para-aortic strip radiotherapy testicular tumour

Para-aortic strip radiotherapy for testicular tumours



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Radiotherapy is a localised treatment and side effects depend on the area of your body receiving the X-rays (in your case the abdomen and pelvis). There are two types of side effects; those which come on during or immediately after treatment (acute side effects) and those which can be long term (late side effects). Your oncologists will have taken these into account when considering the benefits of treatment and will inform you of the side effects you are likely to get. Please discuss any concerns with your doctor, specialist nurse or radiographer at the time of consent or at any time during radiotherapy.

This information sheet aim to provides a brief introduction to radiotherapy and explains the common side effects you may experience. This does not mean you will definitely get them. It is also possible you may experience a side effect not mentioned here.

Your first appointment at the radiotherapy centre will be a planning session. This will either be in the simulator. Report to the reception desk, show them your card, and they will direct you. You will then be welcomed by a specialist radiographer, who are people who operate the machines to plan and give your treatment. You should not be embarrassed to ask them anything you are concerned about. The purpose of this visit is to plan and arrange the radiotherapy so you may not have a formal consultation with the doctor at this stage. Of course any urgent issues will be addressed but others should be saved for the regular consultations you will have during treatment. It is often difficult to judge exactly how long each patient will take - unfortunately it is possible that may have to wait a long time.

The simulator is a machine which is a direct copy of a therapy machine. It takes X-rays pictures to enable the oncologist to decide the exact area of your abdomen which needs treatment. While very accurate measurements are taken, you will have to lie on a fairly hard couch which may be slightly uncomfortable. A small tattoo about the size of a pin head is made on your body - giving a permanent record of the measurements.

The treatment machine looks similar to the simulator. You will not be required to do anything you haven't already done in the simulator. Although the radiographers are not in the room while you are being treated, you are being watched at all times on a video camera. If you feel any distress, the machine can be turned off and the radiographers will be at your side within seconds. There is also an intercom which is left on. Treatment usually lasts only 1 to 2 minutes. While the machine is on, you usually do not have any sensation. After treatment you will not be radioactive and you will not lose the hair on your head.

Acute side effects

Your appetite may be affected. If so try to eat several small meals rather than three large meals a day. Drink lots of fluid - try to double your normal fluid intake. If you are worried about diet ask your radiographer to refer you to a dietician.
You may develop Tiredness, so adequate rest is important.
Your bowels may become loose later in the treatment, possibly causing diarrhoea. If this happens, cut down your intake of fruit, vegetables and fibre and try to increase your intake of eggs, milk and other dairy products. Report any diarrhoea to the doctor or radiographer as it may be necessary for you to have tablets. Take these until the diarrhoea improves and then reduce them. Your bowels should have returned to normal 2-3 weeks after treatment. You can then gradually re-introduce fibre into your diet until you are back on a normal diet. You should continue with your normal diet unless you begin to get diarrhoea.
If your bladder is in the treatment area, you may experience a feeling of wanting to pass urine more often (cystitis). It is still possible to develop a urinary tract infection so drink plenty of fluids and report any burning feeling, on passing urine, to your doctor.
A feeling of nausea or sickness may occur during treatment. Report any nausea or vomiting to your doctor as your symptoms can be relieved with anti-sickness tablets. For larger treatment areas you will be given an anti-sickness tablet to prevent nausea.
The skin in the treated area may become red and sore, especially in the skin creases. You can wash by means of a shower during your treatment but it is not advisable to sit and soak in a hot bath. Simple non-medicated soap should be used, i.e. baby soap, and the treated area should be dried by dabbing with a soft towel; avoid rubbing. If any soreness develops report this to the radiographer who will give you advise.
These side effects will continue for a week to 10 days after your treatment has finished - continue to follow this advice for this length of time. After this time you will begin to recover.

Potential late side effects

In males fertility may be affected if the dose to the testes is high. Special precautions will be taken to reduce the dose and it will be measured to ensure that it is as low as possible. Nevertheless there will be a temporary effect on sperm count which will be reduced to lower than normal levels for about a year. There should then be a full recovery. As a precaution you may have been advised to bank sperm prior to treatment.
Rarely you may have persistent nausea, loss of appetite and looseness of the bowels but this would be expected to settle over some months.
There is a slightly increased risk of developing a stomach ulcer, particularly if you are already prone to them. If this does occurs medication is available.
The risk of producing second tumours in the treatment area has worried doctors for some years. Most centre do not report an increase incidence in their patients but there are some large surveys which have detected a small increase.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.