Radiation therapy
Employs radiation therapy applications of ionizing radiation in undermining the structure of cancer cells and treatment of tumors, both using the elements and isotopes, or by generating a stream radiation revived and high-energy, and the shedding of tissue and tumor cells in order to eliminate it altogether, or reduce the tumor mass to reduce effects at the very least, and traditionally is used for X-rays generated electronically as a source of radiation, high doses times the used hardware imaging, in addition to the use of other sources, such as gamma rays or a stream of neutrons or protons, or beam of electrons, and has contributed to the widespread use of applications of radiation to treat cancer, high rates of healing and significantly longer periods of survival, and is one of the most effective treatments for many of the tumors arising most parts of the body.
And is the effectiveness of this treatment in the ability of radiation on the destruction and fragmentation of DNA cancer cells, a chemical that carries information and codes, genetic, and control the biological processes necessary for reproduction and growth, and the performance of various cellular functions, and in general, cells that grow and reproduce rapidly, like cancer cells, are more sensitive to the effect of radiation and the most affected, and of course, take preventive measures during radiation therapy, avoid exposure largest number of tissues and organs natural sound radiation, and are usually protected using protective shields and various styles, and despite such precautions, however, that some normal cells are affected by radiation and that were generally able to recover greater vitality, due to its ability to use the techniques of the body's natural repair and restoration of damage to DNA.
And is a radiation therapy treatment topically, like surgery (and other than chemotherapy), and may be used alone as a treatment only, or jointly with treatments other tumors, and may be prescribed an alternative to surgery in some tumors as initial therapy and essential, either individually or jointly with chemotherapy, may also be used before direct surgery for tumors, known as the treatment initial Assistant (neoadjuvant therapy) in order to reduce the size of the tumor to facilitate its eradication, or is used after surgery excision as a treatment additive (adjuvant therapy) in order to eliminate any cells of a tumor is a distinctive may be residual, or when you can not complete eradication of the fabric of the tumor, and may be prescribed in some cases to relieve the symptoms as a treatment house only (in the sense that the primary objective is not a cure but to relieve pain or bleeding or pressure of the tumor mass to adjacent tissues, and so curtail the size of the tumor mass ).
Types of radiation
Called the radiation used for cancer treatment ionizing radiation (ionizing radiation), as it is ions while crossing through the tissues, and removes some electrons from atoms and ions are atoms gained shipments of electrical result of the loss or acquisition of a electrons, and from here Valtaan turn cause biological changes genes or lead to cell death.
And in general can be classified as ionizing radiation to the two main types:
Photons (photons): include X-rays and gamma x-rays.
Minutes of radiation (particulate radiation): or fine particles, including electrons and protons and neutrons and other particles and Alpha (alpha particles) and beta (beta particles).
And vary the amount of energy in different types of ionizing radiation, and of course the more energy was greater the greater the depth to which the radiation penetrated into the tissues, and depending on the ability of the force is choose the right type and energy radiation appropriate to the type of tumor in each patient, and include the types of Radiation used:
High-energy photons: either active ingredient, such as radioactive cobalt, cesium, or a machine that generates radiation Almajaj.
Package electrons (Electron beams): and is useful when processing external or surface, which protects the tissue located deep penetration of radiation.
Package protons (Proton beam): protons and are parts of atoms, it is marked as not to cause serious damage to tissues they pass through, while the concentrated impact on tissue cells that are found at the end of the path of rays field treatment, which is useful in shedding heavily on how much radioactive tumor cells while minimizing exposure of cells and tissues nearby.
Package neutrons: it is usually used to treat certain types of head and neck tumors and prostate.
And in this regard it is useful to note the units used to measure the rates and doses of radiation therapy, unity of the raw measurement called RAD (rad), which represents the first letters of the phrase (radiation absorbed dose), which means the dose of radiation absorbed or container, and alaykum is a measure of the amount of radiation absorbed by the body, and the most common unit of measurement is called Gray (Gray Gy) and is equal to 100 rads, and subdivided by unit Alsntejraa (cGray cGy), which is equal to one rad.
Types of radiation therapy
Radiation therapy is classified into two types, external (external), where the broadcast radiation rays from a machine shed on a specific body positions, and internal (internal), where the radiation comes from radioactive material is installed directly into the tumor tissue, or close to it, either temporarily or as permanent, and may be used together with some types of cases.
Internal radiation (Internal radiation)
And is also called implant radiation (implant radiation) or radiation therapy restricted (brachytherapy) and is used in many tumors, such as head and neck tumors, and tumors of the retina, and breast and thyroid and uterus and prostate, and in this type of treatment is employed characteristic radiation of some radioactive elements, which is included within the capsules or are in the form of granules or wires, or placed with a tool catheter, and are planted and installed directly into the tumor tissue, or close to it, whether for just a short period or permanently, and include radioactive materials typically used , the elements radium and iridium, cobalt, cesium and iodine and phosphorus, and doctors usually refers to radioactive material planted planter body means (implant) or fillings when talking about internal radiation, which may be used jointly with external radiation in some cases.
And there are many methods of transplantation of radioactive materials, depending on the position of the tumor and its size, and each method call, of course, may be planted directly into the tumor tissue, including known radiation interface (interstitial radiation), and the stuffing inside the capsules or an angioplasty or the spherical granules, cavity or implanted inside the body, such as the uterine cavity (radiation Tjoafa intracavitary), or implanted within the body channel (radiation duct intraluminal radiation), so that radioactive materials are placed within the stream or channel, or with me, such as the airways or the esophagus, or grown on the surface of the tumor, so as to install the charge holder is small and placed inside or against the position of the tumor, or are placed fillings radioactive cradle of the tumor, any position of the tumor after eradication, in addition to how the injection of some radioactive material intravenously as a means of radioactive isotopes into the blood circulation cavity or mystical, as in the case of injection of radioactive iodine treatment for thyroid tumors, and of course are the development and installation of types of fillings under local anesthesia or fully to the patient.
