Below is an explanation of some of the common side-effects, symptoms and problems associated with radiotherapy treatments, with combined chemotherapy treatments (known as chemoradiation), together with problems you might not have been aware of.
For the first 12 days of radiotherapy I did not get any side-effects from my radiotherapy treatments, including no extra side-effects from my chemotherapy treatments, which was supposed to be the case according to all the specialist and nurses I spoke to. Hence why I was not worried too much during the first two weeks about anything nasty happening to my throat and voice for example.
It was on and after the 13th day (after the 2nd week) of chemoradiation that I began to experience the gradule side-effects, symptoms and problems below whereby most of them were throat related. Many started during the third week of chemoradiation.
The first sign of trouble came in the form of small amounts of flem (sticky bits of saliva) building up inside the back of my throat, sticking to its side walls, whereby I could not spit/regurgitate those flem bits out. Fortunately, gargling mouth wash got rid of the flem.
The extreme phase of chemoradiation treatment causing a thick flem
Another of the first signs I noticed was the feeling that something was making the inner walls of my throat seem tighter, as if that something was clinging to my inner walls; such as the flem I spoke about above. I later realised this was a little inflammation building up, especially on the throat glands and inner walls. I got rid of this problem by taking 3 Ibuprofen tablets every 4 hours for one day.
Although the throat specialist warned of Throat Tightening/Swallowing being a possible side effect of radiotherapy treatment, I still wondered how bad the tightening symptoms would get in the coming weeks. Obviously I was trying to avoid having a Nasogastric Tube (Dobhoff tube) stuck through my nose and down my stomach.
As I did not experience any throat pains or throat soreness in the first twelve days of radiotherapy, I was surprised to receive a sudden build up of sore throat and ulcer-like symptoms under my tongue, on my pallet and at the back of my throat within a matter of days thereafter. The sore/burning throat pains became so excruciating that it felt like I had swallowed some hot chili with a cheese grater.
The swellings and ulcer irritations I later experienced meant I had difficulty in swallowing everyday foods and drinks, because of their sharp bits and/or citrus stings, which in turn meant I ended up blending most foods and avoiding fizzy drinks, hot drinks and citrus drinks. I could not eat simple foods like toast, cereals, cakes, biscuits or soups because of their sharp bits/edges and could not drink fruit, acdic or citrus drinks because they would sting my throat. Even the bubbles in sparkling water or fizzy drinks would hurt my palate.
Fortunately I found a remedy for the swollen throat, which was to alternate the taking of Paracetamol (with Co-dine) and Ibuprofen. I took two Paracetamol (with Co-dine) three times a day (every four hours) while alternating them with three Ibuprofen three times a day (every two hours after the Paracetamol). This remedy meant a 90% drop in inflammation and pain, therefore allowing me to swallow much better.
Radiotherapy treatment caused a lack of saliva, carpet tongue and a sore ulcered mouth
Just as I was taking care of the pains in my throat/mouth, actual ulcers appeared days later (and split/burst days after that causing bleeding) whereby I was given an array of mouth cleaning, lubricating, medicines and gels to help with thrush, ulcers and dry mouth (many of which appeared at the beginning of week 3) whereby some helped and some irritated my throat/mouth further (causing blood to come from my throat); see photo above.
After the fourth week my sore neck (palate, glands and ulcers) had doubled in pain. I could not really swallow small chunks of meat for example. I really had to eat cereal soaked in milk, trifles, sponge cakes with custard, milkshakes, soft boiled chicken, mashed potato and blended food in general to avoid having the dreaded feed-tube. Easier said than done when some of the food ingredients still tickled/irritated my throat, making me cough and/or almost regurgitate every now and then.
Radiotherapy treatment caused a sore burnt face with skin cracks, swelling and peeling
Speaking to the specialists, they said throat bleeding was quite normal. Thanks for not telling me I thought. They told me I could get ulcers and mouth pains in general, but did not tell me the realities of their excruciating pains (i.e. 'razor blade cutting my gums' feeling), an over sensitive tongue (i.e. onions, salt and vinegar crisps and spicy foods would sting like crazy) and the severe dry throat/mouth that would cause a burning feeling. These were nasty surprises.
Creams and gels did nothing to heal my ulcers, stings and bleeding throat simply because there was not enough time to cure them because I always had to eat and drink of course. Something the specialists acknowledged by stating they could only treat the symptoms but not cure the problems. Hence why I was prescribed a stronger pain killer called Oxycodone Hydrochloride (a controlled morphine drug), at 5mg dose, to ease the pains only.
Radiotherapy treatment caused an itchy neck rash that burnt like a Tenerife sun burn
Towards the last week of radiotherapy I developed a red raw, first degree burn, itchy neck that felt like a Tenerife sun burn. Excruciatingly painful on a minute, hourly and daily basis. I only hd to move my neck sligtly and a volcano burn would happen. It was that painful.
One problem with using the creams and gels, when my tongue became hyper-sensitive for example, was the chemicals inside them. It was like I could over-taste their chemicals, to the point they would cause me coughing fits. Most of them would also dry out my throat. I was taking throat soothers such as lemon lockets and black current soothers for a while before their flavours became over powering and stung my tongue.
