The Oncology Aesthetics Podcast
Nurturing well-being through the cancer journey.
The Oncology Aesthetics podcast is a guide to enhancing well-being, self-esteem, and resilience during your cancer journey. Join us as we share expert skin care tips, practical self-care strategies, and inspiring stories to help you navigate life's challenges. Let's rediscover strength, radiance, and joy together—because thriving is possible throughout treatment and beyond.
The Oncology Aesthetics Podcast
Radiation and your Skin
Radiation therapy is a cornerstone of cancer treatment, but what exactly happens when those high-energy beams target cancer cells? Nurse practitioner Katie Bucholt pulls back the curtain on this often-misunderstood treatment, explaining how radiation breaks DNA strands at the cellular level to prevent cancer cells from repairing themselves.
Katie takes us on a fascinating journey through radiation's effects on the skin and body, highlighting how treatment responses vary based on location, dosage, and individual factors. She dismantles the one-size-fits-all approach, emphasizing that nutrition, hydration, and lifestyle choices significantly impact how well patients tolerate treatment. For anyone facing radiation therapy, her practical guidance on timing skincare applications (nothing within three hours before treatment!), selecting appropriate products (alcohol-free and sterile), and protecting vulnerable skin from sun exposure provides a roadmap for minimizing side effects.
Beyond the clinical advice, Katie offers heartfelt wisdom on navigating the emotional terrain of cancer treatment. She encourages patients to advocate for themselves, bring support people to appointments, and embrace the vulnerability of accepting help. Her gentle reminder that allowing others to help is giving them "the privilege" of supporting you resonates deeply with anyone who's struggled to accept assistance during difficult times. Whether you're undergoing radiation treatment, supporting someone who is, or simply curious about this powerful therapy, this episode delivers clarity, compassion, and practical strategies for maintaining dignity and skin health throughout the radiation journey. Subscribe now to access more expert insights on enhancing wellbeing during cancer treatment!
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This podcast is brought to you by the Ricardo Fisus Natura Be Safe Foundation, produced by Lions Creative. All the information contained in this podcast is intended only to provide general skincare guidance. The information is not a substitute for consulting with a physician or other qualified medical professional. Welcome to the Oncology Aesthetics Podcast, where we explore ways to enhance well-being, self-esteem and resilience while navigating cancer. We bring you expert skincare tips, practical self-care strategies and inspiring stories to help you rediscover strength, radiance and joy. Welcome to the show, everyone. My name is Rae Jeanne. I'm your podcast host and the national educator for the Ricardo Fesis Natura Bisset Foundation. Today, I'm here with Katie Bucholt and she's going to talk a little bit about radiation with us. Katie, welcome to the show.
Speaker 2:Hi, thank you for having me. I am a nurse practitioner. I work specifically in radiation oncology in Dallas, Texas, and my job every day is to take care of patients that are receiving radiation. Thanks for having me.
Speaker 1:We are so glad to have you. You're obviously very experienced and an expert in this field, so if you would maybe start off with explaining to us and our guests what is radiation?
Speaker 2:to us and our guests. What is radiation? You know radiation in its simplest explanation if you could think back to your biology class, which is a long time ago for a lot of us. But if you remember DNA and it has two strands and they curl around one another. And then if you remember the electrons in the cellular makeup and if you're thinking back about an atom and there's a number of electrons in there.
Speaker 2:We use a large machine, something called the linear accelerator, that actually hits at the area that we want to target, where there's cancer cells, and it makes those electrons charged and it goes in and the electrons will hit at the DNA and it breaks those DNA strands and it damages that cell, making it unable to be able to repair itself. We capitalize on damaging cells in the path of the radiation. It only touches what we want it to and yes, there are some healthy cells that are in that way. But we do capitalize on the fact that healthy cells have repair mechanisms and their ability to reproduce and repair and repopulate that area with healthy cells as the cancer cells die off and we reoxygenate that area.
Speaker 1:Thank you for such a thorough explanation of that. I've really seen and heard so much about radiation, but have never heard such a succinct and direct way of it being described, so that's perfect. When it comes to radiation and the skin, obviously we can imagine that there would be some sort of impact on that direct hit. So what do you see typically happening on the skin during radiation?