And ensure the method of internal radiation direction and shed doses of intense radiation on the limited space of the body and thereby reducing the exposure of normal tissue to radiation, as well as it allows doctors to give doses of an overall high level of radiation in a time shorter than the time required for radiation outside, and noted it is a way effective in the treatment of tumor stages of early, and on the other hand is determined the time of the survival of fillings Bmoadaha depending on the radiation dose required to achieve the most effective treatment, depending on the planned treatment (which in turn depends on the type of tumor and its position and physical condition of the patient and other treatments received) , and in this regard are classified as temporary fillings into two types depending on the dose rate radiation doses with a low rate (low dose-rate LDR), and can be kept Bmoadaha for several days, and dose-rate is high (high dose-rate HDR), and are removed After a few minutes from the emplacement, and of course not left any radiation the body after removing the temporary fillings.
And than usual to keep the patient inside the clinic isolated room alone when the radiation levels high, and careful medical team not to remain in his room for long periods and not touched him only when necessary and for a short time, and prevent his visits to children and pregnant women in particular, and determine what visits Other members short periods does not exceed half an hour or so, and visitors should not be approached from the patient or sitting in the vicinity of at least two meters from his bed, and may be placed on the cover of lead metal bed between the patient and visitors, or the medical team, On the other hand (and as the subject of transplantation), may require the patient to remain in bed, avoiding the large number of the movement, for fear of filling shifts in position.
And when planting permanent, lost fillings property of radiation quickly and become radioactive after a short period, and lower amounts of radiation to safe levels before leaving the clinic, and despite the low radiation in general, but it could be preventing the patient and for several weeks of direct contact with others , especially children or pregnant women to avoid the possibility of exposure to radiation.
And of course the patient may feel he woke up after anesthesia complications from the transplant, such as dizziness or nausea, which soon disappear, and can be used with some medications, if needed, and often the patient does not feel pain or stress during the time of receiving internal radiation, and may caused by the presence of some filler position pain implant, which may require the use of analgesics when necessary.
External radiation (External beam radiation therapy EBRT)
And is the type most frequently in the treatment of most types of tumors, and is done using machine-generated radiation called Palmjl linear (linear accelerator) or frequent, the generation and transmission X-inflammatory high-energy, directed towards tissue tumor, and a specific area of the adjacent tissues, and There are different types of these machines produce different types of energy, and some is used in the treatment of tumors near the surface of the body, while concerned with other processes tumors located deep inside the body, and is the X-ray the most widely used source of radiation high-energy, and there are many other types used depending on the type of tumor and depth of supposed radiation to penetrate inside the body, such as gamma rays from isotopes of cobalt irradiated (cobalt-60 gamma rays), or package from a stream of neutrons (neutron beams) or protons (proton beams), or beam of electrons (electron beam ).
Perception (simulation) and treatment planning
After consulting various medical to determine aspects of the treatment plan and make decisions with radiation therapy, the doctor make many measurements in order to plan the exact field radiation therapy, the process of perception and simulation prior to actual processing, and similar machine simulation or Almchaabah (simulator) transmitters radiation However, they use technology fluoroscopical, generating X-ray and Flash Utility (fluoroscopic x-ray), allows the doctor to see and identify the target area, and the patient lies during the process of perception on a table with the center can be moved in various directions, and is drawn signs temporarily on the skin to determine the Places treatment target, and is usually used with a measure of the laser using light beams of the laser is low (and is not harmful of course), to determine the field of treatment, and after the completion of the audit measurements, the doctor pick up some x-rays for use in the processing of treatment, including pictures of Planning x-ray tomography, in some cases, and are often ink marks Temporary tattoos using light to keep the limits set for long periods.
And based on information learned after the planning sessions, several measures are taken before starting the actual treatment, such as protective shields and processing of lead-acid templates to protect healthy tissue from exposure to radiation, and determine the radiation doses required and the scheduling and the number of treatment sessions.
About treatment
The doctor using data from the planning sessions for the direct sessions actual processing, and made use of signs specific to the field of treatment to determine where direct radiation accurately, and to stabilize the patient in the correct posture on a bed machine, broadcast, and, of course, is to protect tissues and organs of sound body and is targeted treatment to avoid complications of radiation, where the doctor put armor already processed or buffers (blocks) in particular, between the machine-ray, and between these positions, and may be used molds plastic or adhesive tape to help keep the patient in the position required, and usually takes Most of the time of the initialization process of the treatment session, which in turn may take between fifteen to thirty minutes, take a long while to receive the actual radiation between the minute and five minutes, and in this regard it is useful to wear comfortable clothing and easy to wear dislocation, such as hospital gowns before starting the hearing treatment.
And in most cases, are receiving external radiation without the need for the establishment of the clinic, and for periods ranging from six to eight weeks, five days per week, (and courses therapeutic be shorter when the target treatment alleviate the symptoms and effects tumor only, and usually for a period of between two weeks to three weeks), depending on the type of the tumor and the planned therapeutic approach in each case.
The calculated doses of the College and the number of sessions of treatment depends on the type of tumor and its position and size, and the general health situation of the patient, and other treatments received, and is given doses many and small, on a daily basis (instead of dose-intensive in a few sessions), in order to protect healthy tissue locus of treatment, while helping on a weekly rest periods, recovery of these tissues.
And there is another way to divide the doses of radiation, known as radiation-fragmented (hyperfractionated), where instead of receiving a radiation rate of one session per day, is divided daily doses to smaller doses given several times per day, apart a few hours, ranging from four to six hours, and physicians studying the effectiveness of the fragmentation of radiation at various tumors, and extent of symmetry in the effective treatment and late complications with the way radiation daily, and may when the results were encouraging, so that some tumors had adopted this method of treatment.
In terms of surgeries, there is a method known as radiation therapy during surgery (Intraoperative radiation) radiation therapy incorporating surgery, where initially the surgeon removes more than how much tumor tissue as possible, and during the surgery, the shed is a high dose of radiation to the cradle of the tumor (ie, position that has been removed from it), with an area of the adjacent tissues in case of transmission of cancer cells to it, and is sometimes used this method in addition to external radiation, which ensures shed how much more intense radiation on cancer cells.
It should be noted that sick children do not feel any pain while receiving radiation, and it's like taking X-rays, but it requires that ensconce him the child developed fixed without mobility, and until the end of broadcast radiation, and may need to be sedated for this purpose, especially if small age, and of course the child does not see or hear or radiation smell smell, and his body will not contain any radioactivity, and there is no need to impeach him for visitors, or prevented from communicating with others.
