancer outpatient department
• Dimbleby Cancer Care
• Dimbleby Macmillan Support Centre

Please ask us if you need any more information.

When your treatment ends

The side effects are likely to get worse during the 2 weeks after treatment, before they start to improve. At the end of your treatment, you will see a treatment support radiographer who will review your side effects and advise you how to manage them. You will also receive a call from them over the next few weeks to see how you are managing.

On the last day of treatment, you will be given a treatment completion form summarising your treatment. We will also send a copy to your GP.

Follow-up appointments

Your oncologist will see you 2 to 6 weeks after your treatment is complete. This appointment is to check that you are recovering well, and will take place in the clinic where you were seen originally.

In the long-term, you will have follow-up appointments with your oncologist and referring surgeon. This is to check how you have recovered and responded to treatment. You can book these appointments using the phone number and information you were given at your first radiotherapy treatment appointment. 

You will have more appointments with your oncologist at 6 months, 1 year, and then every year, for the next 5 years. You will also have follow-up appointments with the referring surgical team.

Getting back to your routine

Going on holiday

If you skin is protected from the sun, you can go on holiday when you feel well enough. You can swim when your skin reaction has healed.

Going back to work

Some people continue to work throughout their radiotherapy treatment, while others feel they need a few weeks before returning, especially if they have had chemotherapy as well. If you have had a long break from work, you might want to plan a gradual return and work shorter hours at first.

Financial support during treatment

Dimbleby Cancer Care, based in the Welcome Village at Guy’s Cancer, offer a benefits advice service. For more information, phone 020 7188 5918.