Speaker 2:So when you're set up for radiation treatment, it depends on what area of the body we're touching. If I'm working on a tumor in your throat, we would be touching the areas in and around, potentially your mouth or your neck or both. If I'm touching a tumor on your leg, the tumor area where radiation would touch would only be your leg. Your side effects are directly related to where we're putting the radiation. It's very specific and radiation is very planned out. These days there's not a blanket of radiation unless we're treating someone that's receiving like, for instance, having their bone marrow replaced for, like, leukemia or certain forms of lymphoma. Generally, radiation is only given to small areas where we are targeting a cancerous tumor. The skin in those areas is the first thing that radiation actually touches, and the same effect on the skin is inside the body where we're working on tumors. Sometimes we have tumors that are on top of the skin and we're purposely targeting the skin as our treatment profile.
Speaker 2:So it depends on what kind of radiation you're getting. It depends on how long the radiation treatment plans are, how much radiation dose per day you're getting. It depends on how long the radiation treatment plans are, how much radiation dose per day you're getting, so that can affect how much dose it is, and some of it we, like I said, on purpose want to make the skin irritated. For instance, a person with inflammatory breast cancer, we actually put a layer of silicone on top of the skin so that we trick the radiation machine to delivering more radiation to that area because we want to get rid of cancer cells that may potentially be living there.
Speaker 2:It also depends on patient factors. Patients with diabetes can have issues with healing and skin breakdown. Patients who continue to smoke during treatment are notorious for having challenges with skin, so it's another good space for helping people to quit smoking. Nutrition plays an enormous factor in the quality and condition of the skin and how well they do throughout treatment. Oral hydration with fluids is really important as well, because we are a giant body of water. Not having adequate fluids and nutrition can make a big impact on how well your skin does.
Speaker 1:Wow. So yeah, a lot of different variables in how someone's skin may react. I love that you touched on so many of those topics, because I can imagine that it would make a difference on where it's being applied, how much is being applied, how long it's being applied for. And I love that you talked about that internal hydration and the nutrition aspect too, because it does play such a huge role in skin health. What are maybe some other side effects that can come with radiation? You know whether it's on the head and neck or the breast, just in different areas. What can someone expect?
Speaker 2:I hate to use the phrase. It depends, but it really depends because radiation, again, is incredibly specific. So if you're receiving treatment within the throat area or mouth, it may affect the tissues inside your mouth. Some people will develop mouth sores in and around the throat, tongue and inside the cheek. The skin may get red If we're close by their saliva glands. They may have challenges with saliva being dry. They may have challenges with saliva being dry. They may have some taste changes and, as you can imagine, the mouth source can cause quite a bit of discomfort to the need for medications for pain.
Speaker 2:Overall, almost every radiation plan, even if I'm radiating a toe, can make you tired over time. It's just the biologic process of the immune system activating and doing its job and it causes work on your metabolism. Therefore it can make you tired. Breast is mostly skin, as you can imagine our breasts, depending on whether you've had a mastectomy or preserved your breasts with a partial lumpectomy. The skin is right there. If we have breast tissue up underneath there, it's directly right up underneath the skin, but it's close to the surface. Skin will be something we'll watch closely.
Speaker 2:Tiredness can definitely be part of that treatment plan, depending on if we're treating lymph nodes for the breast cancer patient. Sometimes they can have a bit of a sore throat. If we're fully up underneath the arm, they could have issues with lymphedema. If we're in the stomach or the pelvic area, you could potentially have nausea or diarrhea. So some challenges with eating. There's lots of medications and dietary changes that we can use to manage that.
Speaker 2:If we're in the limb, generally we're out of the really icky side effects that could potentially happen, but you can still have soreness and swelling there. And then if we're in the head, working into the brain area, you could have some loss of hair and some potential neurological things, depending on what's going on with the person. So there's a wide variety of potential side effects and keyword on potential, because I would never want anyone to think that they may have all of these. Most patients do quite well with treatment and we're really good at knowing what's potential coming, so we're able to forecast for that and give medications to help mitigate the side effects. If we're not able to completely manage that, we're able to help the patient plan ahead of time that they have support persons to take care of them during all of this.
