Guidance for Colorectal Cancer Patients During Radiation Therapy

This note provides evidence-based guidance for colorectal cancer patients undergoing radiation therapy, including common side effects, prevention strategies, dos and don’ts, home remedies, dietary changes and supplements, supportive counseling, and medications prescribed by oncologists.

The information is based on international standards (e.g., NCCN, ASTRO) and has been kindly shared by Dr. Narendra Rathore (MB Hospital, Udaipur).

1. Common Effects of Radiation Therapy

Radiation therapy for colorectal cancer can affect the pelvis, urinary tract, and surrounding skin, leading to various side effects.

2. Prevention

The following precautions can help reduce the severity of side effects:

• Hygiene: Keep the rectal area and surrounding skin clean and dry. Use lukewarm water and mild soap (e.g., Dove, Cetaphil).

• Skin Care: Keep the affected area moisturized. Use doctor-recommended moisturizers (e.g., Bepanthen, Aquaphor).

• Hydration: Drink 2–3 liters of water daily to maintain proper digestion and reduce irritation.

• Nutritional Support: Prevent weight loss by consuming enough calories and protein as advised by a dietitian.

• Sun Protection: Cover the affected skin with loose clothing or use doctor-recommended sunscreen.

• Fatigue Management: Maintain a balance between activity and rest; engage in light physical activity like walking.

3. Dos and Don’ts

✔ Dos:

• Wash the affected area 2–3 times daily with lukewarm water and mild soap.

• Apply moisturizers (Bepanthen, aloe vera-based creams).

• Stay hydrated – drink 8–10 glasses of water, coconut water, or diluted juice.

• Eat soft and easily digestible foods (e.g., khichdi, soup).

• Report symptoms like burning during urination, blood in stool, pain, or fever to your doctor immediately.

• Get adequate rest.

✖ Don’ts:

• Avoid fragrant soaps, lotions, or deodorants.

• Avoid spicy, fried, or acidic foods (like lemon, tomatoes).

• Refrain from smoking and alcohol.

• Do not scratch or rub the skin.

• Do not hide symptoms.

• Avoid taking any medicine or home remedy without consulting your doctor.

4. Home Remedies (Only after oncologist's approval)

For Rectal Burning:

• Coconut water: 1–2 glasses per day.

• Cumin water: Boil 1 tsp cumin, cool, and sip slowly.

• Coriander water: Boil coriander seeds, cool, and drink.

For Skin Irritation:

• Aloe vera gel / Coconut oil: Apply gently on external skin (not on open wounds).

• Rose water: Mix in lukewarm water and gently wash the area.

For Pain and Swelling:

• Turmeric water: Mix turmeric in lukewarm water and drink (only after doctor’s approval).

• Cold compress: Wrap ice in a cloth and apply to the affected area for 10–15 minutes.

For Digestive Issues:

• Ripe banana: Aids digestion.

• Ginger water: Boil ginger, cool, and sip slowly.

⚠️ Caution: Do not apply any home remedy to open wounds or sensitive areas without your oncologist's approval, as it may increase the risk of infection.

5. Dietary Changes and Supplements

Recommended Diet:

• Soft foods: Soups made of bottle gourd, carrots, or pumpkin, mashed potatoes.

• Small frequent meals: Eat 5–6 small meals a day for better digestion and energy.

• High-calorie, high-protein foods: Milkshakes, protein shakes (e.g., KABIPRO), soups with nuts.

• Hydration: 8–10 glasses of water, coconut water, or diluted juices.

Avoid: Spicy, fried, acidic, or heavy foods.

Supplements (Under oncologist supervision):

• Protein powder (e.g., KABIPRO)

• Omega-3 fatty acids – may reduce inflammation

• Multivitamins and B-complex – for nutritional support

• Glutamine – helps relieve irritation

• Probiotics – support gut health during treatment

6. Regular Consultation with Oncologist

• Follow-ups are essential to monitor symptoms and adjust treatment.

• Keep a daily record of symptoms – pain, changes in urination or bowel movement, and weight loss.

7. Commonly Used Medications

For Rectal Burning:

• Ural syrup or Phenazopyridine – to reduce burning sensation during urination.

• Antispasmodics – like octreotide for cramping.

• Paracetamol – for mild pain (500–1000 mg as per doctor’s advice).

For Proctitis:

• Hydrocortisone suppository or enema

• Mesalamine – to reduce rectal inflammation

For Skin Reactions:

• Hydrocortisone cream (1%)

• Stronger steroid creams for severe irritation

• Moisturizers – Aquaphor or Bepanthen to prevent dryness

For Digestive Issues:

• Loperamide – for radiation-induced diarrhea

• Lactulose – for constipation

• Ondansetron – for nausea

For Infections:

• Antibiotics – e.g., Nitrofurantoin, Amoxicillin

• Antifungal creams – for skin infections

For Nutrition:

• Enteral nutrition formulas – e.g., Ensure or BonNutra, if regular diet is inadequate

⚠️ Caution: Do not self-medicate. All drugs must be prescribed by your oncologist, as some may interfere with cancer treatment.

🌟 Additional Suggestions

• Stay in regular contact: Share concerns with your doctor, family, or counselor.

• Monitor symptoms: Track any changes in urination, bowel habits, pain, or weight.

• Mental health: Practice meditation or deep-breathing exercises. Avoid strenuous activities.

📝 Important Note

Radiation therapy side effects are common, but with proper care, they can be effectively managed.
Stay in regular touch with your oncologist, follow their advice, and adopt home remedies cautiously.

You are not alone on this journey. ❤️