Radiotherapy for arm or leg may be given to the whole arm or leg; or it can also be given to part of the arm or leg. Normal tissues included in the treatment area are soft tissues, bone and skin.

What Are The Early Side Effects?

Early side effects are the changes or reactions of normal tissues that happen during radiation treatment. The early effect of arm or leg radiotherapy is skin reactions.

Skin Reactions

The skin in the treatment area starts to become red after 2 weeks of radiation treatment. The skin may become dry, itchy, feel tight, warm and swollen too. At the end of treatment, the skin may become darkened, moist and peeling. For information on skin reactions and care please refer to Radiotherapy: Skin Reactions & Care.

How To Care For The Skin And Reduce Reactions?

Always keep the treatment area clean by washing with lukewarm water, using a baby soap and pat dry with a soft towel. Moisturize the skin with a water-based cream that is prescribed by the radiation oncologist. Protect the skin from cut, injury, insect bites and direct sunlight:            – Wear clothes with loose long sleeves and long pants                       – Wear clothes with loose long sleeves and long pants            – Wear soft cotton socks and well-fitting closed shoes Keep finger nails short. Avoid scratching the affected area.

Do not apply on the treatment area any lotion, cream, talcum powder that is not prescribed by the oncologist. Do not use hot pads or ice packs on the treatment area. Do not use adhesive tape on the affected skin area (wound dressing).

Are There Any Late Side Effects?

Late side effects are reactions of normal tissues that occur months or years after radiation treatment has stopped. Some late effects of arm or leg radiotherapy that may occur are soft tissue swelling (lymphedema), thickening of tissues (fibrosis) and increase risk of bone fracture of the affected arm or leg.

Lymphedema

Lymphedema is the abnormal collection of fluid in the soft tissues due to a blockage in the lymphatic system. It is more common for radiotherapy to the whole arm or leg. Early signs of lymphedema are shown in the graphic.

Ways To Lower Risk And Reduce Swelling

Maintain a healthy body weight. Keep the skin clear and dry. Protect skin from cuts and injuries to prevent infections. Place the affected arm or leg resting on pillow when lying down. Do some simple exercises such as moving the fingers or toes, bend and straighten the arm or leg to stimulate fluid circulation and reduce tightness. Seek advice from a physical specialist on exercises, massages and use of compression garments to prevent further swelling.

Do not place the arm hanging down all the time. Do not stand or sit in same position for a long time. Do not cross legs when sitting down but support the affected leg with leg rest. Do not take hot bath or sauna. Do not carry bag or laptop (heavy things) with the affected arm. Do not wear any clothing with tight cuffs and / or jewelry on the affected arm that restricts circulation of body fluid. Do not allow blood sample, pressure taking and injection on the affected arm.

The swelling of the affected limb occur gradually. Early swelling can be reduced and prevented from getting worse but swollen limb with hardened skin (late stages) is difficult to reverse and is prone to infections.

Always pay attention to any changes of the affected limb (size and sensation) that may occur after treatment has completed. Compare arm or leg of both sides and report the changes to the oncologist as soon as possible so that treatment can be carried out to prevent the swelling from becoming worse.

The increase risk of bone fracture is due to lower bone density, which may be improved with diet and exercises.

Radiotherapy is designed specially for each individual, taking into consideration the effects of radiation on normal tissues in the treatment area. However, every person is unique and may react differently to the radiation treatment.

Find out information about the specific side effects that may occur with your treatment from the radiation oncologist and radiation therapist before treatment begins. Always let them know what you are experiencing and how you feel so that they can help you to minimize the symptoms, to reduce anxiety and to cope better.

Reference

1. http://www.cancer.net/navigating-cancer-care/side-effects/lymphedema
2. American Cancer Society.2013.Understanding of lymphedema.
3. Images from slide presentation. Rubiah M P. Medical application for X-ray
4. www.openclipart.com