To the Central Chest
You will be receiving four to six weeks of radiation to the central chest area. Some of the
common side effects from radiation to the chest include skin irritation, dry or sore throat,
problems swallowing, fatigue, and nausea. Side effects can begin roughly 2-3 weeks after the
start of treatments. They can continue for 2-4 weeks after the treatments end. Some side effects
may occur at different times. Not everyone has side effects.
Positioning for Your Treatment
Each day, right before your treatment, you
will be asked to get into position on a
treatment table. The radiation therapists will
help you get into the correct position. Some
patients are put into “molds.” These molds
are made during the treatment planning
Tiny dots or marks may also have been put
on your skin. These marks relate to your
treatment field. They look like tiny freckles
and will not be easy to see. Oil based skin
markers or a dye may be used to make these
If these marks fade, they will be remarked.
After your radiation therapy is finished, you
can allow the marks to fade. You can also
gently remove them using soap and water or
baby oil. These marks may rub off on your
clothes. If this happens, spray the stains
with hair spray or Spray'N'Wash before
you wash your clothes.
Radiation Skin Reaction
Most radiation goes through the skin into
body tissues. Even so, the skin in treatment
sites can become reddened and irritated. It
can also become dry and itchy. Sometimes,
the skin will peel and become moist. This
happens most often in skin folds and curves.
The radiation therapists will tell you which
sites to watch.
Watch your skin closely and report any
changes you notice. Use the skin care
products as directed. As your skin reaction
develops, we will also watch it closely. We
may tell you to change the way you care for
your skin. Some skin reactions can be
painful. Tylenol or ibuprofen is usually
helpful. If you need something stronger or
help with skin care, let us know.
If you have questions or concerns after your
treatments end, call the Radiotherapy Clinic
(open 8am–5pm) at (608) 263-8500 and ask
to speak to a nurse. If the clinic is closed,
your call will be transferred to the answering
service. Give the operator your name and
phone number with the area code. The
doctor will call you back.
Skin Care during Treatment
In order to protect your skin during
treatment, you should follow the guidelines
listed below. You will need to follow these
guidelines during your treatment and
afterwards, until your skin has fully healed.
1. You may bathe or shower as usual using
lukewarm water. If you need soap, use
one that is meant for dry or sensitive
skin. Rinse skin well and gently pat dry.
Do not rub the skin in treatment fields.
2. Avoid heat--heating pads, very hot
water in the bath or shower, and hot
3. Avoid cold. Do not allow the skin to
become chilled from exposure to ice or
very cold water or air.
4. Avoid sunlight or sunlamps on the skin
in the treatment site. When you are
outside, keep the area covered with
clothing. If clothing does not completely
cover the area, use a sunscreen with SPF
of 20 or higher.
5. Avoid rubbing or using friction on the
treated skin. Do not rub or scrub the
treated area. Wear comfortable, loose,
cotton based clothing that will allow
good air flow. Avoid clothing made of
nylon or synthetics because they hold
moisture next to the skin. Clothes that
bind can cause further irritation to the
6. Avoid the use of tape on skin in the
7. In most cases, nothing should be applied
to the treated skin unless approved of by
your doctor or nurse. This includes bath
oils, perfumes, talcum powders, and
lotions. If a skin reaction is expected,
we will suggest a skin moisturizer. Use
it each day as instructed.
Remember: Your skin needs to be clean
and dry before each treatment. Lotions
and creams can be applied 2 – 4 times per
day to help your skin feel better. You
should not apply lotions or creams in the
1-2 hour period before your treatment. If
your treatment is later in the day, you
may apply a skin care product before
your treatment if it will be fully absorbed
by the time your treatment is given.
Skin Care after Treatment
1. Although rare, late effects may
occur. These late effects may occur
months to years after the end of
treatment. Treated skin may
continue to be dry. It may also
darken in color, or become firm and
tough. It may help to apply skin
moisturizer or Vitamin E oil.
