Possible shortterm side effects

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Generally, radiation given to children with leukemia lasts less than two weeks. Many children suffer no short-term side effects. If side effects do occur, it is often hard to differentiate those caused by radiation and those caused by the high-dose chemotherapy that is usually given at the same time. Possible short-term side effects are:

• Loss of appetite

• Nausea and vomiting

Slightly reddened or itchy skin Hair loss

Low blood counts

Changes in taste and smell (sometimes during the treatment) Sleepiness (somnolence syndrome)—from cranial radiation Swollen parotid (salivary) glands—from TBI

Methods of coping with most of the above side effects are contained in Chapter 11, Common Side Effects of Chemotherapy.

Somnolence syndrome is uniquely associated with cranial radiation and is characterized by drowsiness, prolonged periods of sleep (up to twenty hours a day), fever, headaches, nausea, vomiting, irritability, loss of appetite, difficulty swallowing, and difficulty speaking. It tends to occur five to seven weeks after radiation treatment ends, and can last from a few days to several weeks.

Nine weeks after ending her cranial radiation, my daughter started complaining of severe headaches. She would hold her head and just sob with pain. She also vomited several times. Then she became very sleepy, and dozed on the couch most of the day. She developed a low fever and choked when she tried to swallow liquids or solid food. This lasted for about a week, and I was worried sick. I called her oncologist, her radiation oncologist, and her pediatrician, and they all said they didn't think that it was related to the radiation or chemotherapy. I went to the medical library and discovered somnolence syndrome.

Stephan (8 years old) had no side effects from the cranial and spinal radiation other than sleepiness, but he was very affected by it. First, he just started taking naps and generally slowing down. Then the naps got longer, and he was awake less. Finally, he only woke up to eat. Luckily, that part coincided with Christmas vacation so he didn't miss much school. Altogether, it lasted about six weeks.

Ryan (14 years old) had his radiation during consolidation when he was very ill from the chemotherapy. He would develop severe headaches and vomiting an hour after each radiation treatment.

Three weeks after her radiation ended, Rachel (18 months old) slept for three days. We tried to wake her to eat, but she literally would fall asleep with her face in her food. After three days, she gradually became more alert, with the whole episode lasting only a week and a half. Oddly enough, the oncology people warned me about the possibility of sleepiness, but the radiation staff insisted that it wasn't related to the radiation.

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