It is important to reassure the child and remove his fears before starting sessions rays, where it will remain a lonely room treatment during the time of broadcast, and machines used for Intel X-large size and made some noise as they move around the body, to target the placements selected from several angles, and can be a conversation the child and reassure him through the windows control rooms rays, and his vision for his parents and his sense of closeness will increase their presence known from assured, and it is useful to visit the hospital radiology departments, before direct treatments to increase even domesticated situation in general.
Care during radiation therapy
Reacts to the body of each patient with radiation therapy in his own way, which requires follow up on these interactions and planning, and sometimes modify the pattern of treatment depending on developments, and of course patients need special care during radiation therapy, and following are some guidelines about such care by addressing the effects of radiation therapy:
Before starting treatment, the physician should be informed about any medications, and handling under any sensitivity to drugs, also need to be consulted before taking any drugs, even prescribed by another doctor, and before taking vitamins or energy drinks, or blends of natural herbs, for example.
Tiredness and fatigue is common and a companion to receive radiation therapy, as the body needs a lot of extra energy over the treatment period, and the patient feels fatigue of different intensity during the hours of the day, which requires a lot of rest and sleep enough, and determine daily activities, and from the usual fatigue that lasts for periods ranging from four to six weeks after the end of treatment.
Good nutrition and sufficient is very important, and should follow the appropriate diet and nutrient-rich, to avoid the problems of nutrition and nutritional deficiency and weight loss.
The need for intensive care skin, skin treatment position, and to take appropriate preventive measures.
About the side effects of radiation therapy
Although one does not feel anything while receiving radiation therapy, but the effects of radiation are concentrated gradually with the passage of time and longer periods of treatment, and associated side effects depend mainly on the dose of radiation user and position the processor, and the health status and general physical the patient, and vary in intensity and quality, and periods of continuity from one person to another, and often associated with placements that receive radiation and confined them, Esttny of the complications of skin and skin, and problems with fatigue continued, they occur when you receive radiation to any position of the body, and of course , and when the development of severe complications, in particular, may be modified or delayed radiation doses for some time, until the stability of the case.
And can be classified as side effects to severe (acute) any early and quick to emerge, arise after days or weeks, and often disappear after a short period from the end of treatment, or chronic (Chronic) any late and long-term, may appear after months or years the end of the treatments, and some may be permanent, and of course there are several measures taken to manage the side effects and mitigation.
And early side effects include common and that appear within days or weeks: complications of skin and skin, and fatigue, and various complications of oral inflammation and ulcers, dryness, and hair loss, nausea and vomiting, and diarrhea, loss of appetite, changes Alttam sense and taste, and frustrate the bone marrow (low blood cell count).
It should be noted that during the period from 4 to 8 weeks after receiving radiation therapy to the brain, develops in some children what is known as the phenomenon of lethargy (somnolence syndrome), which are clearly distinguished in the large number of drowsiness, and idle motor (lethargy), and low levels of activity and energy, in addition to the loss of appetite, and fever, and bouts of irritability and ease of excitement and nervous tension, and usually ends symptoms during periods ranging from one to three weeks.
As of late complications in the long term which results from treatments tumors different, which may appear several years after, they are linked to the overall effects on physical growth and intellectual development of children, in addition to the effects of a late show on some vital organs, but more importantly may have increased risk factors and prone to the development of secondary tumors is the tumor the original processor, where the proportion of the risk of the emergence of secondary tumor between 3% to 12%, (depending on the type of the original tumor, and treatment received), during the twenty years following the diagnosis and treatment of any kind of tumors of children, and especially the development of some types of leukemia, (please go to the page of late complications of cancer treatments for more details about such complications.)
Management of side effects
The following paragraphs profile for the overall side effects of radiation treatment and management measures. (And please go to supportive care for more details on each):
Effects of the mouth and throat
Cells grow natural constituent parts of the intestinal tract, including the mouth, and multiply at a rapid pace and is a permanent replacement, and therefore, an abused quickly by radiation therapy to the head and neck, and chest and abdominal cavity, and may arise inflammatory mucous membranes throughout the body tract.
And the usual complications that arise mouth: inflammation of the mucous membrane and gums and sores, and dehydration, and difficulty swallowing, in addition to changes in taste and smell. (And please check out the mouth complications for details about adequate oral infections and gum).
Infections and inflammation of the mucous membranes of the mouth
In the event of infections of the mouth and gums, it requires health care, full mouth and teeth all the time, and the use of mouthwashes cleared periodically, and to take additional measures for dental care, where is the first position for the emergence of infection and pain, in addition to maintaining the feed system is good and appropriate , and eat a carefully selected so as not to further irritate the inflamed tissue, and there are creams and medicines to address the situation described can be used with the consent of your physician.
The following suggestions are useful when inflammation of the mouth:
Eating soft foods easy to chew and swallow.
Avoid foods that may irritate the mouth, such as foods and drinks highly acidic, and spicy foods and spicy, and high salt content, or coarse, or dry, or that contain pungent spices.
Cook foods thoroughly until completely soft and tender, and eat small bites.
Use a blender to prepare food, snacks and hydration using sauces or butter or the like.
Use of absorbent straw when you drink various liquids.
Refrigerated foods a bit or at room temperature, increasing the severity of hot foods irritate the mouth weak.
Into account that the child uses brushes or sponge mops cotton to clean the teeth, and if the child can use a very small piece of sterile gauze is Asbha around the finger is clean and smooth.
Palliative use of toothpaste.
Use a combination of salt and soda to rinse the mouth periodically (half a teaspoon of salt, two tablespoons of sodium bicarbonate dissolved in about a liter of water), or a solution sodium bicarbonate (one teaspoon in about a quarter liter of water), every 2-3 hours and after meals.
Avoid using mouthwashes that contain alcohol, which may irritate the inflammation of the mouth.
Should be reported to the physician when there is a dark red spots or white or bright places painful mouth.
Dry mouth
The exhibitors from chronic dry mouth and a long-term, and the resulting damage to the salivary glands due to radiation therapy, and has a direct impact on the ability of the patient to speak and chewing and swallowing and taste, which adversely affect the activities of life.
The following suggestions useful for dealing with dry mouth:
Eating sour foods and drinks such as lemonade may help to increase the secretion of saliva, taking into account the lack of infections or ulcers in the mouth.
