Browser does not support script.
Skip to main content
search here
Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
This information is about the use of radiotherapy| to treat children with cancer in the chest area. We have separate information for children having radiotherapy for head and neck cancer| or to the abdomen and pelvis (tummy) area|.
Radiotherapy| can be a worrying experience for both children and their parents, but understanding what it involves can help reduce your anxiety. It's helpful to read this information alongside the Macmillan/CCLG booklet A parent's guide to children's cancer, which contains more information about cancers in children, their diagnosis and treatment, and the support services available.
Watch the 'One of a Kind' video|
If your child is about to have radiotherapy, it may help to watch the short video ‘One of a Kind’, produced by Aardman Animations and funded by a partnership of eight charities. The animation shows children what to expect on a visit to the radiotherapy department. A young girl explains what happens when she goes for treatment. The images are friendly and the words are simple and easy to understand. Perhaps watch it yourself first to prepare for any questions your child may have and then have a look together.
Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells in one area of the body, while doing as little harm as possible to normal cells. The treatment is given in the hospital radiotherapy department, normally as a series of short daily sessions.
The treatments are usually given from Monday to Friday, with a rest at the weekend. Each treatment session takes about 10–15 minutes. Your child’s doctor will discuss the treatment and possible side effects with you. The length of time the treatment is given for will depend on the type of your child’s tumour, but may last for 2–6 weeks.
In order for radiotherapy to be as effective as possible, it must be carefully planned.
Before planning starts, your child will be assessed to make sure they are able to cope with treatment and the way it's given. The assessment will either be made when your child first meets the doctor who plans the radiotherapy (clinical oncologist), or on their first visit to the radiotherapy department. For treatment, your child will need to be able to lie still in a particular position for a few minutes, and feel comfortable being alone in the treatment room.
A hospital play specialist, paediatric specialist radiographer, nursery nurse, or specialist nurse may spend some time with your child to help them prepare for radiotherapy. Through fun and play, they will help explain the treatment to your child. This can help reduce any fear or worries they may have. Many parents are surprised at how cooperative their child can be during their treatment, once they are given plenty of time to prepare with the hospital play specialist.
If your child can’t lie still for long enough, or would find it difficult to be in the treatment room alone, they can still have radiotherapy but will need to have a daily general anaesthetic. Most children under the age of three will need an anaesthetic; most aged four or over will not.
If at all possible, the radiotherapy will be given without an anaesthetic. For this reason, several visits to the radiotherapy department may be needed for preparation with the hospital play specialist, or nursery nurse, before radiotherapy planning begins. You may be given games and exercises to play with your child at home, to help them overcome any fear or anxieties they may have, and to familiarise them with what radiotherapy involves|.
Treatment planning may take a few visits. On your child’s first visit to the radiotherapy department, they may have a CT scan or lie under a machine called a simulator. The CT scanner, or simulator, takes x-rays of the area to be treated. Treatment is planned by a cancer specialist (clinical oncologist). Marks may be drawn on your child’s skin to help the people giving the treatment (radiographers) make sure treatment is given to exactly the right area each time. Sometimes, small permanent dots (tattoos) are also used. Your doctor or specialist nurse will explain this process to you.
Radiotherapy staff| are experienced in treating children, and can offer you help and support.
At the beginning of each radiotherapy session, the radiographer will position your child carefully on the couch and make sure they're comfortable. During treatment your child will be alone in the room, but they'll be able to talk to the radiographer, who will be watching from the next room, over a communication system. You can stay with the radiographer, so that you can see your child and talk with them. Music, story tapes or CDs can be played for your child, or you can read stories to them.
Radiotherapy is not painful, but your child has to lie completely still for a few minutes while the treatment is being given. If your child is having their treatment under a general anaesthetic, they can't eat or drink for at least four hours before being given their anaesthetic. Because of this, your child will usually have a morning appointment. The anaesthetic is given in the radiotherapy department by an anaesthetist, who is trained in giving anaesthetics to children. You can stay with your child until they are asleep.
Older children may take a while to get used to the size and sound of the machines, but this should become easier once they get to know the staff and surroundings.
The immediate side effects of radiotherapy are usually very mild:
Your child may feel very tired| while they are having the treatment and for a few weeks afterwards. Their energy levels may take a few months to get back to normal once treatment has ended.
Your child may lose their appetite|. It may be useful for them to have frequent small snacks throughout the day, rather than large meals.
