Is cancer radiation therapy painful?

Radiation therapy itself does not cause pain during the session, as the radiation used in treatment cannot be seen or felt. However, various side effects may appear after sessions, which can cause indirect discomfort or pain. These side effects vary from person to person and depend on the area of the body being treated, the type of radiation used, and the total dose. Healthy cells are often able to repair themselves better than cancer cells after exposure to radiation, but the damage inflicted on them can lead to the appearance of these side effects [1].

Understanding Radiation Therapy

Radiation therapy uses high doses of radiation to kill cancer cells or slow their growth by damaging their DNA. Cancer cells whose DNA is damaged beyond repair stop dividing or die, and the body then clears out these damaged cells. These cells are not killed immediately; it takes days or weeks of treatment before their DNA is damaged enough for them to die, and cancer cells may continue to die for weeks or months after treatment ends [2].

There are two main types of radiation therapy: external beam radiation, where radiation is directed from a machine outside the body, and internal radiation (brachytherapy), where a radioactive source is placed inside the body near or into the tumor [2]. The choice of type depends on several factors, including the type of cancer, its size and location, its proximity to radiation-sensitive normal tissues, and the patient's general health [1].

Common Side Effects

Side effects of radiation therapy can vary significantly. Common side effects that may occur regardless of the treatment area are fatigue and skin changes in the treated area. Skin changes can include redness, dryness, itching, peeling, or even blistering. These changes are usually temporary and improve after weeks or months following the end of treatment [1].

In addition, side effects specific to the treated area may occur. For example, if the treatment is in the head and neck area, the patient may experience dry mouth, mouth sores, difficulty swallowing, or changes in taste [1]. If the treatment is in the abdomen or pelvis, digestive problems such as nausea, diarrhea, or bladder irritation may occur [1].

Tips for Managing Side Effects

• For fatigue: Try to get enough rest. Light walking or moderate exercise may help relieve fatigue, but consult your doctor before starting any new exercise program [3].
• For skin care: Keep the treated area clean and dry. Use mild soap and lukewarm water. Avoid scrubbing the skin vigorously. Ask your doctor or nurse about a suitable moisturizer that can be used to soothe the skin. Avoid direct sun exposure to the treated area [1].
• For mouth sores and swallowing difficulty: Eat soft foods that are easy to swallow. Avoid spicy, acidic, or rough foods. Drink plenty of fluids and keep your mouth hydrated. Your doctor may recommend special mouthwashes to relieve pain and inflammation [3].
• For nausea and diarrhea: Eat small, frequent meals. Avoid fatty or fried foods. Drink fluids slowly. Your doctor may prescribe anti-nausea or anti-diarrheal medications when needed [3].

When Should You Seek Medical Help?

It is important to communicate with your healthcare team if any severe or intolerable side effects occur. Signs that require emergency care include fever (more than 38°C), unusual bleeding, severe pain that does not resolve with standard painkillers, or severe difficulty breathing or swallowing [3]. These symptoms may indicate complications requiring immediate evaluation. Remember that everyone responds to treatment differently, so regular follow-up with your doctor is crucial to ensure effective management of any side effects. For more information on types of radiation therapy and how to manage its side effects, you can visit Radiation Therapy for Cancer: Types, Side Effects, and Tips for Management (Arabic).

Medical references

• Radiation Therapy
• Radiation Therapy to Treat Cancer
• Radiation Therapy and You: Support for People With Cancer