De-absorbed hard candy or gum is sugar-sweetened or chips to frozen fruit juices, to help increase the secretion of saliva.
To maintain moisture on lips always using moisturizers lips.
Eating soft foods easy to chew and swallow.
Take sips of water over time to help in speaking and swallowing.
Moisture conservation mouth permanently, and eating more fluid.
A moisturizing creams of the mouth can be used with the consent of your physician.
Changes in sense of taste and smell
Result of changes in sense of taste and Alttam and smell due to radiation therapy or because of the cancer itself, and you know such a case, blind oral or blindness, taste, and is usually to make the foods taste a stinging or taste (metallic), and lose many of the foods taste, altered to taste different, and usually clear up complications after the treatments.
The following suggestions helpful when you change the taste:
Use plastic utensils and plates or paper plates instead of metal or ceramic, and change the appearance and position of eating meals from time to time, and provide meals at room temperature.
Avoidance of foods that caused the taste is unpalatable in earlier times, and diversification of meals, and catering for the child that looks like a good patient's taste and smell.
Experience of different spices and flavors with meals, and eating various meats or fish dipped after Beslsat sweet.
Experience sour foods such as lemonade or orange (in the absence of oral infections).
The red meat seemed to taste or smell unpleasant, useful change to the white meat or eggs or dairy products.
Skin reactions and skin
Is the inflammation of the skin and skin from the common side effects of radiation therapy with placements of treatment, and varying skin reactions to radiation from the appearance of redness slightly placement and dry skin like Bhroqat the sun, and itching and sensitive skin, to the scaling and Altzlkh severe and the emergence of the rash, and it is important address the situation in its early stages, to avoid the aggravation of inflammation, which usually progresses to suppuration and Altzlkh accompanied Benz liquids and the appearance of pimples, and there are medications and different treatments help to address these impacts, such as the use Aldhiror and topical ointments and creams antibiotics or steroidal to relieve inflammation and itching and to speed up the recovery of the skin, and, of course, necessary not to use any medication without consulting your physician.
Although the majority of the effects of skin and skin go away after several weeks of the end of radiation therapy, but that in some cases, the skin remains the locus of treatment is different and shows a dark-colored, and be particularly sensitive to the sun.
(Please go to a page that complications of skin and skin to see additional details).
In the following points helpful suggestions for dealing with such effects:
Wear loose fitting clothes and loose soft cotton, for example, places of treatment, and use cotton sheets for the family, and avoid wearing woolen clothing or textile industry because it increases the severity of skin irritation.
Avoid wearing tight clothes, or what would nerve or repackaging into treatment, and avoid the plant and coarse clothes.
Erosion and irritated places exposed to the air from time to time.
Consult a physician before using any products to take care of the body and skin treatment position, including soaps and hair rinses and pastes, paints, oils and perfumes and sunscreen and Aldhiror.
Palliative use of soaps all the time, and skin moisturizers can be used after consulting your physician.
Avoid scratching and itching skin when the subject of treatment, and massage or rubbing hard.
Avoid the use of adhesive tape on the position, and when the need for bandages, adhesive can be used for paper only, proves beyond area of skin exposed to radiation.
Avoid heating or cooling position (such as use of ice packs or heating pads), or use hot water, and advised to use lukewarm water when washing and drying position and gently without rubbing.
Be careful of exposure to the sun as much as possible to avoid Hroqatha, and follow-up of sick children in this matter and away from the presence of the cold, and it is necessary to protect the subject of treatment of exposure to the sun, and covered clothes soft before leaving the house, and should consult a physician before using paints or protective oils from the sun.
Hair Loss
Result in hair loss treatment for radiation treatment only in the positions, and of course happen that in adults in any position of the body where hair grows, while important in children is the loss of hair, which is impossible to avoid, and even though he has a few cases Atqcef hair without hair loss, but he falls completely in most cases.
And the usual start of precipitation during periods ranging from two to three weeks after the start of treatment, and although the hair loss opposed a temporary, where the hair grows back again after periods ranging from 6 to 8 weeks after the treatments, the hair may not grow again placements which were exposed to high doses of radiation, and it is common to grow new hair color or a slightly different structure.
And of course it may be difficult to accept it on the sick child or the child, and even the parents because of changes in external appearance dramatically and the significance to the case of the disease, and may wish the patient to wear a wig and it does not affect the growth of hair again, and would prefer to shorten the hair long start of treatment, and wear a headgear appropriate to spare the scalp directly to the sun or to cold, as is always advised during the period of rainfall using washes hair palliative, and not to use hair dryers or chemicals, such as dyes, or electrical appliances such as Aaqsat hair and others.
The following suggestions useful for dealing with hair loss:
Parents are advised to deport their own feelings on the subject, and make it normal to be a bald.
Prepare children to accept changes its appearance, and shorten his hair the way that suits him.
If you want to wear a wig, preferably chosen before starting the treatment to match the original hair.
Once treatment begins, it is preferable to use washes hair type dampening and drying the hair gently, without rubbing, and discharged gently with soft brushes or combs the lashes wide teeth.
Avoid using hair dryers or Aqsat or dyes or chemicals.
The use of cushions of the fabric smooth to avoid friction and rubbing the scalp with hair.
Wear hats and appropriate child chooses to leave as he wished, and head protection from exposure to the sun or cold.
Shaving the head completely that the child did not mind, it reduces the problems of dealing with hair loss.
The child suffered irritation of the scalp, some drugs can be used with the consent of your physician.
Fatigue (Fatigue)
Can be defined fatigue as a feeling of correlative tired and fatigue and weakness and exhaustion, physical and energy shortages, and one of the most side effects of radiation therapy commonly used, and the intense feeling of fatigue is usually after two to four hours of the end of the treatment session, and most likely go away manifestations gradually after Several weeks of the end processors.
(Please go to a page that fatigue in cancer patients to see more details).
And the following suggestions helpful when feeling tired:
Determine the physical activity, and increased rates of comfort and relaxation.
Increased rates of sleep at night and avoid staying up late, and take naps during the day.
Increased rates of ischemic and eat more of fluids to avoid accumulation of waste cells.
Maintain the rates of adequate nutrition and appropriate all the time, and just take a little bit during the growing sense of fatigue, will raise the body's energy.
