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  • Management of side effects image
  • Proton therapy itself is painless. Patients who are treated with proton therapy also experience fewer side effects than patients treated with conventional radiotherapy. However, patients may experience side effects such as hair loss, mouth changes, skin changes, throat changes, diarrhea, urinary and bladder changes, and nausea/vomiting.
    Hair loss
  • Hair loss during radiotherapy only occurs at the part of your body being treated, unlike chemotherapy, which can cause hair loss all over your body. For example, you may lose some or all of the hair on your head following radiotherapy to your brain. After radiotherapy of your hip, you may lose pubic hair but not hair on your head. You may start losing hair in the treated area 2-3 weeks after your first radiation therapy session. Your hair may grow back 3-6 months after completing treatment. Once your hair starts to grow back, it may not look or feel the way it did before.
    Ways to manage hair loss on your head
    Before hair loss
  • Be gentle when you wash your hair.
  • Do not use curling irons, electric hair dryers, curlers, hair bands, clips, or hair sprays.
  • Do not use products that are harsh on your hair, such as hair colors, perms, gels, mousse, oil, grease, or pomade.
    After hair loss
  • Protect your scalp. Your scalp may feel tender after hair loss.
  • Cover your head with a hat, turban, or scarf when you are outside.
  • Try not to avoid very cold or very hot environments by staying away from the direct sun, sun lamps, or very cold air.
  • Because your hair helps keep you warm, you may feel colder once you lose it. You can stay warmer by wearing a hat, turban, scarf, or wig.
    Mouth changes
  • Radiotherapy kills cancer cells and can damage healthy cells, including cells in the glands that make saliva and the soft, moist lining of your mouth. Some problems, like mouth sores, may go away 2-3 weeks after completing radiotherapy. However, others, such as taste changes, may last for several months or years. Some problems, like dry mouth, may never go away.
    Mouth changes include
  • Mouth sores (small cuts or ulcers in your mouth).
  • Dry mouth (also called xerostomia) and throat.
  • Loss of taste.
  • Tooth decay.
  • Changes in taste (such as a metallic taste when you eat meat).
  • Infections of your gums, teeth, or tongue.
  • Jaw stiffness and bone changes.
  • Thick, rope-like saliva.
    Ways to manage mouth changes
  • Visit a dentist at least 2 weeks before starting radiotherapy of your head or neck.
  • Check your mouth every day. You may see or feel problems as soon as they start. Problems can include mouth sores, white patches, or infection.
  • Keep your mouth moist. You can do this by:
    • Regularly sipping water during the day
    • Sucking on ice chips
    • Chewing sugar-free gum or sucking on sugar-free hard candy
    • Using a saliva substitute to help moisten your mouth
    • Asking your doctor to prescribe a drug that increases saliva production
  • Keep your mouth, teeth, gums, and tongue clean.
    • Brush your teeth, gums, and tongue after every meal and at bedtime using an extra-soft toothbrush
    • Use a fluoride toothpaste
    • Do not use mouthwashes that contain alcohol
    • Rinse your mouth at bedtime with a solution containing 1/4 of a teaspoon of baking soda and 1/8 of a teaspoon of salt mixed in 1 cup of warm water
    • Keep your dentures clean by brushing them each day
    Throat changes
  • Radiation therapy to the neck or chest can cause the lining of your throat to become inflamed and sore. This is called esophagitis. You may feel as if you have a lump in your throat or burning in your chest or throat. You may also have trouble swallowing.
    Radiotherapy of the neck or chest can cause throat changes because it kills cancer cells and may damage healthy cells lining your throat. Your risk of throat changes depends on the radiation dose, whether you are also receiving chemotherapy, and whether you use tobacco and alcohol during treatment. You may notice throat changes within 2-3 weeks after starting radiotherapy. The symptoms usually start to improve within 4-6 weeks of completing the treatment.
    Ways to manage throat changes
  • Choose foods that are easy to swallow.
  • Cut, blend, or shred foods to make them easier to eat.
  • Eat moist, soft foods such as cooked cereals, mashed potatoes, and scrambled eggs.
  • Wet and soften food with gravy, sauce, broth, yogurt, or other liquids.
  • Eat foods that are cool or at room temperature.
  • Eat small meals and snacks.
  • Remain sitting or standing upright for at least 30 minutes after eating.
  • Sip drinks through a straw.
  • Do not consume foods/drinks that can burn or scrape your throat.
  • Talk to your doctor or nurse. Your doctor can prescribe drugs that may help relieve your symptoms, such as antacids, gels that coat your throat, and painkillers.
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