Learning About Total Body Irradiation

Total body irradiation is a type of cancer treatment. It delivers low doses of radiation to your entire body.

Total body irradiation is done before a bone marrow or stem cell transplant. It's often part of a treatment plan for people with blood cancer, including leukemia and lymphoma. This procedure can be done with or without other cancer treatments, such as chemotherapy.

Total body irradiation helps prepare your body for a bone marrow or stem cell transplant. It does this by killing cancer cells in certain areas of your body that can be hard to reach using radiation or chemotherapy. Those areas include your central nervous system, testes, bones, and skin. This procedure also is done to weaken your immune response before a transplant. This can help keep your body from rejecting the transplanted stem cells or bone marrow.

Before getting this therapy, you may have:

• Pre-treatment simulation. Your healthcare team will do a simulation of the procedure. It's not the actual procedure, but it helps plan your treatment. You may be asked to try different body positions to see which one works best.
• Imaging tests. You may have a CT scan of the areas on your body that will be treated.
• Skin markings. Small marks may be drawn on your skin to show where to focus the radiation.

Follow any instructions for not wearing lotions, powders, or jewelry before treatment.

There are different ways to get total body irradiation. You may:

• Stand on a platform.
• Lie on a treatment couch.
• Be on a table or stretcher.

Then the radiation therapist puts you in the right position. They may place special devices or coverings on your body to protect sensitive organs, such as the lungs, from the radiation.

The radiation therapist leaves the room. You can talk with them through a two-way intercom during your treatment. You will remain still and breathe normally. You may hear noise from the radiation machine. But getting radiation therapy doesn't hurt. Each treatment lasts about an hour.

The schedule depends on your treatment plan. The radiation treatment may be given a few times each day for up to five days. Ask your doctor about your specific schedule.

Possible early side effects include:

• Skin changes, such as itching, irritation, and color changes.
• Hair loss.
• Diarrhea.
• Nausea.
• Vomiting.
• Feeling very tired.

Other possible later side effects may include:

• Cataracts.
• Infertility. If you think you may want the option of having a child after treatment, be sure to talk to your doctor before you start treatment.
• Inflammation or swelling of the sac around your heart (pericarditis).
• Kidney damage.
• Liver damage.
• Lung damage.
• Thyroid issues.

Your radiation oncologist will meet with you during your treatment. Tell your healthcare team about any concerns you might have. Follow all instructions on how to manage side effects, such as how to care for your skin during radiation treatment.