It is one of the most common cancer treatments. One of the most frequent side effects is damage to irradiated skin. Most patients experience some degree of radiation dermatitis that causes redness, swelling and itching to blisters, peeling and, in very severe cases, scars and marks. Luckily, many effects are resolved over time, but in the meantime, there are measures that can be taken to relieve them, avoid complications and protect the skin as much as possible .
It is estimated that half of cancer patients will receive radiation therapy as part of their treatment. At the same time that radiation therapy attacks and eliminates diseased cells, it can affect healthy tissues near the treatment area, causing certain side effects . One of the most common, which affects 85 percent of patients, is a type of acute skin reaction, known as radiation dermatitis that can range from a mild reddish rash (or erythema), itching, and scaly skin. skin (or dry reaction) to a more severe reaction with blisters and scaly, moist skin (wet reaction).
Almost all patients who receive radiation therapy experience some degree of radiation dermatitis. For most, the reaction is moderate to severe. This resolves over time, usually in a few weeks, although it may leave some type of discoloration or thickening of the skin, and in the most severe cases, even scars. What influences the intensity of the reaction? Several factors, including:
- Daily and high doses of radiation
- Accumulation of doses over a period of time
- The type of beam used for radiation, a large area of treatment, or areas with skin folds (such as the head and neck, groin, or below the breasts)
- If radiation therapy is combined with chemotherapy
The type of moderate to severe reaction, such as the wet reaction and the appearance of blisters, usually occurs towards the end of treatment, four to six weeks after the end of treatment or with a cumulative radiation dose of 45 to 60 Gray ( GY, a measure of the dose of radiation).
Skin irritation and radiation burns (similar to those caused by exposure to the sun), can interrupt the treatment if not controlled in time and in the right way. It is important that the patient communicates with his / her oncologist to indicate the skin care during the treatment, the medications or creams that he / she can use and what to avoid.
The National Cancer Institute recommends the following precautions:
- Cover the area of the body that receives radiation whenever the patient goes out to places exposed to the sun and apply a cream with an adequate sun protection factor.
- The treatment area should always be clean and dry.
- Wear loose and loose clothing to avoid friction. While the treatment lasts, fabrics that irritate or cause itching should be avoided.
- The bedding should be soft cotton.
- If the doctor authorizes shaving, do so with an electric shaver. He or she must also authorize the use of products such as lotions, perfumes and deodorants. During and after treatment, topical (local) application products containing metals in their formula (such as zinc oxide creams or aluminum-based deodorants) should be avoided.
- Bathe only once a day and with warm water. The hot water dries the skin too much.
- Avoid immersion baths or reduce them to only twice a week and do not extend them more than half an hour.
- After showering or bathing, dry the skin gently, applying light touches instead of rubbing with the towel.
- Wash the affected area with warm water and a mild soap to prevent any infection.
- The patient should avoid extreme temperatures, neither too hot nor too cold.
Next, what patients should NOT do:
- The doctor will make marks on the skin to indicate where the radiation should be applied. These marks should not be deleted.
- Neither should bags of hot water, ice or bandages be used on the skin that receives the radiation.
- Do not use tanning beds ( tanning beds ).
For relief of irritation and itching, the doctor may indicate the use of creams with low-dose corticosteroids, but these should be stopped if a wet reaction occurs with ulcers or blisters. In these cases, it is necessary to resort to bandages or special dressings with saline solution or enzymes to dissolve the dead tissue. Ulcers and more severe injuries that heal very slowly can be eliminated by a surgical procedure known as debridement, or they can also be solved by plastic surgery.
We must remember that each patient is different and reacts differently to another. The main thing is to maintain a positive attitude and a very direct communication with the oncologist to relieve the most annoying symptoms and get ahead as soon as possible to any type of complication that may arise during the treatment. Hopefully it is a step towards the cure.