Nausea and vomiting
The nausea and vomiting side effects common and associated with radiation therapy, especially when you receive radiation to the abdominal cavity or the brain, and may occur as nausea as soon as the session rays or delayed for several hours, and noted that nausea direct that appears during doses, usually appears in patients who have been subjected to nausea or vomiting during the previous session therapeutic response to the expectation of treatment, and notes that it is not imperative that all patients suffering from nausea or vomiting during the treatment periods, usually determined by the pace and pattern of occurrence after several treatments.
(Please go to a page that nausea and vomiting to see more details).
The following suggestions are useful when the emergence of nausea and vomiting:
Make sure the intake of anti-nausea drugs under the supervision of a doctor before starting treatment, and consulted about the necessity or not at each session, in addition to the possibility of the use of any tranquilizers to help the child patient submissiveness and sleep during the bout of acute nausea.
At the start of a heart nausea and the emergence of vomiting should not be giving the child any food or liquids that are to control the vomiting and stops, (hospital doctor may need to rely solely on parenteral nutrition to prevent dehydration for the child) and then be given a clear liquid (like water, fruit juices, fruit ice cubes, broth soup, net, non-carbonated beverage flavored with fruit), small Brishvat every half hour (30 to 60 cubic centimeters) would be increased gradually, and while the child is able to keep fluids down, you are eating more solid foods (such as Fresh fruits, especially high water content such as watermelon and cantaloupe and kiwi, boiled and mashed vegetables such as potatoes or carrots, yogurt), and then begin solid foods.
Child nutrition foods light three or four hours before treatment session, and many children benefit from the feeding of soft foods, or types of soup or a milk shake or fruit jelly or honey, or liquids such as juices.
As is usual with all patients during cancer treatments different, always preferred snacking multiple throughout the day instead of the main meals are heavy, and is recommended when the expected nausea that addresses the child's meal with a small amount and without hurry, and chew the full and the need to avoid a full stomach, and time before fluid intake is sufficient (half an hour to an hour), and relatively cold foods or at room temperature instead of hot.
Avoid foods provide many fats or oils or fried and marinated spicy or sweet, or foods with strong odors.
The need for good ventilation and get rid of smells strong odors, especially the kitchen, Valroaúh cause nausea usually advised to avoid the presence of the child near the kitchen after receiving treatment, and helpful to eat a well-ventilated room or outdoors, or use fans, and prefer to use cups with lids or use a straw when drinking fluids absorbent.
Need to pay the child to relax and rest after eating and to identify activities, and avoid lying down horizontally for at least an hour because that would increase the nausea and keep the head vertical development is high.
Avoid giving foods or favorite items for the child when the nausea, because it might make it Ievha which increases the problems of loss of appetite and lack of eating and lack of nutrients.
Wear loose fitting clothes and comfortable.
When you eat a dry up in the morning, (such as biscuits, salted and toasted bread), taking into account that the child is not under the ban of salt.
The use of methods of distraction and diversion to distract the child from thinking nausea.
Diarrhea
Produces diarrhea affected cells channels intestinal radiation therapy to the abdominal cavity or pelvis, and the symptoms usually after the third or fourth week of treatment, and if they had shown before that in some cases, and always advised treatment early, so it should be reported to the physician If you complained about the child from colic or gas contagious or stand for more than three times in one day, or was noted that the stool soft textures, liquid or contains a trace of blood, or that warmed the patient for more than 38 degrees Celsius, in addition to dizziness and weakness, and is usually described anti-diarrhea medicines, as the case, and should inform the doctor if the condition persists without improvement after one day of use of prescription drugs.
And because the drought is one of the greatest risk of diarrhea as a result of rapid loss of fluids to the body, may be initially limited to fluids net low sugars in sufficient quantities, and does not allow Balasaúr only after watering it down to a quarter of its focus almost given the content of diabetes higher, which in turn increases the diarrhea , and the children usually suffer from the digestion of sugars Milk (Lactose) until the end of diarrhea, are giving vehicles milk, low-lactose at low frequency of diarrhea and enables the child from eating solid foods, which should be a low-fiber, low fat and spices, which in turn, can worsen diarrhea.
The following suggestions are useful for treatment of diarrhea:
Eat small meals throughout the day.
Eat a little warm or cold, hot or cold foods increase the food bowel movement, and worsening diarrhea.
Urge the child to eat more to compensate for fluid losses during diarrhea.
Should not eat something that will increase gas when there is colic, such as carbonated beverages and dry beans and cabbage and cauliflower and Alalkat.
Determine the activities of the child for an hour or so after the meal, to allow digest better.
Eating soft foods high in protein and calories and low fiber and minerals such as: white rice, cooked chicken without skin, fish, cooked or canned fruits without rind, yogurt, hard cheese, cooked vegetables such as mashed potatoes and carrots, boiled eggs, pasta and Alasaúbah.
Eat foods rich in potassium and fluid and sodium (after consulting a doctor), such as red meat, bananas, apricots, peaches, orange juice, diluted, mashed potatoes.
Avoid high-fiber foods such as fresh fruits except bananas, dried fruit and fresh vegetables, dried legumes, nuts and popcorn corn, rye bread, jams.
Avoid foods high in mental and spicy, such as fries, fried meats, potato chips, spicy food spicy pepper and paprika and cumin and ginger and Cree, mayonnaise, margarine, meat, spicy sauces, peanut butter, cheese, whipped and creamy.
Avoid high sugar foods such as sweets, chocolate and sweetened cookies, juices and concentrated.
Frustrate the bone marrow
The frustration of bone marrow a most important side effects of radiation treatment, which varies depending on the subject of treatment, and does not happen this effect automatically when each of the receiving radiation therapy, (other than chemotherapy), but rather it depends on the extent to which the cord to radiation in different parts of the body, and bone marrow is the soft spongy tissue located inside the bone, which is produced by the different blood cells continuously, and frustration leads in turn to lower the body's ability to produce the necessary quantity of blood cells, different, and the usual rate to decrease the production of white blood cells and platelets , and in the event that large areas of bone marrow to radiation, the lower rates also red blood cells, and so are monitored censuses blood periodically during treatment, and often when they fall to low levels, is to postpone hearings radiation for some time, and until the recovered cells, bone marrow, and census return to normal levels.
