Shripal K. Bhavsar

Radiation will only cause hair loss if treatment is directed at the area of hair in question. When treating with whole brain radiation, it is common for patient a to see some thinning after 2 weeks with hair regrowth after 6-8 weeks. If higher doses are needed such as for a primary brain tumor, we tend to see some permanent hair loss near the area being treated after 5-6 weeks. Most hair loss for patients is a result of chemotherapy.

Radiotherapy is no longer commonly used in leukemias due to improvements in combination chemotherapy regimens. However, certain situations call for radiotherapy as a very effective treatment. In higher risk patients, cranial radiation is still used, for instance, if there is involvement of the eyes or of the spinal fluid. Another use is a induction treatment before a bone marrow rescue (transplant). The radiation treats the whole body (including all the cancer and all the bone marrow). The patient then gets a bone marrow transplant to rescue the bone marrow. The induction can be done with high-dose chemotherapy or with total body irradiation (TBI). This is a very effective treatment.

Please have a robust discussion with her doctors regarding the risks and benefits of treatment and it has to have an actual radiation oncologist explain the radiotherapy part as they’ll give you more accurate information than the pediatric oncologists will be able to.

I sincerely hope it all turns out well.

First and foremost, thank you for asking a question. I would start by rephrasing the question. This should not be a question of radiation versus chemotherapy. They serve different purposes. When is it appropriate to use radiation? And when is it it appropriate to do chemotherapy? And when do we use both.
The role of radiation is to eliminate microscopic deposits of leftover cancer cells remaining in the breast to prevent local recurrence. The role of chemotherapy is to prevent cancer cells that may have already spread beyond the breast to other parts of the body from taking root and growing. Rule of thumb, most women who have a lumpectomy will be recommended to have radiotherapy. Many of those women will be recommended to have chemotherapy based on a. Number of factors including tumor size, lymph nodes, and receptor status.

Generally, radiation will not have any effect that would weaken bones. This is something that is usually associated with older age (osteoporosis) or with treatments that lower hormones (estrogen or testosterone).

The effects of radiation are local to the area being targeted. You don’t really need to worry about the other skin. Ask your physician or nurse for specific information on which areas you should apply creams to. That being said, it’s winter time now and some patients have chemotherapy at the same time, both of which can cause our skin to be dry all over. A little lotion goes a long way with dry skin.

There is a complication called osteoradionecrosis of the jaw that can occur when a tooth is pulled. Quite simply, the tooth is pulled and the bone doesn't have the blood supply to heal and fill in the hole. There is a radiation dose level below where we don't see this happen, around 30-35 Gy. If the tooth to be pulled or part of jaw to be drilled is in a high-risk area where a high dose of radiation was deposited, we usually treat patients with hyperbaric oxygen to help increase oxygen levels in the wound to help the bone heal. It's always better to know this ahead of time than to be caught unawares. I would put him in touch with your radiation oncologist so the radiation oncologist can make specific recommendations as to if any precautions need to be taken.