Speaker 1:So Wow, that is a great way to cover it. Absolutely, just like you said, it seems like there's a lot of different variables that go into it. I love that you emphasized potential side effects, because you never really know. You also talked about the preparation aspect, and that's something we talk a lot to our clients about helping to keep the skin prepared prior to starting treatment. So that way there's a little bit more of that mitigation of some of those skin side effects. So, on that note, what are some other things that you do to help prepare your clients before they actually start their treatment?
Speaker 2:So, specifically for skin, we take a look at the site before they get going and see what condition they're in.
Speaker 2:Sometimes patients have had surgery, so we want to make sure that that surgical site is as healed as properly as we can, that the edges look good, that they've been cleared from their surgeon, then that the patients again hate to keep going back to.
Speaker 2:Nutrition Helps with healing for everything, but it sets the stage for how well they will do during treatments. Generally, the neck and breast area can be quite reactive. We want them to start a good skincare regimen ahead of time. If their treatment's getting going quickly, that may not be possible, but just getting in a regular routine of washing with a gentle soap, making sure that they're wearing soft clothing items and start a moisturization product on a regular basis before we even get going you want to ideally. I mean, summertime in Texas is challenging Getting people to really take care of the site that we're working on and use sunscreen or cover that area as much as they can so that we're not going into radiation with a fresh burn from the sun. So doing the best that you can to take care of yourself prior to getting treatment is always good.
Speaker 1:That's great advice and then kind of leading up closer to actually receiving the radiation. How long do you recommend someone puts on a moisturizer before they're actually going in to get that radiation?
Speaker 2:Yeah, I'm glad you asked that because that's pretty specific and most radiation departments across the country are really internationally Because remember I was talking about how sometimes we trick the radiation beam to delivering extra radiation on top of the surface. So we use a layer of silicone to do that. It's a very thin product that we use and if you have fresh product on top of the skin it does the same thing. So we don't want fresh product in the area we're working. So if I'm treating your breast you can do whatever you want to the rest of your body, but within the breast area that we're treating breast, underarm and neck area you want to avoid putting on any products at least three hours before treatment. So if you're going to go to work in the morning and your treatment's not till three o'clock in the afternoon, do your normal everyday care. Then right before radiation you'll come into the department, get undressed, do your normal everyday care. Then right before radiation you'll come into the department, get undressed, do your treatment and then the first thing you'll do after treatment is completed. A lot of my patients I have them put the cream on before they put their clothes on, because it prevents them from going home and forgetting about it. I'll have them put the cream on in the appropriate area, which is usually where the radiation beams are touching, and then they'll do it again before they go to bed. So three times a day is generally a good rule of thumb.
Speaker 2:If you're a morning person and get your radiation in the morning before work, come to us clean and dry and that's just using a gentle soap. I always typically pick out Dove unscented, just because it's easy, but just a non-stripping non. Some of the antibacterial soaps can be harsh. A moisturizing, non-scented soap is usually a good rule of thumb. No scrubs, no loofahs. I wouldn't put anything rough on the skin. I'd pat dry, skip any deodorant or lotions in the area where we're working and then get your treatment.
Speaker 2:And then the first thing you'll do when you get into the treatment room is put the coat of the lotion. Your radiation department may have a preference of a product that you use, or there's lots of suggested products out there. You'll put that on in the dressing room before you put your clothes on and then go to work and live your day, and then, if you could sneak in the bathroom during lunchtime, do that again in the radiated area and then before you go to bed. I usually recommend a little heavier product at night, just because it soaks in a little bit better and it helps with hydration. But you can certainly use the same product throughout. But that's generally the pattern of skincare that I tell patients.
Speaker 1:It sounds like just bullet points of making sure not to put anything on at least three hours prior and then encouraging people to put on moisturization afterwards to really keep that hydration sealed in there. I love that that hydration sealed in there. I love that. Within ingredients and products, are there any ingredients that you do not recommend to use prior or after You'd?
Speaker 2:be surprised if you flip over a bottle of lotion. Many products have alcohol as a base, even some baby products. You'd be shocked when you look at the ingredient list, how harsh they are. And if you put it on skin, if you've burned yourself and you put something with an alcohol base to it how much that stings. So you really need to be mindful that the products that you're using have as few ingredients as possible and are extremely hydrating. So that's something really important to look out for.
