Side Effects of Radiation for Colorectal Cancer

Radiation may be a treatment option for colorectal cancer when there is a need to:

• Shrink the tumor before surgery so it can be more easily removed
• Kill any cancer cells that may remain in nearby lymph nodes after surgery
• Relieve disease side effects, such as pain or intestinal blockage

If you have radiation treatment for colorectal cancer, you may have some side effects during and after the treatment. When radiation kills cancer cells, some healthy cells are destroyed too. Not everyone who has radiation gets the same side effects. Some may go away when treatment ends and others can start several months to a year after treatment. Possible side effects from radiation treatment for colorectal cancer are:

Early side effects

• Skin changes and irritation may result from radiation treatment. Your skin may feel dry and itchy and may peel or blister. You can help relieve these symptoms by doing the following:
• Don't use hot water or shower more than once a day.
• Gently pat yourself dry afterward.
• Don't use heating pads or ice packs on radiated areas.
• Ask your doctor what skin products may be helpful to use.
• Tell your doctor if you develop sores.
• Fatigue is common during radiation treatment. It may go away when your treatment ends or last up to a year afterward. To boost your energy:
• Get eight hours of sleep a night and take naps (of under an hour so they won't interfere with nighttime sleep).
• Adjust your schedule so you don't overload yourself with too many activities.
• Put some activity, such as short walks or yoga, into your day. Check with your doctor first.
• Ask others for help with daily activities if needed so you don't wear yourself out.
• Nausea and vomiting may occur any time from a half hour to several hours after you have a radiation treatment, so you'll probably be free from these symptoms on non-treatment days. Some things you can do to try to avoid nausea are:
• Eat foods that don't tend to upset your stomach, such as clear soups, noodles and broiled or baked chicken without skin. Stay away from very hot or very cold foods and drinks.
• Try eating small meals and snacks often, rather than three large meals.
• See if you feel better if you eat before or after treatments.
• Eat slowly and try going for a walk after meals.
• Diarrhea can occur at any point during your radiation treatment. To help relieve it, you may:
• Drink plenty of clear liquids (such as water, tea and bouillon) throughout the day.
• Eat small meals often, rather than three large ones.
• Eat foods that soothe your stomach, such as those on the "BRAT" list (bananas, rice, applesauce and toast).
• Avoid foods that can make your condition worse, such as spicy foods, raw fruit and vegetables, dairy products and beverages with caffeine or alcohol.
• Ask your doctor if there is a medicine you can take for diarrhea if needed.
• Rectal urgency (a sudden, overwhelming need to have a bowel movement) is another possible gastrointestinal side effect of radiation, especially for rectal cancer.
• Urinary problems can start three to five weeks after you begin radiation. They usually go away within two to eight weeks after your treatment ends. Problems may include:
• Incontinence, being unable to control your bladder muscles so that you may:
• Sometimes leak urine, especially when you sneeze or cough
• Have to get up often in the night to urinate
• Have sudden, overwhelming urges to urinate
• Burning or pain when you urinate
• Trouble starting to urinate or getting all the urine out
• An inflammation in your urinary tract (cystitis)
• Painful cramps in your bladder muscle
• Blood in your urine

Talk to your doctor if you have any of these problems. Drink plenty of clear liquids (in small sips) and avoid beverages with caffeine or alcohol to help relieve symptoms.

Late side effects

• Infertility is the inability for a man or a woman to create a pregnancy. It can be a late side effect of radiation, but is rare. Infertility may develop six months or more after treatment has ended. If you want to have children, talk to your doctor about ways you may be able to prevent infertility and what you can do if it does happen. There are things you can do to prepare for potential infertility. Men can bank some sperm before radiation begins. Women may choose to have some eggs preserved. If infertility occurs after radiation, there are still ways that you can have a child, such as adoption or the use of donor eggs or sperm.
• Erectile dysfunction (also known as impotence or ED, the inability to have an erection). Sexual changes after radiation may develop six months to a year after you finish your treatment. If you do have erection problems, talk to your doctor. This problem may be corrected through surgery, medical devices or medications.
• Lymphedema is a build-up of lymph fluid that occurs when lymph nodes are damaged from radiation. It often develops in the legs. You may at first notice redness, swelling, pain or a feeling of tightness, heaviness or weakness in your leg. If you have these signs, talk to your doctor about medicines or compression stockings to help relieve symptoms. Exercise can also help prevent or reduce lymphedema.

Related Articles Radiation Treating Colon Cancer

External Sources National Cancer Institute. Radiation therapy and you. Accessed October 22, 2007. National Comprehensive Cancer Network. Colon and rectal treatment guidelines for patients - version IV, February, 2005. Accessed October 22, 2007.

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