During the period of decline, rates of blood cells to low levels, the patient is subject to several risks, the risk of a weakened immune system due to the low level of white blood cells, leading to easily pick up infections different without the ability to resist, and the risk of anemia due to lack of rate of red blood cells, then the risk of easy bleeding and lost the ability to repair wounds or lacerations in any position of the body, as a result of low platelets, which requires precautionary measures to avoid such risks, and to point out that the state of frustration spinal increase when you receive the patient to address common treatments chemotherapy and radiation.
About the paragraphs following the effects of low levels of different blood cells, and please go to a page that chemotherapy and blood cells and blood censuses Page for more details about the risks of low rates of blood cells:
Low white blood cell count
Are white blood cells, key elements of the immune system, they are struggling infection and defend the body by attacking foreign objects, such as bacteria or fungi, viruses or bacteria of different or any foreign objects to the body, and kill them by various means, such as diners, or the secretion of toxins to destroy it, and When the bone marrow frustrating as a result of radiation treatment or chemotherapy, the lower the ability to produce white blood cells in the numbers needed, which the body loses immunity natural, the lack of ability to fight infection and a weakened immune system, and patients are exposed to risk of contracting various infections easily, which can some threat to his life in a short period of time.
From here calls it Time control cell count white blood while receiving treatments, and time on the lookout for symptoms of any infection, in addition to taking all precautions to avoid them, including the isolation of the sick child entirely in a protected environment as possible when the low census to maintain safety.
And of signs of infection in the patient, and that need to take into account the appearance and notify your physician:
Fever and high temperature to more than 38 degrees Celsius Sweating Trembling or severity of coughing and shortness of breath or difficulty breathing, or inflammatory white or red patches or gums, mouth and gums, change the color of burning or pain when urinating or having the smell of urine redness or pain or swelling in any position in any skin ulceration wound unhealed.
And recommendations that should be taken into account when low white blood cell count:
Taking into account the need to wash hands constantly sick child and for all the family and the medical team, and the medical use of soaps and lotions sterile and antiseptic.
The use of non-alcoholic mouthwashes, and focus on oral hygiene and teeth constantly.
Removal of the sick child for the sick and of being infected with one of the infectious diseases easily spread like flu, and reduce visits or prevent them, taking into account the lack of contact with the child for the flowers that offer as gifts, or eating food is reliable, or shake hands without sterilization of hands or allow kissing the child.
Remove a child from infant vaccination of live vaccines such as measles vaccine, and to avoid giving the child any vaccines or vaccines without the consent of your physician, especially live vaccines that prevent completely.
Remove a child from domestic animals, and to avoid or change the decorations of the house painted during therapeutic sessions.
Remove a child from communities, markets, public transport and avoid the mass games.
Remove a child from coming under direct sunlight and avoid sun burns, and not the child's hair shaving blades and the regular use of electric shaver to avoid cuts, and avoid shaving the face adolescents.
Periodically monitor the temperature of the child close and specific periods, and to inform the doctor immediately if the temperature reached 38 degrees Celsius.
Avoid raw foods and non-cooked, such as fruit salads and fresh vegetables, fish or salad and raw natural cheese and unpasteurized milk and raw eggs, fruit and fresh or frozen or dried, and condiments and spices, juices and those attending the cold .
Not to give suppositories or measure the temperature anally.
Low count of red blood cells
Red blood cells are the basic elements of the blood, and represent about half the size and contain the protein hemoglobin which carries oxygen from the lungs to various organs and tissues of the body, and at low rates in blood, and falling hemoglobin level, symptoms of anemia (anemia), and the child appears pale and tired and feel tired and weak, because the blood does not carry enough oxygen to the heart, lungs and muscles and various organs, and of course, is periodic measurement of the rates of red blood cells and hemoglobin, and finding the symptoms of anemia, including:
Pale skin and lips leukemia feeling of weakness and physical exhaustion, ease headaches, dizziness, fainting and shortness of breath short and gasping for the slightest effort, rapid pulse and heart and pocket ringing ears feel cold.
And when the recommendations of the emergence of anemia:
Determine the activities of the patient physically exhausting and increase comfort and relaxation.
Taking into account the necessities of good nutrition and adequate, and nutrient-rich and calorie and protein, and especially eating vegetables, and red meat and liver.
Increased rates of ischemic and eat more of the various fluids and juices, and avoid taking stimulants such as coffee and caffeine compounds.
Deficiency of blood platelets
Of plates or plaques bloody great importance, in turn, to be effective in protecting various tissues from bleeding Bertgaha and close to the positions of cuts or cuttings in any position of the body, and that the main role in the formation of clots of blood, and offers low rates the patient's risk of easy bleeding and blood loss to the property of clotting, so population should be monitored to anticipate and to lower their rates during the processors, and take all precautions to prevent cuts or bruises.
And of signs of lack of blood platelets:
Rash or red granules and patches under the skin or bruising is justified in dark, minimal bruising or easy bleeding from the gums or nose, bleeding from the nose does not stop the emergence of signs of bleeding in the stool (red or black) or in the urine (pink, red , brown) or vomiting (red or dark brown).
And of the precautions taken into account to avoid the emergence of bleeding:
Into account the cleanliness of the mouth, and teeth cleaning Taraute Pferashi soft and soothing creams, and avoiding mouthwashes that contain alcohol, to avoid dryness of the mouth and gums and to prevent the ease of bleeding.
Take sips of water or juice continuously to moisturize the mouth, lips and use moisturizers to prevent Thqqatha.
Recommendation of the child to blow your nose gently and do not blow your nose.
Unit to avoid coughing, consult a physician for an appropriate description of cough syrup.
When a child is recommended to avoid constipation try to defecate or strongly Alhsr, and consult a physician is required to describe the appropriate laxative.
Avoid using a thermometer to measure temperature anally, and not to give suppositories.
Avoid team sports or any activity that may cause bruising or fall and cause injuries, as well as avoid the big weights.
Always wear sneakers to protect the foot, and wearing wide clothes.
Avoid aspirin or any of its compounds or any other non-steroid drug or antacids without the consent of your physician.
Increase perfusion to avoid constipation and to maintain the moisture of the mouth and digestive cycle.
Eating foods rich in protein and fresh vegetables and avoid the harsh and difficult to digest.