2. The skin in treatment areas may always
be extra sensitive to sunlight. When
outdoors, use a sunscreen of SPF 20 or
higher on treated skin exposed to the
sun. This is because treated skin is at a
higher risk for a certain type of skin
Dry or Sore Throat
Sometimes a dry or sore throat can occur
with radiation to the chest. Listed below are
some things that you can do to help this side
1. Use a vaporizer in your living area or in
your bedroom at night when you sleep.
2. Avoid smoking and chewing tobacco.
3. Drink plenty of liquids – 8 to 10 glasses
4. Suck hard candies, mints, or medicated
5. Avoid alcohol, hot foods, acidic foods
and juices (orange, lemon, lime, or
grapefruit) and spicy foods.
6. Your doctor may prescribe a numbing
spray or liquid, if needed.
Problems with Swallowing
Problems with swallowing can develop
when the esophagus is in the treatment field.
The nature of this type of problem can vary
from person to person. Some may notice
burning or fullness in the throat. Others may
notice a problem only when swallowing.
This problem can begin two weeks after the
start of treatment. It can last for two to four
weeks after the treatments end.
These tips may be helpful.
1. Relax, eat slowly, and chew your food
well. Eat small meals (4-6 per day).
2. Eat cool, soft, moist or wet foods.
3. Drink 8 to 12 glasses of liquid each day.
4. Antacids can coat and protect the
esophagus. Ask your doctor if it is okay
to use before meals.
5. Sometimes pain medicine is needed. If
pain is preventing you from eating or
drinking, talk with your doctor.
Foods to Choose Foods to Avoid
Beverages Milk products, milkshakes, eggnog; pear,
apple, prune, grape or cranapple juice;
water-diluted citrus juices; Kool-Aid®;
Carnation Instant Breakfast® or other
Alcohol; full strength citrus
juices; carbonated beverages;
very hot or cold drinks.
Breakfast Foods Milk toast; soft cooked or poached eggs;
diced, moist meats; hot cereals cooked
Dry cereals, dry toast, and
Main and Side
Tender, moist, cooked meats - grind or
blend meats with gravies and sauces, if
needed; moist casseroles; rice or noodles
with gravy or sauce; macaroni and cheese;
mashed potatoes; baby food; creamed
soups; soft, cooked vegetables; moist
Highly seasoned or spicy
dishes; chewy, dry, tough meat
or poultry; fried foods;
Snack Foods Slices of cheese or cheese spread; sliced
bananas; cooked fruit; graham crackers
soaked in milk; peanut butter on soft
Dry crackers; nuts; potato
chips; raw fruit or vegetables;
hard bread; rough textured
foods; spicy dips.
Desserts Pudding; ice cream; gelatin; custard;
tapioca; yogurt; Fudgesicles; popsicles.
Any crumbly, dry, chewy
Radiation to the central chest can cause
nausea and vomiting. Some patients reduce
their intake or stop eating entirely to avoid
these symptoms. This is not recommended.
Your body needs food to heal and rebuild
normal tissue damaged by radiation. Food
also provides energy and strength to help
you complete your treatments. Tell your
doctor or nurse if you have nausea or
vomiting. Often, these symptoms can be
These tips may be helpful.
1. Eat small amounts of salty foods such as
crackers or pretzels.
2. Drink small amounts of clear, cold
drinks such as 7-Up®, gingerale, and
caffeine-free cola. Avoid drinking large
amounts as this can cause gas. Do not
drink carbonated beverages if you have
esophagitis (irritation of your
3. Try cold foods such as popsicles, gelatin
desserts, yogurt, cottage cheese, cheese,
deviled eggs, and cold meats.
4. Relax, eat slowly, and chew your food
well. Doing this will help you digest
your food more easily. Eat small meals
(4-6 per day).
