Is Radiotherapy Painful?

One of the first questions patients ask is, “Does radiotherapy hurt?” The short answer is that the radiation itself is not painful. Still, radiotherapy lasts several weeks, and some discomfort can develop during that time. It’s best to know exactly what might happen.

What do you feel during the radiation?

In external radiotherapy, a machine called a linear accelerator (the radiotherapy machine) sends the beam from outside the body to the treatment area. Reliable sources, including the UK’s National Health Service (NHS), describe external radiotherapy as “completely painless.” You can’t see the beam, and it has no smell or heat. The experience is like having an X-ray taken, just a bit longer.

You lie on a table while staff control the machine from another room. They see you through a camera and talk with you through a microphone. If needed, the machine is stopped at any time. The radiation itself takes a few minutes.

What may bother you is mostly about staying in one position:

• Lying still. If you have back pain or joint pain, tell the care team before the session so they can set up a more comfortable position. Some patients talk with their doctor about taking pain medicine before the session.
• The mask. Some people feel tight or anxious in the mask. You can talk with the care team about it; there are solutions.
• A hard table and a cold room. These can be a nuisance at times. Ask whether you can have an extra blanket or pillow.

Pain over the weeks of treatment

The effect of radiotherapy is cumulative. That means side effects usually appear gradually over the weeks of treatment, not at the moment of the radiation. Depending on the treatment area, these may be painful or uncomfortable:

• Skin. Redness, burning, and itching, similar to sunburn. Sometimes blisters.
• Head and neck. Mouth sores, sore throat, and trouble swallowing.
• Abdomen and pelvis. Stomach pain, nausea, burning when you urinate, or discomfort when you have a bowel movement.
• Chest. Burning when you swallow.

None of these means the treatment is going badly. They can often be managed, and most of them gradually get better after treatment ends.

What to do if you have pain

• Speak up. Don’t put up with pain or wait it out. Every time you have pain or discomfort, tell your doctor or nurse. Many of these problems can be managed with simple care or medicine from your doctor.
• Describe the pain. Where is it? Is it burning or throbbing? How bad is it from 0 to 10? What makes it better or worse?
• Don’t choose medicine yourself. Don’t take or apply any medicine or cream for pain or fever without asking your doctor. Some medicines interfere with treatment or hide important symptoms.
• Use simple comforts. Soft clothing, proper skin care, and soft food for mouth sores. Don’t put ice packs, hot water bottles, or massage on the treatment area unless the care team has allowed it.
• Pay attention to tiredness and anxiety too. These can make pain seem worse. Deep breaths, light walking, and talking with family or a counselor can help.

When should you tell someone right away?

Contact the care team right away if you have severe or sudden pain, chest pain or shortness of breath, a fever of 38 degrees Celsius or higher, skin that has blistered and has pus, or if you can’t eat or drink.

If you’re nervous before your first session

Feeling nervous is natural. These things can help:

• Ask the care team to show you the machine room and explain the steps of a session before you start.
• Don’t be afraid to ask. Every question, even a simple one, is your right.
• Bring your companion along; they can stay with you until you go into the treatment room.
• Practice slow breathing during the session. Some centers allow you to listen to music.
• Remember that staff can see you on camera and hear you, so help will come whenever you need it.

Summary

The radiation itself is not something you feel. What you may feel are the gradual side effects in the treatment area, and the care team can help you manage them. Report any pain or discomfort early; a problem that is looked at early is less likely to grow.

Every patient’s treatment plan is different; ask your doctor about your own situation.