During radiation, you lie alone in a dark room, hold your breath and lie perfectly still with your arms above your head while a machine circles your body giving small, targeted doses of energy with the intent of blasting away any residual cancer cells. Radiation happens daily for several weeks depending on your treatment plan. Most radiation happens after surgery, so it is a unique place for your body and has certain challenges. Your energy reserves may not be as deep and you may have physical limitations. 

​

• Keep Moving: Maintain and improve your range of motion before, during and after radiation with gentle stretches that target the muscles of the shoulders, flanks and chest. Ask your surgeon and seek the guidance of a physical therapist to give you the tools to stretch carefully and purposefully. 

​

Before radiation begins, a planning session occurs at which time the radiation team will create a cradle (like a hard bean bag) that fits your body. The position you'll like be in during your radiation therapy is with your arms up above your head so your chest wall, arm pit, neck, and shoulder can be radiated. It may be difficult to hold your arms up for a prolonged period of time because of recent surgery. 

​

• When getting positioned and creating your treatment plan, you may get permanent tattoos to make sure that you are lined up properly during treatments. Ask if you have the option of pink ink (UV light sensitive) or blue ink. You may not need tattoos at all depending on the center’s technology. 

​

After a few treatments, it begins to feel and look like you've had a bad sun burn to the radiation field. You may notice fatigue and skin changes half way through treatments, and the fatigue can last for up to 4 weeks after completion of radiation therapy. The appearance of radiated skin may persist for months to years. It is challenging logistically and mentally to have radiation everyday, especially after just completing chemotherapy and surgery. Your body's emotional and physical reserves may be a little depleted. Keep moving (even a short, daily walk) to combat fatigue and prevent lymphedema. 

​

• Skin care: Use gentle, moisturizing skin care during and after radiation. Aquaphor, Vanicream, or coconut oil (blue, underlined words are Amazon affiliate links) are helpful. Keep it simple. Avoid fragrances, dyes, exfoliative particles, retinols, acids. Radiated skin looks and feels like a bad sunburn. Be very gentle to your skin. Avoid body washes or soaps with exfoliative scrubbing particles. Avoid coarse loofahs or washcloths. Ask your radiation oncologist for specific recommendations or a sample.

• Wear loose fitting, comfortable clothing that won't rub your skin. 

• Avoid metal containing products like zinc or aluminum containing deodorant when getting radiation therapy as it may increase the dose to your skin. 

​

Your skin will keep changing and needs special care years after your radiation treatment. Radiation kills rapidly diving cancer cells, but can also damage or kill normal cells and blood vessels in the radiated area. Sweat glands and hair follicles are also damaged or lost in the radiated skin area. Cell damage and decreased blood supply can cause fibrosis. Fibrosis is the process of scar formation from skin damage due to radiation. It begins during radiation therapy and lasts for months to years. It is most common during the first two years of therapy and may look and feel like redness, tightness, tenderness, and firmness. 

​​

• Be vigilant about sun protection. Radiation treatment increases the risk of developing skin cancer in that area. Skin cancer appears many years later, so sun protection is important for the rest of your life. Treated areas should not be exposed to direct sunlight for up to a year after treatment. Apply a sun screen with a Sun Protective Factor (SPF) of 30 to 50. The SPF is the amount of time you can be in the sun without getting a sun burn. Sunscreen should block UVA and UVB rays. Wear sun protective clothing with an Ultraviolet Protective Factor (UPF) or 50+.

• Keep moving! I know, I'm sounding like a broken record, but movements like stretching and deep breathing with aerobic exercise will stretch the tight skin and open up your chest and shoulder muscles and stretch against the fibrosis of the skin. 

• An emerging research area is using vitamin E oil to combat radiation fibrosis and scarring. Vitamin E oil is used topically to soften and decrease the appearance of scars. If considering, discuss this with your radiation oncologist first.