Speaker 2:A lot of people use aloe is out there. That's a very common product across the United States. I lived in Florida for a long time and some people would think that plucking the aloe plant out of their yard is really the most natural thing they can do, which is great. But it's not sterilized. And think about when we're irritating skin. You can have little micro breaks and if you have bacteria, that's on that product, which it's in our environment, and we have pets and all sorts of things. Think about what you're putting onto your body which may not be purified. So whatever product you want to look for, make sure that it's sterilized in a bottle.
Speaker 2:Your radiation oncology team may have a few recommended products. There's a variety of different things, there's something different for you. If you look, everybody has a different opinion and if you look at the mask guidelines, which is where we get patient care guidelines for they can't even agree. The most recent one my girlfriend, was on the mask committee, which is international. There's experts from all over the world and they still could not agree on one product. This past go around. Some of it plays into finance, because some of these products that they recommend are quite pricey. In my personal experience, having clientele from all sides of life, none of them are really necessarily any better than the other. What they all have in common is something hydrating. So hyaluronic acid is a great hydrating product. Aloe, in some forms it needs a little bit more of a boost, in my humble opinion. Really, it's what you're comfortable with, what fits in your budget and something that you're going to consistently use, that feels good on your skin, that does not have alcohol in it and is a purified item in a bottle.
Speaker 1:Those are all very great points, so thank you so much for that. One thing I do want to touch on is SPF. As a skincare girly, I'm very much so an advocate for SPF, but I can imagine that the need is much higher when you're receiving radiation.
Speaker 2:And that's in the areas that are exposed. I mean, obviously you know I worked on South Florida. My discussion about bathing suits were really different versus Texas. I lived close to South Beach and wearing a bathing suit top was definitely a comment that I had to make. I don't really have to make that comment here in Texas, but wearing a higher coverage bathing suit and covering the breast area where we're working also asking are you radiating into the lymph nodes by my neck? Because that area might need to be covered with an SPF based top. But I also recommend at least 50 and higher sunscreen in the radiated areas. You know for we're radiating your bum and most people are wearing pants you don't necessarily have to put SPF on your bum, but if you're out in the sun and that's exposed, you need to make sure it's covered. If you've burned yourself cooking, you wouldn't want to go out and get a sunburn on top of that because that would feel terrible. It would definitely cause further skin breakdown and injury and you definitely don't want to do that.
Speaker 1:Absolutely. That makes so much sense to me To just kind of maybe even start wrapping it up. I would love to hear from you, just from your experience with these patients, what's some other advice that you give to people that may not be skincare specific or even radiation specific, that can help them feel a little bit more supported.
Speaker 2:Well, I mean, I think, not being afraid to ask questions Some folks are afraid to bother people or take up too much time but own your space. The only person that can advocate best for you is you. The other thing is if you have the ability to have someone come with you during appointments even as my own experience as a cancer survivor, having someone there to catch some of the things that I don't catch when you're really stressed out, even if you have all the knowledge in the world about it, you're not going to hear everything. It's so not always the most setting where you remember everything. If you're not a person who generally relies on other people for help and you do everything.
Speaker 2:Being okay with giving people the privilege to help you, most people don't know what to do. When you get a cancer diagnosis and they don't know how to help. They keep saying let me know if you need anything. They're afraid of asking questions. Giving people permission saying hey, can you please help me with my laundry, feels icky for a lot of people, but it gives them the privilege of feeling like they have some control back to you because they don't know what to do and how to help you. So you know, just giving people permission to hop in your life and the joy of of giving back to you because probably you've given a lot to them. Those are probably the things that I could pick out. That would be the best.
Speaker 1:I love that. I feel like that's so supportive and, honestly, katie, this has been absolutely amazing. Thank you so much for joining us today and being on the show.
Speaker 2:Thank you, I appreciate the invite. I love talking about patients receiving radiation. That's what I do all day.
Speaker 1:Well, we're so glad to have your knowledge and your expertise and we hope to have you back soon, absolutely Thank you. Thank you for joining us. We hope you found this information helpful. It's your reviews and feedback that help make this podcast even better. If you enjoyed this episode, please subscribe, leave a review and share it with someone who might benefit. Until next time, take care, stay radiant and we'll see you soon you.