UW MEDICINE PATIENT EDUCATION RADIATION TO THE HEAD AND NECK KOREAN 머리와목에대한방사선부작용과자기관리 머리나목에대한방사선치료는그부위에부작용을일으킬수있습니다. 이러한부작용은개인에따라다릅니다. 대부분의부작용은몇번의치료후시작되며, 치료가끝난다음수주가지나면사라지기시작합니다. 방사선의부작용 방사선치료의가장흔한부작용들 : 피부반응 미각변화 입과목앓이 입안건조증 귀밑샘부기와이하선염 (3 및 4 페이지참조 ) 탈모 피로 피부반응 방사선치료를받는중에피부반응이있을수있습니다. 이러한반응은엑스선이피부를통과하여종양에닿아야하기때문에발생합니다. 치료부위의피부를특별관리함으로써피부반응의최소화에도움이됩니다. ( 피부관리에대한자료용지참고.) 부드러우며칼라가부드러운 ( 풀을메기지않은 ) 셔츠와블라우스및스카프를착용하십시오. 치료받은부위를문지르는옷은입지마십시오. 치료부위에는전기면도기만을사용하거나면도를절대하지마십시오. ( 방사선요법은모발성장을억제합니다.) 치료부위에는면도전또는면도후용로션을사용하지마십시오. 방향제나탈취제가없는연한비누를사용하십시오. 치료부위에는방사선요법팀의직원이사용을허락한로션만을바르십시오. Aquaphor 나 RadiaGel 과같은피부관리용제품들은피부반응을완화시키거나치료하는데도움이될수있습니다. 1 / 4 페이지 머리와목에대한방사선
치료도중에는태양광으로부터피부를보호하십시오. 태양광노출시간을제한하며치료부위의피부를태양광으로부터보호하는모자나의복또는양산등을사용하십시오. 탈모증 방사선에노출된모발은빠질가능성이큽니다. 이것은방사선치료시작이후몇주일이지나거나치료가끝난다음발생할수도있습니다. 모발은다시돋아날확률이크더라도몇달동안은그렇지않을수있으며가늘어질수있습니다. 레몬차나레몬수는미각의변화에도움이될수있으며또는입안의마름을덜어줄수있습니다. 맛 미각은방사선치료도중에변할수있습니다. 음식맛이달라지거나미각이약해질수있습니다. 미각은대개치료후 2 에서 6 개월이지나면개선됩니다. 레몬차, 레몬수, 레모네이드, 무가당레몬드롭스, 무가당검을들어보십시오. 이것들은입안을덜마르게해줄수도있습니다. ( 입앓이가있다면, 레몬으로인해불쾌감이심해질수있습니다.) 바닐라나박하또는바질과같은연한향료를사용하여음식의풍미를더해보십시오. 입앓이와목앓이 치료후 2 주나 3 주째부터입앓이와목앓이가있을수있습니다. 이러한통증은치료의진행과함께증가할수있습니다. 치료가다끝난다음수주이내에나아지기시작해야합니다. 이러한증상을개선시키는방법 : 부드럽고연하며촉촉한음식을먹습니다. 차거나실온의음식이나액체가뜨겁거나따뜻하거나혹은매우찬음식보다는삼키기가더쉽습니다. 크래커, 감자칩, 프레쩰, 팝콘, 날채소와과일과같은말리거나거친음식을피합니다. 건강에좋은부드러운음식을드십시오. 모든식품의종류를골고루드십시오. 방사선요법동안에는체중감량을하지마십시오. 식사후치아와잇몸을부드러운칫솔로가볍게닦으십시오. 베이킹소다나비오틴치약을사용하십시오. 물한컵에소금 ¼ 티스푼과베이킹소다 ¼ 티스푼을넣은용액을준비하십시오. 이용액으로하루에 8 번이상입을린스하십시오. 시중에서파는마우스워시는사용하지마십시오. 적은분량의음식을자주드십시오. 하루에 3 번많이먹는것보다는소량을 4 번이나 6 번먹는것이나을수있습니다. 2 / 4 페이지 머리와목에대한방사선
음주나흡연을한다면, 중단하십시오. 두가지모두입과목을심하게자극합니다. 또한방사선의부작용을악화시키며회복을더디게할수있습니다. 삼키기어려울때도와주는약이있습니다. 자세한정보는간호사나의사에게문의하십시오. 방사선요법을받는동안에는매일 10 잔에서 12 잔이상충분히액체를섭취하십시오. 입안건조증 방사선은침샘에영향을주수있습니다. 또한입안건조증을초래할수있습니다. 이것은치료중에문제가될수있으며, 사람에따라치료후에도장기간문제가될수있습니다. 다음요령이도움이될수있습니다 : 매일 10 에서 12 잔이상충분히액체를섭취하십시오. 입이매우마르면, 물병이나작은스프레이병을지참하여자주입을적셔주십시오. 액체나그래비또는소스가있는음식을드십시오. 칼로리가높은액체건강식품이나셰이크를마셔서필요한비타민과단백질을꼭섭취하십시오. 쿨미스트가습기를사용하여자는동안습도를높이십시오. 침의양이감소하면, 충치나잇몸병이발생할수있습니다. 양치질과치실사용을자주하며불소치료를받아서치아를보호하십시오. 이러한관리를상세히설명해주는위생사를만나는것에대해의사나간호사에게문의하십시오. 침의양이감소하면입안에더끈끈한점액이생길수있습니다. 점액이끈끈해지지않도록하거나입안에서점액을없애는방법 : - 클럽소다나파파야주스를드십시오. - 육류연화제로준비한용액을드십시오. 연화제 ¼ 티스푼을 1 컵의액체에첨가하면됩니다. - 사일리멜트로젠지또는보습용비오틴마우스스프레이를사용하십시오. 이제품들은처방없이드럭스토어나온라인으로구입가능합니다. 귀밑샘부기 / 이하선염 이하선염이란귀밑샘이붓는것입니다. 이샘은가장커다란침샘입니다. 귀앞의뺨에하나씩 2 개가있습니다. 이하선염은귀밑샘이방사선을쪼이면흔히발생합니다. 이하선염의증상은첫치료후 4 시간에서 24 시간후에발생합니다. 얼음팩과아세트아미노펜 ( 타일레놀및기타브랜드들 ) 은부기에의한불편함을완화시킵니다. 아세트아미노펜을복용하기전에종양전문의와상의하십시오. 부기는첫번째방사선치료후 24 시간에서 72 시간후에사라집니다. 3 / 4 페이지 머리와목에대한방사선
이하선염이있다고해서이하선염이없는사람보다치료에따른문제가더많을것이라는뜻은아닙니다. 피로 방사선요법동안신체는많은에너지를사용하게됩니다. 질병과관련된스트레스나치료를위한매일의방문그리고정상세포에대한방사선의영향으로매우피로하게느낄수있습니다. 피로의정도와그지속기간은개인에따라다릅니다. 사람에따라치료가끝나면없어질수있습니다. 어떤경우에는피로가 2 년이상지속될수있습니다. 활동을분산시키며휴식을취함으로써과로를막는데도움이됩니다. 가능하면규칙적인운동을권장합니다. 좋아하는운동을하십시오! 집안청소와쇼핑또는식사준비에대해남의도움을청하십시오. 피로할때그러한도움을활용하십시오. 혼자사는경우너무피곤하여식사조리를할수없다면, 균형잡힌냉동식사제품을들거나, Meals on Wheels 와같은커뮤니티서비스를고려해보십시오. 다른부작용 그밖에덜흔한부작용도있을수있습니다. 다른증상이있다면의사나간호사또는치료사에게알리십시오. 질문이있으시면간호사나의사에게문의하십시오. 질문? 귀하의질문은중요합니다. 질문이나염려되는내용이있다면귀하의의사나의료서비스제공자에게연락하십시오. UWMC Cancer Center 는평일오전 7 시반부터오후 5 시까지 206-598-4100 으로연락하십시오 ( 통화가연결되면 1 번을누르십시오 ). 주말과휴일에는 206-598-6190 에전화하신다음방사선종양전문의당직레지던트의호출을요청하십시오. University of Washington Medical Center Radiation to the Head and Neck Korean Published PFES: 10/2001, 04/2013 Clinician Review: 04/2013 Reprints on Health Online: https://healthonline.washington.edu 4 / 4 페이지 머리와목에대한방사선
