Radiotherapy: Exhaustion, Healing, and Everything in Between

I have to be honest—radiotherapy was tougher than I expected. In my cancer support group, everyone always talked about how brutal chemo was, but they made radiotherapy sound like a breeze in comparison. I’m not saying it was worse than chemo, but I definitely underestimated just how exhausting and challenging it would be. I think the accumulation of all the treatments just caught up with me in a way I wasn’t fully prepared for.

For those unfamiliar, radiotherapy is a targeted treatment that focuses on specific areas affected by cancer. Unlike chemotherapy, which affects the whole body, radiation is directed precisely at the tumor site. In my case, the treatment areas included my left breast (where the tumor had been), my breastbone, and the underarm area where my lymph nodes had been removed.

Before starting treatment, I had a radiotherapy planning session. The radiographer used a Sharpie to mark key areas on my body, ensuring everything would be perfectly aligned. Then came the CT scan to confirm the placement, followed by three tiny permanent tattoo dots, just little freckle-like marks, to guide the daily treatments. Those tiny dots became a constant reminder of the journey ahead: 20 rounds of radiation.

Each day, I checked into the radiotherapy center, put on a blue vest (which, thankfully, I was allowed to keep on, along with my jeans and shoes), and made my way to the treatment room. The room was always freezing, so I was grateful for any extra layers I could keep on.

Lying on the treatment table, the radiographers carefully adjusted my position. Staying completely still was harder than I expected, my instinct was to help them move me into the right spot, but I had to resist. Once they had me perfectly aligned, they left the room, monitoring me through cameras and microphones.

Before each session, a quick CT scan checked that everything was in place. It wasn’t as loud as an MRI, so at least I didn’t need earplugs. Then came the actual radiation - just seven minutes of it - but the whole process, from walking in to walking out, took about 30 minutes.

I didn’t feel anything during the treatments themselves, but the effects crept up on me. By the second week, I was completely drained. Radiation damages both cancerous and healthy cells, and my body was working overtime to repair itself. The daily hospital visits only added to the exhaustion.

By week three, my skin in the treated area started to react turning red, tight, and irritated, like a severe sunburn. The discomfort was constant, and even now, the tightness in my skin hasn’t fully gone away. Between the fatigue and the irritation, I felt pretty miserable by the final week.

One thing that made radiotherapy feel lonelier than chemotherapy was the lack of interaction. My treatment times changed daily, so I never saw the same people. With chemo, I spent hours sitting next to other patients, forming connections, supporting each other. Radiotherapy, on the other hand, was just me and the machines. It made me think about younger patients going through this alone, it must have been terrifying for them.

By the end, I was counting down the days, desperate to be done with the daily hospital trips. I was ready to let my body rest and start the next phase: hormone and targeted therapy. One step closer to healing.

If you’re about to start radiotherapy, here are a few things I wish I had known:

• Tiny permanent tattoos: During your planning session, small ink marks (tattoos) may be made on your skin for alignment. These are permanent but tiny.
• You won’t be radioactive: Radiation passes through you in a straight line; it doesn’t stay in your body. You won’t glow in the dark or turn into the Hulk.
• Skin reactions are common: The treated area may become red, swollen, itchy, and less elastic - like a sunburn. If your lymph nodes have been removed, radiation can also cause stiffness in your arm and shoulder.
• Avoid extreme temperatures: Don’t apply heating pads or ice packs to the treated area.
• Use gentle skincare: opt for a mild, low-pH cleanser in the shower and a lightweight, fragrance-free lotion. Apply moisturizer two to three times daily.
• Clothing matters: Avoid tight clothing or bras that rub against the treated area.
• Bring baby wipes: Keep fragrance-free, 99% water baby wipes handy to remove additional Sharpie markings after each session.
• Fatigue is cumulative: If your radiotherapy follows chemotherapy, expect fatigue to build up over time. It peaks about 1-2 weeks after treatment ends before gradually improving.
• Side effects take time to settle: Skin irritation and fatigue will likely worsen before they get better. Be patient with yourself.
• Strange but effective tip: A radiographer suggested placing a savoy cabbage leaf on my swollen, red skin. Surprisingly, it brought some relief.
• Your body needs support: Radiation causes damage, and your body needs nutrients to repair it. Eating well, staying hydrated, and doing light exercise (like walking) can help manage fatigue.

I’ve highlighted a few products that helped me manage symptoms, but everyone’s experience is different. Always check with your oncology and radiotherapy team for personalized advice.

If you’re about to start radiotherapy, be kind to yourself. It might be harder than expected, but you will get through it. Healing takes time, and this is just one step on the road to recovery.