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Chest: Care of Radiation Therapy Side Effects

Information for patients having radiation therapy to their chest.
Side effects

The chest does not include the breast or the chest wall. 

Some organs in the chest include the lungs, esophagus (swallowing tube), trachea, thymus, mediastinum and heart.

Radiation treatment damages cancer cells but can also affect normal tissues in the treatment area. Damage to normal tissues may cause side effects.

These side effects will vary depending on:

  • The amount of radiation prescribed.
  • The area of your body being treated.
  • The size of the treatment area.
  • Whether or not you are having chemotherapy.

Your BC Cancer health care team will explain which side effects you may have during or after your treatment. You will see a nurse or a doctor regularly during your treatment to talk about your radiation side effects. The doctor you see may not be your radiation oncologist.

If you have a problem or concern between visits with the nurse or doctor, please talk to your radiation therapists who can help you right away.


Fatigue is a feeling of extreme tiredness. If you are fatigued, you may want to rest and sleep more than is normal for you.

There are many causes of fatigue:

  • Radiation therapy
  • Previous treatments
  • Emotional stress
  • Changes in lifestyle

You may be able to continue your normal lifestyle or you may need to adjust your routine according to your energy level. For more information, go to our Managing Fatigue page.

Increased coughing and shortness of breath

You may experience more coughing and you may cough up more mucous (clear thick liquid) or possibly blood. You may also have shortness of breath (called dyspnea).

To help with these side effects:

  • Drink fluids regularly so that mucous does not become too thick or sticky.
  • Rest in a reclining chair or use pillows to prop yourself up when lying down. Lying flat on your back may make your cough worse.

Visit our Breathlessness page for more information and relaxation exercises. 

Difficulty eating, loss of appetite, and weight loss

You may have difficulty eating and/or have a loss of appetite during your radiation treatment. This may lead to weight loss. It is very important to maintain your weight so that your body shape is the same as when your treatment was planned. Eating well also gives you energy and helps you manage side effects.

Here are some tips:

  • Eat small meals and snacks frequently.
  • Eat high calorie, high protein foods.
  • Eat when your appetite is best.
  • Try to drink at least 8 - 10 cups (2 - 2.5 litres) of fluid each day (unless you are on a fluid- restricted diet).

For more information, go to our Nutrition Information page.

 These handouts may help you:

If you are unsure what to eat or drink, or you are having trouble with weight loss, please ask to speak with a BC Cancer dietitian.

Difficulty swallowing (dysphagia)

If your esophagus (swallowing tube) is included in the treatment area, you may have difficult or painful swallowing. It may feel like food gets stuck or is slow to get to your stomach. This may feel uncomfortable.

If you are having trouble maintaining your weight due to your swallowing difficulty, talk to your BC Cancer health care team. You may need to speak to a BC Cancer dietitian.  Please go to our Swallowing Difficulties page  for more details.

Nausea and vomiting

If your stomach is included in the treatment area, you may have nausea (feeling sick to your stomach) or vomiting. We suggest a non-prescription medication, Dimenhydrinate (Gravol ®). If nausea and vomiting is more frequent or severe, talk to your BC Cancer health care team about a stronger medication.

Weight loss and dehydration (loss of water from the body) can happen with vomiting. It is important to try to drink 6-8 cups (1.5 – 2 litres) of fluids daily and maintain a healthy diet

Here are some food and drink suggestions when you have nausea and vomiting:

  • Write down all of the things that give you nausea or make you vomit.
  • Eat and drink what works for you. Try foods that have made you feel better in the past.
  • These might be bland foods, sour candy, dry crackers, toast, flat ginger ale, or flat soda.
  • Try not to eat your favourite foods when you have nausea or vomiting. This may cause you to dislike them when you are feeling well.
  • Try eating small meals more often instead of three large meals a day.
  • Sip fluids often during the day including water, juice, soups, broths, sports drinks, herbal tea, or nutritional drinks such as Ensure®.
  • Try chewing food slowly and well.
  • Eat foods that are lukewarm or cold. The smell of hot foods may make your nausea worse.
  • Do not eat fatty, fried, very spicy, or very sweet foods.

If you are not sure what fluids to drink or foods to eat, talk to your BC Cancer health care team.

You can also speak with a BC Cancer dietitian or call 8-1-1 and ask to speak with an oncology dietitian. For more information, go to our Nausea & Vomiting page.


If you have pain from your cancer or radiation treatment, please tell your BC Cancer health care team. Also, go to our Pain from Cancer page.

Skin care

If you are having external radiation therapy, a skin reaction in the treated area is possible. Talk to your BC Cancer health care team about whether this might happen to you.

The skin in the treated area may become warm, dry or itchy. It may change colour (become pink, red, darker or tanned looking) and you may have hair loss in the treated area.

Most skin reactions begin within the first week or so of starting treatment, but timing can be different for each person.  Some people do not have a skin reaction until after their radiation treatment is finished.

Skin reactions usually go away a few weeks after your last treatment. Some skin changes, like skin darkening or scarring, can be permanent (they will never go away).

Here are some tips to protect your skin and help it feel better:

Lifestyle and well-being

  • Be very gentle with the skin in the treated area.
  • Wear loose, comfortable clothing.
  • Protect the treated skin from wind and direct sunlight. If you cannot cover the area, use sunscreen with an SPF of 30 or higher.
  • It is okay to swim as long as your skin is not broken or irritated. It is best to shower right away after swimming: gently wash off the chlorine, pat dry and apply moisturizer

Hygiene and moisturizing

  • Keep your skin moisturized to prevent dryness. There is no evidence that any cream or product is better for this. If you like a certain product or brand, please continue to use it.
  • If you do not have a moisturizer, use one that is water-based (water or aqua is the first ingredient on the list).
  • Once you start your radiation treatment, use the moisturizer many times each day.
  • You can use deodorants and anti-perspirants.
  • When you bathe or shower, use warm water (not hot) and pat dry with a soft towel.
  • Use an electric razor if you want to shave.
  • If you have a skin reaction, your BC Cancer health care team may ask you to use a steroid-based cream or antibiotic on the treated area.

'Do Nots' for the treatment area

  • Do not use perfume, alcohol, astringents, and adhesives on the treated skin.
  • Avoid extremes of hot or cold (heating pads, ice packs, saunas, etc).
  • Do not use hot tubs or Jacuzzis®.
  • Do not rub, scratch, or massage the treated skin.
Support services

BC Cancer helps those living with or affected by cancer to cope with the physical, practical, emotional, and psychological aspects of their care.

If you have any questions or concerns, please talk to your BC Cancer health care team.

Alcohol & smoking

Alcohol & smoking

Please try not to smoke during your treatment. Smoking may cause more irritation and increase the side effects you experience.

Stopping smoking has major and immediate benefits for people of all ages. It:

  • Helps improve your body's ability to heal.
  • Improves your body's response to cancer treatment.
  • Lowers the risk of your cancer returning or another cancer developing.
  • Lowers your risk of pneumonia and respiratory failure (when your lungs cannot work properly).

If you use tobacco or have recently quit, ask your BC Cancer health care team for more information. You can also go to our Smoking Cessation Program page.

Depending on the area of your body being treated, alcohol may worsen your side effects. Small amounts of alcohol may be fine for some people. Please check with your BC Cancer health care team.

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