Side effects from radiation therapy to the spine

During radiation therapy to the spine, you may experience different short-term side effects.

What are the possible short-term side effects?

Radiation therapy to the spine may cause a number of short-term side effects. However, everyone is different and you’re unlikely to experience all of the same side effects as someone who is receiving the same treatment as you.

If you’re concerned about any side effects during your radiation therapy treatment to the spine, we encourage you to speak with your care team who can help you with strategies to manage your side effects.

Types of short-term side effects

Skin reaction

Two to three weeks after your treatment begins, your skin may become red, dry and tender. This reaction will peak about a week or so after treatment ends and usually returns to normal four weeks after treatment finishes.

Your nurses will show you how to care for your skin and manage any skin reactions. Tell your nurse if you’re worried about a skin reaction or are experiencing any skin changes.

Pain and discomfort

We will provide you with information to help control any pain or discomfort you may be experiencing. If required your doctor will also prescribe pain relief to help control any pain.

Pain flare

Radiation therapy to bone areas in the spine can cause a temporary increase in pain in the area being treated. It can occur after one dose of radiation and usually lasts for 12 to 36 hours. Let us know as soon as possible if you experience a pain flare, as we can control this with the use of additional pain medication.


You may feel tired or lack energy for daily activities during your treatment. You may feel increasingly tired as you reach the end of your treatment. This is a common reaction to radiation therapy and each person is usually affected to varying degrees. Fatigue usually eases a few weeks after treatment finishes. Finding a balance between rest and activity will help you manage daily life.

Side effects specific to your treatment area may include:

Radiation therapy to the cervical spine

Difficulty swallowing

Difficulty swallowing is a common reaction when the throat is in the treatment area. The throat may become inflamed and feel painful when swallowing or produce a sensation like a lump in the throat. Early assessment by your doctor and nurse may help to prevent swallowing difficulties from becoming worse.

Radiation therapy to the thoracic spine

Inflamed oesophagus

This is a common reaction when the oesophagus is in the treatment area. You may feel pain when swallowing or a sensation like a lump in the central chest area. If you experience discomfort or notice any changes, let your care team know as soon as possible. Dietary changes may be required, or a referral to a dietitian if needed.

Nausea and vomiting

If your treatment area is near your stomach, you may experience nausea and vomiting. To help manage this your doctor may prescribe you anti-nausea medication. You may need to take this before treatment for your comfort.

Radiation therapy to the lumbar spine

Nausea and vomiting

Refer to the ‘Nausea and vomiting’ section under Thoracic spine.

Bowel irritation

Bowel irritation may occur two to three weeks after treatment starts. Symptoms may include:

  • An increase in the amount of times you use your bowels
  • Softer/looser bowel actions

Bowel irritation can be more noticeable if you’re also receiving chemotherapy. It is usually temporary and returns to normal two to three weeks after finishing treatment. Let your nurse know as soon as possible if you experience diarrhoea, or notice mucus or blood in your bowel movement. They will monitor the severity of the irritation and can also provide advice to help you manage. Dietary changes may be required, or a referral to a dietitian if needed.

Radiation therapy to the sacral spine

Bowel irritation

Refer to the ‘Bowel irritation’ section under Lumbar spine.

Bladder irritation

There can be irritation to the bladder lining and urethra (the tube that you urinate through) when you’re having treatment to the sacral spine.

Symptoms may include:

  • The need to urinate more often, including overnight
  • A sudden urge to empty your bladder
  • A burning sensation when you urinate

Let your nurse know as soon as possible if you experience any irritation as they can provide advice and treatment options to reduce your discomfort.

How can I manage skin changes?

Avoid excessive temperatures

Avoid exposing the treatment area to excessive temperature including direct sunlight, heat packs, ice packs, saunas or hot spas during the course of your radiation therapy. Do not use talcum powder or sunscreen in the treatment area.

Wear loose fitting clothing

Avoid wearing tight fitting clothing that could potentially rub or irritate the skin. Loose cotton underwear is best.

Wash with warm water and pat dry

You may wash the skin that is being treated with warm water and a mild non-perfumed soap. Pat dry the skin – do not rub.

Moisturise twice a day

Your care team will recommend a cream to help manage any skin changes. At the start of your treatment, apply cream to the area being treated twice a day. As treatment progresses, you may need to apply the cream three to four times per day. Do not apply cream within the hour prior to your treatment, as cream needs to be well absorbed. Let your nursing team know if you continue to experience skin changes.


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