UW MEDICINE PATIENT EDUCATION Radiation to the Head and Neck Side effects and self-care Radiation treatments to your head and neck can cause side effects in the area. These side effects vary from person to person. Most will begin after you have had several treatments and will start to go away a few weeks after your treatment is done. Radiation Side Effects The most common side effects from radiation treatments are: Skin reactions Taste changes Sore mouth and throat Dry mouth Parotid gland swelling and parotitis (see pages 3 and 4) Hair loss Fatigue Skin Reactions You may have skin reactions while you are receiving radiation treatments. These reactions occur because X-rays must pass through the skin to reach the tumor. Special care of the skin in the treatment area helps minimize skin reactions. (See the handout on skin care.) Wear shirts, blouses, and neck scarves that are soft and have soft collars (no starch). Do not wear clothes that rub the treated area. Use only an electric razor, or do not shave at all within the treated areas. (Radiation therapy will suppress hair growth.) Do not use a pre-shave or after-shave lotion in the treatment area. Use a mild soap that does not contain perfume or deodorant. Use only lotions on the treatment area that a radiation therapy team member gives you or tells you are OK to use. Skin care products like Aquaphor and RadiaGel can help lessen and treat skin reactions. Page 1 of 4 Radiation to the Head and Neck
During treatment, protect your skin from the sun. Limit your time in the sun and use things like hats, clothing, or umbrellas to block the sun from your skin in the treatment area. Alopecia Try lemon tea or lemon water to help with taste changes and to help your mouth feel less dry. Your hair in the radiation field will likely fall out. This may happen a few weeks into radiation or even a few weeks after treatment is over. Your hair will likely grow back, but it may not do so for several months and it may be thinner. Taste Your sense of taste may change during your radiation treatments. Foods may taste different or your sense of taste may get weaker. Taste usually improves 2 to 6 months after treatments are done. Try lemon tea, lemon water, lemonade, sugar-free lemon drops, and sugar-free gum. These will also make your mouth feel less dry. (But, if you have mouth sores, anything with lemon in it may increase your discomfort.) Try using mild flavorings such as vanilla, mint, or basil to add flavor to your food. Sore Mouth and Throat You may have a sore mouth and throat starting in the 2nd or 3rd week of treatments. The soreness may increase toward the end of your treatments. It should start improving within a few weeks after your treatments are done. To help ease these symptoms: Eat foods that are soft, smooth, and moist. Foods and liquids that are cool or at room temperature are easier to swallow than warm, hot, or very cold foods. Avoid dry or coarse foods such as crackers, potato chips, pretzels, popcorn, raw vegetables, and fruits. Eat a healthy soft diet. Include foods from all the food groups. Try not to lose weight during radiation therapy. After eating, gently brush your teeth and gums with a soft toothbrush. Use baking soda or Biotene toothpaste. Make a solution of ¼ teaspoon salt and ¼ teaspoon baking soda in 1 cup of warm water. Rinse your mouth with this solution at least 8 times a day. Do not use mouthwashes you can buy. Try eating smaller amounts of food more often. Some people find that 4 to 6 small meals are better than 3 large meals a day. Page 2 of 4 Radiation to the Head and Neck