Every day or so, towards the end of the week and thereafter, I would get a nose bleed. Usually when my platelets (blood count) had dropped below 100; such as 68. Nose bleeds would happen without warning, in public places; which meant carrying tissues around with me all the time. On rare ocassions I would need to stuff tissue up my bleeding nostril(s) to stop the bleeding, which was heavy some times and watery at other times.
On one ocassion I was just coming out of a deep sleep and wiped my forehead thinking I was sweating; which isn't unusual for a diabetic. As I was wiping near my nose, because of the sweat feeling trickling down my face, I switched the light on to move to the kitchen for a glass of water when all I saw on my pillow was a pool of blood. I must of been laying (sleeping) in it for a while because the blood was also on and around my shoulders, neck, head and chest. It ruined my two duck feather pillows.
Radiotherapy caused nose blockage with hard to remove dried blood (secretion)
Towards the middle of the fourth week of radiotherapy, which was my first week of chemotherapy Cycle #5, I began getting stronger nose bleeds and clotted blood on the walls of both nostrils. The pain, which felt like someone had newly punched me really hard in the nose, breaking it, usually lasted for 2-3 hours after receiving a radiotherapy treatment. Luckily, at the weekends I had a chance to rest and recover; before being battered the following week!
I got very slight numbness in my right hand fingers when on chemotherapy treatment alone, but very rarely, and even got a little numbness in my right arm through diabetes alone. However. Since being on a combination of chemotherapy and radiotherapy treatments I noticed the numbness becoming much more intense, especially in the second week of radiotherapy. Since reading the internet and checking with my specialists, I found out this symptom is known as Peripheral Neuropathy.
Unfortunately the intensity of the tingling numbness in my fingers doubled in pain after week four of chemoradiation treatments. More fingers were affected, even in my left fingers, whereby my fingers begun to get split lines (wrinkles) in them; like when you have been in bath water for ages.
In the first two weeks I did not feel tiredness that much, even though the radiotherapy treatment certainly zapped a little more energy from me. As an example: I was still able to walk, go on my treadmill for 30 minutes or cycle for 90 minutes (very slowly and not uphill anymore), but only on selected days when I really felt the energy to do so; which was rare (i.e. my cycling went down to once every 7-10 days).
Before I would exercise even if I did not feel like it, just to keep up my strength and energy, but while on chemotherapy and radiotherapy treatments I had to be more careful not to over exercise or cause myself additional health problems; such as catch a nasty cold. After all, I was trying to beat cancer in the winter months of November, December, January and February; and having radiotherapy treatments over January and February.
The problem with cancer treatments are that they take out your good cells/dna in order to kill off your bad/cancer cells/dna, which is fine but they also give side effects such as lowering your Magnesium levels and/or increasing your Creatinine levels.
After having a routine blood test the specialist noticed my Creatinine level was slightly high, enough for them to warrant a two hour intravenous drip the following day to flush out my kidneys/system.
Creatinine is a natural substance (debris) in your body that comes from the wear and tear of muscles for example, which the kidney usually flushes out. However, when having a combination of chemotherapy and radiotherapy your kidneys can be over worked whereby they can no longer flush out certain debris from your system quickly enough or efficiently enough, therefore causing a build up of that debris (creatinine in my case).
A week before my high creatinine diagnosis, I was diagnosed as having a low level of Magnesium; which meant a one hour intravenous drip of magnesium - Magnesium is responsible for creating energy, maintaining cholesterol levels, regulating the body (including the heart) and building new cells among other things.
Unfortunately, almost three weeks later my level of magnesium dropped again; requiring a two hour intravenous drip of magnesium that time.
After deciding to take the last (sixth) chemotherapy treatment, the one three weeks after my radiotherapy treatment had finished, I had to spend nearly 48 Hours in an A&E ward after bug infection of the bowel; probably caught on the way home from hospital after that last chemotherapy treatment.
I was warned that an infection might occur because a last chemotherapy treatment after radiotherapy treatment can sometimes lower your immune system too much. Even so, the nurse in the chemotherapy ward was telling me this normally happens between days 7 and 14. What p*ssed me off was that my blood count and other readings were all fine, doing well after my short three week recovery period from the radiotherapy treatment, and now the last chemotherapy treatment was trying to bump me off!
Apart from the boredom of staying in hospital for two nights, I was put on a week of anti-biotics for the diarrhoea that lasted four days before becoming solid poo. During my short hospital stay I lost weight because I was not allowed to eat anything, setting my recovery back by one week. Very frustrating.
Two weeks after the above bowel infection my saliva (parotid) gland swelled up to the point I had to use the A&E service again, this time via using NHS Direct and an 'Emergency Doctor'. I had to stay 6 hours in hospital before being prescribed two lots of anti-biotic for a week.
The anti-biotics were so strong that they knocked out my whole energy whereby on one ocassion I slept for 20 hours non-stop. The fatigue level was to the point of being on deaths' door. I could not eat and was losing weight fast; dropping down to 78 Kg.