Review physician
It is important for parents to know great review oncologist when a child receives treatment without accommodation the clinic, and taking account of the symptoms that necessitate the need for presentation to the physician, and of course the medical team to provide parents with information and instructions on side effects anticipated and measures administered prior to departure.
And the most important points in the following symptoms that require physician review as soon as possible if they appear on the child:
The presence of fever and high temperature for more than 38 degrees Celsius, especially at the low rate of white cells in blood.
Signs of infection and inflammation, such as red spots or white mouth and gums.
Widespread exposure to infection, especially chicken pox or measles.
Difficulty walking or pain the joints and limbs.
Impaired vision and consideration, such as blurred vision or double vision, or difficulty in pronunciation, or sickness and dizziness or fainting.
Depression and frustration, or a sudden change in behavior.
Vomiting unjustified, or vomiting is expected to occur as a result of eating a property.
Persistent headache or pain in any position of the body.
Bleeding, including bleeding from the nose, or signs of bleeding in the stool (red or black), or in the urine (pink, red, brown) or vomiting (red or dark brown).
Tkdmat appearance is justified, and easy bruising occurrence or the emergence of digits.
Appearance of redness or swelling in any body position.
There are problems preventing the child from eating, such as oral infections, or difficulty chewing and swallowing.
The presence of constipation that lasts for more than two days.
The presence of diarrhea.
The presence of heartburn and pain during urination or bowel movements.
Late complications of radiation therapy
The term late effects, to the complications that result from the use of applications of radiation different in the treatment of tumors, which appear over a long time, and periods may exceed several years after the treatments, and these complications are linked to the overall effects on physical growth and intellectual development of children, as well to the effects of long-term appear on some vital organs, but more importantly may have increased risk factors for any potential vulnerability for the development of secondary tumors is the tumor processor, and as noted above, the proportion of the risk of a secondary tumor (according to the type of tumor is the original processor and treatments received) ranging from 3% to 12% during the twenty years following the diagnosis and treatment of any kind of tumors of children, (and to point out that this figure includes the various cancer treatments used, and are not limited to radiation therapy alone).
And these effects arise as a direct result of the damage caused to healthy cells and tissues in the body permanently or temporarily, and due to many factors, including the cells of food deficiency, and permanent damage to the structure of tissues, organs and death as well as some healthy cells.
As different patterns of response and reaction towards the tumor and therapies from child to child, as well as the command with the complications of treatment late, which is highly dependent on the type and pattern of treatments received and dosage and periods of time, and to point out that very young children are most vulnerable to the effects as a result of exposure to disease and treatments strong during the early period of life where the physical constitution is weak and still under the phases of different growth and, of course, be necessary follow-up attentive and careful monitoring in anticipation of such complications, and thus distinguish them early and then treatment and management complexity, and it should be noted that no one can predict how the emergence of any of the late effects when a patient specifically, but includes modern effects can arise in general.
In the following paragraphs About the late effects of radiation therapy, according to the functions and parts of the body, and please go to a page of late complications of cancer treatments for more details.
Complications of the central nervous system
Of the most important effects of radiation therapy on the central nervous system in the long run is a shortfall in growth hormones, which could lead to the small strength and short stature than normal, and is the children who received radiation therapy to the skull and spine before age five are more susceptible to risks of lack of growth , and is attributed to radiation damage effect on the hypothalamus or brain hypothalamus (hypothalamus) responsible for regulating growth, and may sometimes need to be addressed Balaaadh receiving hormonal growth hormones to address the situation.
Can radiation treatment alone or jointly with chemotherapy to affect the level of intelligence and cognition in children, they could face the difficulties of the capabilities of learning and often language skills and memory, and can be encountering children enactment of school difficulties in reading, writing, arithmetic operations and the weakness of memory and the low level of attention and concentration, as well as reduced information processing speed and slow reactions, and observed that whenever the child is older when you receive treatments as less than the damage can be done, was also noted that learning disabilities can worsen over time.
Complications on physical growth
From the usual problems during the processors tumors childhood a failure rate of growth of physical natural, and may appear something of late for this rate the extent varies from child to child, and may become some of the effects lasting in some cases, such as short stature, as a result of the delayed natural growth, and can be radiation treatment to cause serious effects directly on the natural growth of bones and muscles that fall within the field of treatment, including radiation of the head, of course, which may slow the pace of this growth and development at any age, bones and soft tissues and muscles and blood vessels, is a tissue sensitive to radiation during the sessions of rapid growth, and for this children less than five years or of passing phase of puberty, which is accelerating in some of the patterns of growth, they are more vulnerable to these effects, and add to the slow growth may appear nothing is not symmetry growth of members, joints and problems with subsequent pain, and the occurrence of what is known as the fragility and osteoporosis (osteoporosis).
And still how radiation affects the bone growth is understood to be exact, and perhaps the answer lies in how it would impact on the system, endocrine glands and body functioning and excretion of hormones, and is known as screens endocrine glands and of thyroid gland, and thyroid adrenals and ovaries, secrete hormones, circulatory, and hormonal urges and stimulates a lot of physical functioning, such as motivating factors, puberty, and fertility, and adjust the pace of physical growth, and the system is multiple and complex the human body and easy-sensitive treatments of tumors.
And can develop complications different when disruption and obstruction of the hormonal system, (whether as a result of direct injury to the members of different, such as the testes or ovaries, or for part of the brain that controls the activities of the endocrine glands, which may be affected by radiation therapy to the head and neck), recall of delayed puberty or the appearance of the signs early on at the time, and impaired fertility, and problems with growth retardation and delayed rates, combined with the effect on bone structure and height, and delay in achieving full attainment, and as already indicated, children are very young children and infants are more likely Therefore, low and shows clearly the pace of growth during the first five years after receiving treatment.
And may help Balaaadh hormonal replacement therapy, giving doses of growth hormones, and treatment in the Abolition of such harmful complications of radiation therapy, and, of course, necessary to study this option very carefully when taking into account, and investigated the extent and consequences of the need to use it.
Effects of vision and hearing
May be affected by the capacity optical in several ways as a result of treatments, especially when there is tumor position comes into contact with the eyes or close to it, and while highlights of radiation on the bone near the eye may cause weakness and shortcomings their growth, leading to distortions growth of the face may not seem obvious in some cases, as that radiation therapy to the eye area can lead to complications as diverse as blurred vision, and the emergence of bug cataracts or bung eye (cataracts), in addition to the radiation therapy to the brain or of the ears can in turn lead to poor audio capabilities, or hearing loss.
