Life After Radiation Therapy

Once your course of radiation therapy is finished, continuing to take good care of yourself is essential. No matter what type of cancer you've had, you will need regular checkups and perhaps lab tests and X-rays to determine how successful the treatment was and if you need additional therapy.

The doctor who referred you for radiation therapy will schedule follow-up visits as needed. “During your follow-up care, your doctor may recommend more cancer treatment, rehabilitation and counseling, depending on how you are coping and how your body is responding to your cancer care,” says Lynn Wilson, MD, a Yale Medicine radiation oncologist who is the vice chair of Therapeutic Radiology and a professor of therapeutic radiology and dermatology at Yale School of Medicine. Most patients return to their radiation oncologist for regular follow-up visits. Others are referred back to their primary care doctor, to a surgeon, or to a medical oncologist—a doctor who is trained to give chemotherapy (treatment with anticancer drugs). The kind of follow-up care you need will depend on the kind of cancer you have and on other treatments that you previously underwent or may need going forward.

Follow-up care is tailored to each patient. “Your doctor will prescribe a customized plan to monitor your improvement and help schedule the care that you need,” says Dr. Wilson.

Here are some of the questions that you may want to ask your doctor after you have finished your radiation therapy:

• How often do I need to return for check-ups?
• Why do I need more X-rays, scans or blood tests?
• What would test results tell us?
• Will I need chemotherapy, surgery or other treatments?
• How will doctors know if I'm cured of cancer?
• What are the chances that it will come back?
• How soon can I go work and engage in sports or sexual activity?
• Do I need to take any special precautions?
• Do I need a special diet?
• Should I exercise?
• Can I wear a prosthesis?
• How soon can I have reconstructive surgery?

Some patients need help managing pain that can sometimes result at the treatment site after radiation therapy. You should not use a heating pad or warm compress to relieve pain in any area treated with radiation. Mild pain medicine may be enough for some people. If you have severe pain, ask the doctor about prescription drugs or other methods of relief. Be as specific as possible when telling the doctor about your pain, so you can get the best treatment for it. If you are unable to get relief from pain, you may want to talk with a doctor who is a pain specialist. Because pain can be worse when you are afraid or worried, it may help to try relaxation exercises. Other methods such as hypnosis, biofeedback and acupuncture may be helpful too.

Patients who have had radiation therapy also need take special care of their skin, since sensitivities and treatment-induced burns, infections and rashes may last for several weeks after your treatments end. Also wear sunscreen and be vigilant about it for at least a year, as your skin will be more sun-sensitive after radiation therapy.

“Be sure to be gentle with your skin in the treatment area until all signs of irritation are gone,” Dr. Wilson says. Some good advice: Don't try to scrub off the marks in your treatment area, which will compromise the skin’s barrier function and cause irritation. It’s better to let the marks fade and wear away on their own.

You may find that you still need extra rest while your healthy tissues are rebuilding. Keep taking naps as needed and try to get more sleep at night. You may need some time to rebuild your strength, little by little, so it might be a good idea to resume activities partially rather than going for a full schedule right away.

After treatment for cancer, you're likely to be more aware of how your body feels. If you notice any unusual symptoms, be sure to discuss them with your doctor, says Dr. Wilson. These include:

• Pain that doesn't go away, especially if it's always in the same place
• Lumps, bumps, or swelling
• Nausea, vomiting, diarrhea or loss of appetite
• Unexplained weight loss
• A fever or cough that doesn't go away
• Unusual rashes, bruises or bleeding

While many people continue to work during radiation therapy, others make the decision to stop working for a while. You can return to your job as soon as you feel up to it, even while your radiation therapy is continuing. If your job requires lifting or heavy physical activity, you may need to change your activities until you have regained your strength.

When you are ready to return to work, it is important to learn about your rights regarding your job and health insurance. If you have any questions about employment issues, contact the Cancer Information Service or the American Cancer Society. They can help you find local agencies that respond to problems cancer survivors sometimes face regarding employment and insurance rights.