Thus radiation to the mouth, throat or nose can cause soreness and sometimes ulceration. Radiation to the stomach can cause a vague stomach ache, loss of appetite and nausea. Radiation to the intestines can cause diarrhoea. Radiation to the lungs can cause a dry irritating cough. Radiation to the bladder can cause cystitis-stinging and burning when passing, urine and a desire to pass urine frequently. Radiation to the skin can cause redness, soreness and ‘peeling’.
It is important to try not to place any extra demands on these areas during radiation. For example, you will be asked not to rub skin that is being radiated, and to avoid tight clothing and hot or cold applications. Steps will be taken to prevent infection in any of these areas—for example, by using antiseptic mouth washes if the mouth is being irradiated. Any infection that does occur must be treated promptly.
The bone marrow is another tissue which normally contains a high proportion of actively dividing cells. However, radiation of part of the bone marrow doesn’t usually cause any symptoms provided the rest of the marrow is normal. A large proportion of your active marrow must be irradiated to produce any change in radiation treatment the blood count. Even then, you would be unlikely to experience any symptoms as a result.
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Cancer
Now let’s just see what this means for you in real life—what symptoms can result from those reactions?
These symptoms fall into two distinct groups. There are acute symptoms which occur during or immediately after radiation. There are also delayed symptoms that can occur long after radiation. The severity and nature of both acute and delayed symptoms depend on the type and dose of radiation and on what tissues are irradiated.
Many of the immediate symptoms are due directly to damage to actively dividing cells. There is normally a high proportion of actively dividing cells throughout the linings of the whole intestinal tract from mouth to anus, the whole respiratory tract from nose to bronchial tubes, and the bladder. The skin is another surface which is kept healthy by frequent replacement of its cells with new ones. Radiation stops the normal process of constant renewal of these surfaces.
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Cancer
This is not to say that having an operation cannot possibly result in some patients dying of cancer a bit sooner than they would have otherwise. For example, it is known that anaesthetics and stress depress the function of the immune system. Experiments on animals with extensive cancer have shown that those that have a ‘look and see’ operation do die, on average, a little earlier than animals which do not. Notice that I said animals having a ‘look and see’ operation, not animals having an operation at which something is done to the cancer.
Try to keep these facts in perspective. If your cancer is apparently localised, surgery probably offers you the best, and maybe the only, chance of cure. If it is extensive, surgery could be the best way of controlling or preventing very unpleasant symptoms. If you stand to gain a lot from surgery, the possible temporary effects of the stress and anaesthetic on your immune system would not be enough to outweigh the probable benefit. On the other hand, they could be if your planned operation has only a small chance of achieving some minor and temporary benefit.
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