Total body irradiation
Total body irradiation is radiation to your whole body. It is done if you are being prepared to receive a stem cell or bone marrow transplant.
How does total body irradiation work?
Total body irradiation prepares your body to receive a stem cell or bone marrow transplant by:
- Killing any cancer cells that may be left behind in your body after your chemotherapy.
- Getting rid of your bone marrow, which makes space for the transplanted cells.
- Suppressing your immune system, which prevents your body rejecting the donated stem cells.
Planning and preparation for total body irradiation
Before you receive any treatment, you will attend the radiotherapy department for a planning appointment. This is called simulation. An X-ray machine called a simulator is used to plan your treatment. You will have to lie still on a hard table in a room with machines above you. This may be uncomfortable but does not hurt.
Your planning session can last up to an hour. During this time you will need to lie very still while a doctor and radiation therapist take some X-rays and measurements. CT scans may also be taken to plan your treatment. The radiation specialist then calculates the exact amount of radiation that you are to receive, while also protecting your important organs.
Your doctor will explain your treatment. Ask as many questions as you like, so that you understand what will happen during and after treatment.
Having total body irradiation treatment
Your treatment may be given as a single dose or as 6-8 smaller doses. The number of doses may depend on the type of cancer you have, but your doctor will discuss this with you.
Your treatment is given in a radiotherapy department by radiation therapists. In most cases, you will have to stay in the hospital as an inpatient.
During the treatment, you will have to lie still in the same position you were in on your first visit.You will be alone in the treatment room but the radiation therapists will watch you from outside on a TV monitor and can talk to you. It may be helpful to bring some music with you so that you do not hear the machines working. You do not have to undress if you wear light, loose clothing with no metal clips or buttons, such as tracksuit bottoms and a t-shirt.
What are the side-effects of total body irradiation?
Radiotherapy affects cancer cells but also the normal tissue nearby. This can lead to side-effects. It is difficult to know in advance what side-effects may occur, as every patient is different. Talk to your treating team if side-effects are troubling you.
- Early or acute side-effects happen within a few hours of treatment
- Late or long-term side-effects develop years after treatment develop years after treatment
Early or acute side-effects
You may have experienced nausea and vomiting before due to chemotherapy. Generally, nausea from radiotherapy is milder than that caused by chemotherapy. You will be given anti-sickness medication before your treatment. If you do get nausea or vomiting, let your nurse know.
Your salivary glands are located in your upper neck and also known as your parotid glands. These glands can become inflamed after radiotherapy. The swelling of these glands in turn can cause stiffness in your jaw and some discomfort. It can be treated with painkillers and usually settles down quickly.
Dry mouth
As your salivary glands make most of your saliva, you may find that you have a very dry mouth. This can begin 2 to 3 days into your treatment and can last a number of weeks. This can often make eating uncomfortable. It may help to drink fluids regularly and practise good mouth care. You may need to be prescribed artificial saliva by your doctor as well.
Sore mouth
Radiotherapy and chemotherapy can also cause your mouth to get sore. This is called mucositis. Again good mouth care is important. You will be advised to clean your mouth with a soft toothbrush and use mouthwashes regularly.
Your skin may become red, dry, itchy and sore due to radiotherapy. This usually does not last long and is mild. You will be advised to try and reduce this by:
- Washing your skin gently
- Using a non-perfumed soap
- Using tepid warm water
- Patting your skin dry
- Using a mild non-perfumed moisturiser
Diarrhoea is a distressing symptom that can start within 48 hours of getting radiotherapy. Tell your nurse if you are having diarrhoea. Medications may be given to stop it, if there is no infection present. You will be encouraged to keep your anal area clean and dry, as it can get sore.
If you have had chemotherapy, more than likely you will already have lost your hair. If you have a full head of hair before treatment, you will get some hair loss about 2-3 weeks after your radiotherapy is finished.
Fatigue is a side-effect of both chemotherapy and radiotherapy. You will find that you have less energy and are extremely tired after your treatment.
Your immune system is affected by chemotherapy and radiotherapy, which makes you more likely to get infections. After treatment, you will be nursed in a single room and observed very closely for any signs of infection. These will be treated immediately. You will be given more information on infection control by your nurse.
Find out more about side-effects
Tips and support to help you cope with different side-effects.
Late or long-term side-effects
Sleepiness or somnolence is where you feel very drowsy, tired and need to sleep constantly. This happens about 6 weeks after you have completed your treatment and may last from 2 to 6 weeks. It can be upsetting but it will pass.
Cataracts are a complication of total body irradiation. They cause a cloudy film that develops over the lens of your eye. Cataracts can happen 6 months to 5 years after treatment. They can be corrected with small surgery.
This is inflammation of your lung tissue. Because your lungs are shielded during the radiotherapy, this side-effect is uncommon. It can occur from 6 weeks to 6 months after your treatment. You may experience a cough and shortness of breath at first. It is important to let your doctor know if these symptoms occur.
Radiotherapy can affect glands that control hormones in your body. Hormone level changes can cause side-effects.
During your regular check-ups, you will have blood tests to measure these hormones.
Pituitary gland hormones
The pituitary gland in your brain controls many hormones in your body, such as growth hormones. These hormones affect muscle and bone strength. The pituitary gland is very sensitive to radiotherapy. If treatment is given at a young age, it may affect future growth. However, as an adult, it is unlikely to affect your growth.
Thyroid gland hormones
Your thyroid gland is in your neck and also makes a hormone called thyroxine. Thyroxine helps with your body’s metabolism. The thyroid gland can be affected by radiotherapy and become underactive as a result. You may then gain weight and feel that you have less energy.
As your heart will receive some radiotherapy, you might have some heart problems in the future. Some chemotherapy drugs that you receive might also affect your heart.
The testicles and ovaries receive radiotherapy during total body irradiation. The chemotherapy drugs used when preparing for your stem cell or bone marrow transplant will also affect them. Sadly, this will lead to permanent infertility. Discuss this with your doctor before your treatment. Read more about fertility and cancer treatments.
People can have more than one cancer in their lifetime and these are not all caused by cancer treatments. However, the high doses of radiation and chemotherapy used before your transplant can cause a second cancer later in life. These cancers can include skin, mouth or lung.
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