And is very important to make periodic tests of the capabilities of visual and audio during the treatments, to investigate such effects, which can change or modify treatment plans early to avoid complications, and of course may be necessary in some cases recommend certain treatments, such as removing bung eye or the use of glasses or the use of audio devices.
Effects of reproductive functions and fertility
Fertility in males is generally more affected by the cancer treatments than in females.
Can radiation therapy to reduce sperm production, and of radiation doses low a temporary impact on production rates, while the doses of high radiation to the lack of a permanent and final, and deficiency affects rates of sperm production negatively, of course, on fertility and reproductive capacity, and noted that young children who are receiving treatment with tumors at an early age are less vulnerable to the emergence of such a deficit, and of course, and when possible, is to take measures to protect the testes from radiation exposure, and the direct radiation of the testes leads often to infertility and delayed puberty.
Of the possible complications of radiation therapy to the brain of male emergence of imbalances in the frequency of sexual development, as a result of damage to the hypothalamus (hypothalamus), and includes a change in the levels of male hormone the main testosterone (Testosterone), which leads to delayed puberty, or slow rate of progress, or the inability to complete, or the appearance of signs of precocious puberty (Precocious puberty), that seems clear from the signs of puberty at an early age is not normal, (and you can stop this process until the time is reached, the appropriate use of some medicines for this purpose) Add to the likelihood of sexual dysfunction and depression desires and bug impotence in later periods.
Result in radiation therapy to the cavity abdominal females to the malfunction of the ovaries and affect the properties of eggs and its sound, and based rate risk on the age and stage of puberty at diagnosis and treatment, and observed that females who received treatment before puberty a long period are less susceptible to these effects.
As is the case in males, can radiation therapy to the brain in females that affects the hormones necessary for the functions of the ovaries, resulting in complications that can lead to irregular menstruation, and changes in the production of eggs, in addition to the impact on the pace of sexual development, whether to delay start-up period in the stages or slow the rate of progress, or the appearance of signs of early puberty.
Caused by radiation therapy and chemotherapy used indicators when the configuration and preparation for operations marrow transplant bone marrow hurt deep gland (gonads), ovaries and testicles, and lead thus to infertility, and can treat children with these treatments also influence their ability to progress normally through the stages of puberty and reproductive performance of the functions normally, in addition to the delayed development of the different physical properties such as the appearance of hair reaching to the body, and the growth of breasts, and the growth of the scrotum and testicles.
Necessary to control the following aspects when follow-up long-term health:
Irregular menstruation, pregnancy or abortion, the outcome of pregnancy, contraceptive use, and the importance of avoiding sexually transmitted diseases, and is required for males who are at high risk of infertility sperm count check periodically.
Respiratory effects
From the usual problems in children who received radiation therapy to the chest wall created imbalances respiratory such as decreasing the size of the lungs, and fibrosis of lung tissue (fibrosis), (and this treatment is used especially in patients with disease Hodgkin's disease, and patients who evolved to have secondary tumors lung moved from elsewhere), and also the emergence of complications of lung tissue or inflammatory illness of the lung (pneumonitis), and that the initial symptoms of difficulty breathing, dry cough, and complications can become more difficult when the integration of radiation therapy and some types of drugs and chemicals that can to cause such complications such as drug Bleomaesen (bleomycin), and is worth mentioning that the complexity of the respiratory system can occur even after several years after the treatments and that was usually appear initially during the period of one to two years.
Is very important to be aware and cautious of the dangers of smoking in children treated for cancer, especially those who have received treatments affect the lungs.
That necessitated the need to use full anesthesia in subsequent stages of life, the anesthesiologist should be informed about the medical history of the child wizard of cancer and treatments received.
Effects of heart
The risk of radiation therapy to the chest area the emergence of a decline in job performance of the heart and cardiovascular following the end of treatments, and should be carried echocardiography (Echocardiogram) periodically, in addition to planning demarcated electrical heart (Electrocardiogram ECG) to examine the effectiveness of the functioning of the heart if the end of treatment, and from then testing every two to three years.
It is very important to control other risk factors that can contribute to the increased complexities and complications of the heart in the later years of life after the end of treatments, such as smoking or alcohol, and obesity and lack of exercise and physical activity, mobility, and should avoid strenuous sports that can increase the pressure and burden on the heart.
If the need arises to use the full anesthesia in the subsequent stages of life, the anesthesiologist should be informed about the medical history of the child wizard of cancer, where it can be to some methods of anesthesia and drugs to cause disruption of the pulse of the heart.
The risk of developing secondary tumors
The survivors of cancer in general, more vulnerable to the risk of developing secondary tumors in their future life and the extent of which varies from child to child, and the more progress they age high rates of risk and vulnerability of the development of tumors common in adults, and rely rate risk on several factors, such as the type of tumor the original processor, and the type of treatments received, for example, had received radiation therapy in high doses appear to have the proportion of higher risk for the development of secondary tumors at sites of radiation, in addition to genetic factors, the effects of aging and living conditions of different, and environmental conditions, and personal factors of each patient.
According to many medical reports for increasing the rate of risk for the development of tumors, stroke secondary when using radiation therapy to the skull (cranial radiation), especially if used in children age less than five years, and are tumors known tumor glial (Gliomas) of the most common types of brain tumors is possible appearance, and on the other hand there are reports of the risk of developing thyroid cancer (thyroid cancer) when radiation of the neck, especially when dealing with cases of tumor and Hodgkin's, which is higher risk with the development of tumors, solid high school when the use of radiation therapy, such as breast cancer and bone tumors Algarnih and lung cancer.
Increases risk for the development of breast cancer in females who received radiation therapy to the chest area of treatment of Hodgkin's tumor in age between the tenth and sixth centuries, which requires a half-yearly breast examinations periodically after the expiration of ten years from the end of treatment.
Medical studies have linked one of the radiation therapy to the entire body (Total-body irradiation), and the user configurations, especially when the marrow transplant bone marrow, and between the rate of the seriousness of the development of secondary solid tumors by 8% during the 13 years after the treatments.
