You are about to undergo radiation therapy to the pelvic area. Your small intestines may be in the radiation field. In order to monitor how much of your small bowel is in the radiation field, you physician may request a small bowel X-ray and will review it for blocking of the small bowel in the treatment field.

In addition, please follow the directions below as this procedure will also decrease the risk of damage to the small bowel within the treatment area.

DAILY TREATMENT

Before arriving for your treatment drink 3 or 4 glasses of water or other fluid to distend your bladder.

Do not urinate until after the radiation treatment is given.

A full bladder pushes the small bowel higher in the abdomen. This minimizes the amount of radiation the small bowel will receive and reduces the possibility of side effects or damage to the bowel.

Blood Counts

A CBC will be drawn routinely to monitor your bone marrow fumction during treatment.

DO & DON’T

Skin Care

• Bathe or shower with warm water and a mild soap such as Ivory, Basis, or Eucerin. Do not use hot water. Do not rub the treatment area with a washcloth or towel. Pat the area dry. Apply lotions as per “Skin Care Instructon” sheet.
  
  
• If lines have been placed on you by the therapists do not wash them off without checking with the therapist first.
  
  
• Skin changes such as redness, dryness, itchiness, and tanning are normal reactions to radiation. Use a moisturizer such as Curel, Nivea, Eucerin, or Aquaphor several times a day to minimize these side effects. Aloe Vera Gel is also soothing. You may use these as often as necessary. Should you notice any break in your skin, please notify our nurse.
  
  
• A sitz bath with Aveeno Oilated Bath powder may be soothing to irritated skin.
  
  
• Use cornstarch powder to absorb moisture. Do not use talcum powder.
  
  
• Do not expose the treated area to direct sunlight such as sunbathing. Do not use heating pads on the treated skin.
  
  
• Do not swim or sit in a hot tub during your treatment as the heat and chemicals in the water may irritate your skin.
  
  
• If any of the above symptoms persist or are severe please notify our medical staff.

SIDE EFFECTS

Rectal Discomfort (Proctitis)

You may experience cramping and tenderness in your rectum or burning and painful bowel movements. You also may notice some bleeding. These are due to sensitivity of the lining of the rectum to radiation therapy. To manage these side effects, please refer to the enclosed handout "Rectal Discomfort (Proctitis)".

Diarrhea

You may experience some gas, mild cramping, an increase in frequency of bowel movements, and soft or liquid stools. If these symptoms occur please refer to the enclosed handout "Diarrhea". It includes dietary and medication instructions.

Urinary Irritation

• After 2 or 3 weeks you may experience burning or frequency of urination. If that happens, please notify our nurse. Medication can be prescribed to help alleviate this.
  
  
• Drink extra fluids to ease the burning sensation.
  
  
• If you are expereincing external irritation with urination use a squeeze bottle of tepid water as an irrigant while urinating. Hold the labia (vaginal lips) open and squeeze the water over the area while you urinate. Use the same method to cleanse your self afterwards and dab dry. Then apply a cream or ointment barrier to the labia. We recommend A & D Ointment, Desitin Oinment, or Lantiseptic Skin Protectant (available at medical suppliers). Some people find the cleansing agent, Balneol, easy to use and comforting after urination or defecation.

Fatigue

There is a possibility that you may develop fatigue due to the radiation. The severity and duration will vary according to your past medical history and present treatment area. Increasing your rest time will help manage this side effect, and it will clear once the radiation therapy is completed. Please see the enclosed hand out entitled "Fatigue" for more ideas.

Hair Loss

Within 2 - 3 weeks after the start of radiation you may lose some or all of your hair in the area of treatment. Usually your hair will grow back 2 or 3 months after completing the treatment.

GENERAL CARE

Diet

Eat a well balanced diet. Do not try to lose weight during treatment. Dietary supplements may be helpful if you have trouble maintaining your weight. Our nurse can discuss these dietary supplements with you as needed. Your weight will be monitored weekly.

Sexual Relationships

You are encouraged to continue your normal sexual relations for as long as you are comfortable. Please feel free to discuss with the nurse or doctor any concerns or problems you might be experiencing. If you are experiencing dryness and or pain, you might find it helpful to to use a water soluble lubricant such as Astrolube or K-Y Jelly. Both can be found in the feminine hygeine department of your drug store.

Emotional Support

Emotional support is very important at this time. If you would like a referral to support group or a therapist or if you have questions regarding physical closeness, sexual relations or other concerns, please speak with our doctors or nurse. You may also find the enclosed hand out entitled "Emotional Reactions" to be of help to you.

Questions

The severity of side effects vary from person to person, but if after using the previously mentioned suggestions you are still not comfortable or the side effects are severe the physicians and nurse are always ready to speak with you.

You will meet with one of the doctors every week for review of you case. The doctor will be monitoring your progress during the treatment. Your questions can be answered at those times, but of course if a more pressing question arises during your treatment, please notify one of the therapists so that you may speak with our nurse or physician.