5. Avoid eating 1-2 hours before and after
Feeling tired (fatigue) during radiation
treatment is a common side effect. The
severity of fatigue varies from person to
person. Fatigue does not mean that your
tumor is getting worse. Some people feel no
fatigue and are able to keep up with their
normal routines. Others feel the need to take
an extra nap each day. Still others change
their routines, working only part time, for
example. Some people don’t do anything
that requires a large amount of energy.
Fatigue can begin right away, or it can occur
after 1 – 2 weeks of treatment. It can go on
for several weeks to months after treatment
has ended. Rarely, it can last for up to a
Low blood counts may also cause you to feel
tired. Your bone marrow makes blood cells.
If a lot of bone is in your radiation field,
your production of blood cells may be
slowed down for a time. This is a short term
side effect. Your doctor may order a blood
test from time to time to check your blood
Here are a few tips that may help with
1. Listen to your body and rest when you
need to. A short nap during the day or
sleeping a little longer may help.
2. Make time for activities you enjoy.
Take a walk in the fresh air, visit with a
friend, or pursue a hobby during the
times that you feel most energetic. Do
things that help you feel good.
3. Stop smoking and do not drink alcohol
to excess. Do something healthy for
yourself. If you need help with this, talk
with your doctor or nurse. There are
ways we can help.
4. If you work you may want to keep
working. Some people are able to
maintain a full time job. Others find it
helpful to work fewer hours. Many
employers understand and will agree to
part time work. We can schedule your
treatment times to fit in with your work
5. Plan regular active exercise – daily
walks, riding an exercise bike, or any
mild exercise. Go at your own pace.
Never exercise to the point of fatigue.
A good rule of thumb is that you should
feel less tired after the exercise than you
did before the exercise.
6. Take advantage of emotional outlets.
Pent-up emotions can add to fatigue.
Talk with family or friends. Having a
good cry or laugh can be helpful.
7. Eat well. Keep foods around that need
little effort to prepare – cheese, yogurt,
or slices of meat. When you feel well,
prepare and freeze meals to eat later
when you are tired. Extra calories and
protein are needed to maintain energy
while getting treatments. They also help
repair normal skin cells damaged by
your treatment. Speak with a clinic
nurse if you have problems eating.
8. Drink lots of fluid – 8 to 12 glasses per
day. The water will help to flush some
of the by-products of your cancer
fighting treatment out of your body.
9. If you need help with your basic daily
needs, ask your nurse or the social
worker to help you contact your local
resources. You may be able to receive
help with meals, housekeeping, personal
care, transportation, support groups, and
10. Accept offers of help from family and
friends. If friends ask if they can help,
accept it! If they ask you to call if you
“need anything,” they may need specific
ideas from you. Often people want to
help but don’t know what things you
need the most help doing. Things like
mowing the lawn, baking a casserole or
watching the kids, can help both you and
your friends to feel good.
11. Visits from family and friends can be
pleasant, but also tiring. You do not
need to be the perfect host or hostess.
Let your friends and family fix dinner,
and get the drinks and snacks for you!
12. Some people may have pain from cancer
or other causes. Pain can be very tiring.
Your doctor and nurse can work with
you to achieve good pain control. Let
them know about any discomfort you
have during treatment.
A diagnosis of cancer brings concerns other
than the need to manage the acute side
effects of treatment. Often, it affects many
other areas of your life. Patients feel its
impact on their emotions, marriage, family,
jobs, finances, thoughts and feelings about
the future, and many other important areas
of life. The nurses and social workers can
help you cope with these issues. They can
suggest support services and resources. Feel
free to speak them at any time.
Cancer Resource Services
Cancer Connect is a service of the UW
Comprehensive Cancer Center. The staff
can answer your questions about local
treatments. Cancer Connect has knowledge
of community resources and support
services. The number is (608) 262-5223.
Cancer Information Service is a phone
service of the National Cancer Institute. It is
a resource for local cancer care as well as
cancer care around the country. The toll free
number is 1-800-422-6237.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 2/2017. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4554