Managing Side Effects of Radiation Treatment

These instructions are for Children's Hospital of Philadelphia (CHOP) patients who are receiving radiation treatment or recently completed radiation treatment.

Follow these instructions if your child has skin irritation after radiation treatment:

• It is important to treat your child's skin that is exposed to radiation gently.

• Use only lukewarm water and mild soap. Let water run over the treatment area. Do not rub.

• Your child should not wear tight clothing over the treatment area.

• Try not to rub, scrub, or scratch any sensitive spots.

• Avoid putting anything that is hot or cold, such as heating pads or ice packs, on the treated skin.

• Do not use powders, creams, perfumes, deodorants, body oils, ointments, scented lotions, or home remedies on the treatment area. Please continue to follow these guidelines during treatment and for several weeks after treatment is over. Some products can irritate the skin. Only use lotions (such as aquaphor) and soaps that have been recommended by your radiation oncology team.

• Keep your child out of the sun during treatment and for at least 1 year after treatment. If your child is in the sun for more than a few minutes, he should wear protective clothing. Ask your radiation oncology team about using sunscreen lotions.

Instructions for nausea:

• If your child's stomach feels upset before radiation treatment, it may be helpful for him to eat a bland snack such as toast or crackers. If your child is having anesthesia, please remember to follow the eating and drinking instructions from your child's anesthesia team.

• If your child has nausea after radiation, they should stop eating for several hours before treatment. Sometimes it is better to receive treatment on an empty stomach.

• After treatment, wait 1 to 2 hours before eating again.

• Give small meals.

• Avoid foods that are fried or high in fat.

• Provide cool liquids between meals.

• Serve foods that have a mild smell.

• Serve foods cool or at room temperature.

• For a very upset stomach, serve clear liquids (broth and juices) or bland foods that are easy to digest, such as dry toast and Jell-O®.

• Ask your radiation oncology team if there are medicines that can prevent or reduce nausea during radiation treatment. If your child takes nausea medicine, be sure that they take the medicine as prescribed. If your child has general anesthesia for radiation treatments, the anesthesia team may also give anti-nausea medicine.

• Talk to your CHOP registered dietitian for more ideas on managing nausea.

• Nausea usually goes away within a few weeks after completing radiation therapy.

Instructions for low blood counts:

• If your child received radiation to an area of the body that affects blood counts, it may take several weeks before your child's blood counts recover.

• Continue to have your child's blood counts checked as directed.

• Call the medical oncology team with any signs of low hemoglobin or platelets.

Instructions for fatigue:

• Your child may continue or return to normal routines and activities (such as school) as tolerated or per the radiation oncologist's recommendations.

• You may notice your child is more tired during and/or after radiation therapy, or you may notice that your child is more tired a few weeks after radiation is completed. Fatigue is a common side effect and may last a few weeks.

• Allow your child to rest in between activities and introduce more activity gradually. It is common for your child to sleep more.

• If sleeping is limiting your child's eating, please contact the radiation oncology team.

Call the radiation team at the Perelman Center for any of the following radiation-related problems or concerns:

• Repeated episodes of diarrhea or watery stools in 24 hours

• Repeated episodes of nausea and vomiting in 24 hours

• Mouth sores

• Sore throat

• Skin irritation

Penn/CHOP Radiation (Monday-Friday, 7:00am-3:30pm)
CHOP Front Desk/Pediatric Waiting Room: 215-615-5678
PACU Nurses' Station: 215-615-5691
Penn Nurses' Station: 215-615-5604 (after 3pm)

Call the CHOP Oncology team if your child seems ill or has a fever:

Fever of 101.3 degrees F (38.5 degrees C) once, or 100.4 degrees F (38 degrees C) three times in a 24-hour period, taken at least 2 hours apart.

Oncology Contact Information

8:30am-5:00pm, 7 days a week (including holidays)
215-590-2299 (select Phone Nurse)

Every day after 5:00pm, all patients
215-590-1000, ask the hospital operator for the Oncology Fellow on-call

Reviewed on March 1, 2022, by Elizabeth Cummings, MSN, CPNP-AC, CPHON, Kelly Clegg, RN