Radiotherapy to some parts of the body can affect bone marrow|. This is where the different types of blood cells are produced. If this is likely to happen in your child’s case, they'll have regular blood tests during treatment to check their blood cell levels (blood counts). If their red blood cell levels are low (a condition called anaemia), they may feel very tired and lack energy.
Radiotherapy is less effective if the number of red blood cells is too low. If your child is anaemic and has a haemoglobin (Hb) level of less than 10, they may need a blood transfusion|.
Only the treated area will be affected by local side effects and your child is unlikely to experience all the side effects listed here:
Some children develop a skin reaction, similar to sunburn, while having radiotherapy. This normally happens after 3–4 weeks. In children with pale skin, the skin in the treatment area becomes red and sore or itchy. In children with dark skin, it becomes darker. The severity of the skin reaction depends on their skin type and the area being treated. Some children have no skin problems at all. The radiographers will look for these reactions, but you should also let them know if your child feels any soreness.
Radiotherapy staff will give you advice on how to look after your child’s skin in the treated area. This varies according to the part of the body that's being treated and the dose of radiotherapy being given. You may be asked not to wash the treatment area at all while your child is having treatment. Or you may be asked to wash the area only with warm water, and then to gently pat it dry with a soft towel. You could also dry the skin with a hairdryer on the coolest setting. Try not to rub the area, as this may make it sore.
It's important not to use soaps or talc on the treated area of skin. Hospital staff may suggest that you gently apply unperfumed moisturisers, such as E45 cream or aqueous cream. Always check before applying anything to your child’s skin.
These restrictions apply only to the affected area; the rest of your child’s skin can be treated normally. Their skin may peel after the redness has faded, but it should heal quickly. Skin reactions usually settle 2−4 weeks after the radiotherapy has finished, but the treatment area may remain slightly darker than the surrounding skin.
Because the skin in the treated area is very sensitive, it should not be exposed to the sun or cold winds. It's very important to cover the treated area if your child goes out in strong sunshine, for at least the first year after their radiotherapy. They should wear clothing made of cotton or natural fibres that have a closer weave and offer more protection against the sun. Even after this time the skin will be delicate, so extra care should be taken. Your child should use a sunscreen of at least factor 30. It's important to remember that their skin can burn, even through clothing, if they're in intense sunlight for a long time.
It's fine for your child to swim as soon as any skin reaction has settled down, usually within a month of finishing treatment. But if they're swimming outdoors, they should not stay in the water for too long, and should use a waterproof sunblock.
About 2−3 weeks (but sometimes only a few days) after radiotherapy to the chest has started, your child may tell you that their chest feels tight, making it difficult for them to swallow| solid foods. This is a common reaction to treatment. It may help to try a soft, plain diet, supplemented by high-calorie drinks that your child’s doctor can prescribe. They may also prescribe painkillers, or liquid medicines, for your child to take before meals to make eating less uncomfortable. This difficulty usually gets better on its own in about 5−8 weeks.
Some children find that their treatment makes them feel sick, and sometimes they may actually be sick. This is most common when the treatment area is near the stomach. Tell your specialist if your child experiences any nausea or vomiting|, as they can prescribe anti-sickness drugs (anti-emetics). These drugs are usually very successful. Any feeling of sickness usually stops once treatment is over.
After radiotherapy to their chest, your child may have a dry cough and experience breathlessness|. This may not occur until several months after the treatment. If you notice this, you should tell your child’s doctor, who may give treatment with steroids| and possibly antibiotics.
Radiotherapy can cause some other long-term side effects|, which may start gradually, months or sometimes years after the treatment. With time, the effect of radiotherapy to any growing tissues may become more noticeable. In particular, radiotherapy can sometimes affect growth and development and sometimes normal breast development. Rarely, radiotherapy to the left side of the chest can affect your child’s heart. Not all children will develop long-term side effects. Your child’s doctor or nurse can discuss this with you in detail.
Your child will have regular check-ups, in the children’s (paediatric) or adolescents' cancer clinic. The doctors will monitor them regularly for signs of any problems or long-term side effects.
As a parent, the fact that your child has cancer| is one of the worst situations you can be faced with. Knowing that they need radiotherapy treatment that may cause side effects can also be very difficult. You may have many different emotions, such as fear, guilt, sadness, anger and uncertainty. These are all normal reactions| and part of the process that many parents go through at such a difficult time.
We cannot address here all of the feelings you may have. However, the booklet A parent's guide to children's cancer talks about the emotional impact of caring for a child with cancer, and suggests sources of help and support.
Our booklet Peppermint Ward| is a storybook for younger children with cancer. It looks at the issues that they and their family may face and helps them to explore their feelings.
This information has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.