During your treatment

You will start treatment 1 to 2 weeks after your planning appointment. 

You will not be able to wear any clothing or jewellery during your treatment. You should also remove any nail polish, or false nails, before you come for treatment. 

Please bring a robe and slippers to wear between the changing room and treatment room. We can provide a hospital gown if you need it. 

You will not be able to wear any underwear during treatment (including a bra). You will be given underwear made out of a net material to wear, and a special bra, if you need it. 

During your treatment

You will need to stand for the treatment, holding a bar within the treatment frame.

Treatment positions 

The radiographers will ask you to move and stand in 6 different positions, with your arms raised. 

You will need to hold each position for a few minutes then change to the next. 

You will have to wear goggles over your eyes for every treatment. The goggles protect your eyes from the radiation. They are heavy and dark. This means that you will not be able to see anything while you are wearing them.

If your hands and feet do not need treatment, we might ask you to wear a special shielding made with lead, or place a Perspex device in front of you during treatment. This protects the areas from radiation.

For the first treatment, we will place 25 small packets of crystals at different points all over your skin. These monitor the dose (amount) of radiation that you receive. 

During treatment, you will be in the treatment room on your own, but the radiographers will be watching you on a monitor and can hear you on an intercom. When the machine is switched on you will hear a beeping sound, but you will not feel anything from the treatment.

You might need to have boost treatments to some areas such as your, scalp, eyes and perineum (the area under your bottom). This is to treat the areas where the TSEBT might not have reached. 

After you have had your treatment, you can leave the hospital. 

Care during your treatment

You will have a weekly check-up with the radiotherapy doctor who will monitor your treatment closely. You will have a blood test at the start of treatment, and this will be repeated in weeks 3 and 5. You will only have a repeat blood test if you are having the 5-week course of treatment. 

The nurses in the clinic can advise you on skin care or any other problems that you might have. 

Side effects of TSEBT

Having TSEBT can cause some side effects, but there are ways you can manage these.

Itchy skin

Your skin might itch after treatment. To help with any discomfort, you can:

• keep your skin moisturised
• wear cotton clothes (and avoid wool and synthetic fabrics)

Your doctor might prescribe antihistamine medicine to relieve the itching, but this might make you drowsy.

Fissures (cracks in your skin)

You might develop some cracks in your skin after treatment. You will be prescribed an antibiotic ointment, which you should apply to your skin, as well as dressings for your wounds. Not all dressings are suitable to use on your skin, so check with the nurses for suitable dressings before applying any. 

Sun sensitivity

Your skin will be more sensitive to sunlight for up to 6 months after your treatment. To protect your skin, you should:

• wear a hat and long sleeves when you go out into sunshine
• wear a sunscreen that protects you from ultraviolet A (UVA) radiation and ultraviolet B (UVB) radiation
• wear sunglasses that protect you from UVA and UVB

The NHS website has more information on protecting yourself in the sun. 

Skin infections

If you have any skin infections, make sure you keep the skin clean and well moisturised. You should apply your prescribed antibiotic ointment to any lesions.

Fatigue

You might feel very tired towards the end of your treatment. This can be because of:

• the biological effects of radiation
• travelling for treatment each day
• lack of sleep
• itchy skin or other symptoms
• feeling anxious or depressed

The tiredness will gradually resolve, but it might last for several months. To help manage tiredness you can:

• plan rest periods into your daily routine
• take a walk or do something that you enjoy
• if you are working, you might want to work reduced hours
• ask friends and family to help you with everyday activities
• eat a healthy diet

Sweating  

Sweating is your body’s natural way of controlling its temperature. After TSEBT, your sweat glands might not work properly for a few months and you might sweat less than before. Avoid strenuous (intense) exercise, such as jogging and running, in hot humid weather, and drink plenty of fluids. In cooler weather, wear layers of clothes to keep you warm if you feel chilly.

Swelling

Towards the end of your treatment, your ankles and feet might swell. You might also get blisters on your feet. Wearing soft shoes and slippers might help to prevent blisters. 

Brittle nails

If your nails are not shielded during treatment, they may become brittle and split. Keep your nails trimmed. Treatment can also cause nails to fall out, but if they do, they should grow back again a few months after treatment has finished.

During this time, you can wear thin cotton gloves to protect your nails, and to prevent scratching your skin or snagging your clothes. 

Do not apply any nail polish to fingers and toe nails while you are having the treatment, until skin reactions have reduced.  

Hair loss (alopecia)

You might lose your hair, but it usually grows back 3 to 6 months after treatment has finished.    

Other side effects

You might have:

• changes in taste
• a dry mouth
• nose bleeds
• dry eyes
• stiffness in your hands and feet

If you have any of these side effects, please let your doctor or the radiographers know.  

Radioactivity

With TSEBT, the radiotherapy you have will not make you radioactive, so there is no need to avoid close contact with other people (including children and pregnant people).

The radiation does not stay in your body after the treatment.

You can be sexually active during your treatment with radiotherapy, unless your doctor tells you otherwise.

Looking after your skin

It is important that you take care of your skin during your treatment, and up to 3 months after, to avoid any skin reactions.

If you are worried about any areas of your skin, please tell the staff caring for you.