If you drink alcohol or smoke, STOP. Both are very irritating to the mouth and throat. They can worsen your side effects from the radiation and slow your recovery. There are medicines that can help with your swallowing discomfort. Ask your nurse or doctor for more information about these. Drink plenty of fluids during your radiation treatment, at least 10 to 12 glasses each day. Dry Mouth Radiation can affect the glands that produce saliva. This can cause dry mouth. This may be a problem during treatment and, for some people, for a long time after treatment is over. These tips may help: Drink plenty of fluids, at least 10 to 12 glasses each day. If your mouth is very dry, carry a water bottle or small spray bottle to wet your mouth often. Eat foods with liquids, gravies, and sauces. Drink high-calorie liquid supplements and shakes to make sure you are getting the vitamins and proteins you need. Try using a cool-mist vaporizer while you sleep to increase the moisture in the air. When the saliva is decreased, tooth decay and gum disease may occur. Brush your teeth and floss often, and get fluoride treatments to help protect your teeth. Ask your doctor or nurse about seeing a dental hygienist, who will explain more about this care if needed. Decreased saliva can also lead to thicker mucus in your mouth. To help make the mucus thinner and help clear it from your mouth: Drink club soda or papaya juice. Drink a solution made with meat tenderizer. Add ¼ teaspoon tenderizer to 1 cup of liquid. Try Xylimelt lozenges or Biotene Moisturizing Mouth Spray. You can buy these at a drugstore or online without a prescription. Parotid Gland Swelling/Parotitis Parotitis is swelling of the parotid glands. These are your largest salivary glands. You have 2 of them, one in each cheek in front of your ears. Parotitis often occurs when the parotid glands receive radiation. Symptoms of parotitis occur 4 to 24 hours after the first treatment. Ice packs and acetaminophen (Tylenol and other brands) help relieve discomfort from the swelling. Check with your medical oncologist before you take acetaminophen. The swelling goes away 24 to 72 hours after the first radiation treatments. Page 3 of 4 Radiation to the Head and Neck
Having parotitis does not mean you will have more problems during treatment than someone who does not have parotitis. Fatigue During radiation therapy, your body uses a lot of energy. You may feel very tired from stress related to your illness, daily trips for treatment, and the effects of radiation on your normal cells. The amount of fatigue and how long it lasts varies with each person. For some, it may go away when their treatment is done. For others, the fatigue can last 2 or more years. Spreading out your activities and taking rest breaks will help you from getting over-tired. We encourage you to do regular exercise, as you can. Do things you enjoy! Ask someone to help you clean your house, shop, or cook meals. Take advantage of their help while you feel tired. If you live alone and are too tired to cook a full meal, try eating a well-balanced frozen dinner, or consider using a community service such as Meals on Wheels. Other Side Effects Other less common side effects may also occur. Tell your doctor, nurse, or therapist if you have any other symptoms. If you have questions, please ask your nurse or doctor. Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. Weekdays from 7:30 a.m. to 5 p.m., call UWMC Cancer Center at 206-598-4100 (press 1 after call goes through). After hours and on weekends and holidays, call 206-598-6190 and ask for the Radiation Oncology resident on call to be paged. University of Washington Medical Center Published PFES: 10/2001, 04/2013 Clinician Review: 04/2013 Reprints on Health Online: https://healthonline.washington.edu Page 4 of 4 Radiation to the Head and Neck