An estimated 5.5 percent of the US population is afflicted with cancer, with prevalence rates of 436 cases for every 100,000 of the population. The mortality rates have declined with advanced treatments and effective screening. However, the difficulties associated with the condition and the side effects linked to therapies still persist, despite the advances. Following sub-sections offer a detailed view of radiation treatment side effects among patients, along with information of how to cope with the effects. While it may not be possible to prevent the effects, the same can be mitigated, or handled better, so as to make it more tolerable and less visible.

Overview of radiation therapy

Medically known as external beam radiation therapy, this is essentially one of the treatment methodologies for cancer. This involves the use of intense energy beams such as X-rays/protons to destroy the cancer cells. The therapy involves the focusing of the high-energy beams at the desired location on the body. The purpose of the therapy is to target and destroy the genetic material that is responsible for the growth of cancer cells. Though the purpose is to target the cancer cells, there is a high possibility of damage to healthy cells, and this is one of the reasons for the side effects or undesirable effects of radiation therapy.

While the cancerous cells are effectively destroyed, the healthy cells have the capability to repair most of the damage from the effects of radiation. It is necessary to add that another form of radiation therapy is also practiced, known as brachytherapy, wherein radiation is not through the focusing of high energy beams. Radiation therapy is used for treating most types of cancer, and in certain instances, it is also used for treating tumors that belong to the benign (non-cancerous) form. Radiation therapy is typically used in the following scenarios – primary treatment, neoadjuvant therapy prior to surgery, adjuvant therapy post-surgery, combination therapy with chemotherapy, and symptomatic treatment among patients with advanced stages of cancer.

Commonly associated risks with radiation therapy

Contrary to common perceptions that the effects of radiation therapy are lifelong, or persistent, in nature, most of the effects actually resolve over time after the therapy has concluded. It is also necessary to add that the actual effects of radiation therapy may be experienced differently by patients, and is determined by the amount of radiation, and the part of the body that is being subjected to radiation. Certain patients may experience more side effects, while some may experience none. The effects can be broadly classified as early effects and late effects.

The early effects typically occur either during the therapy or immediately after the therapy. Early effects are typically short-term in nature and resolve in a few weeks after the conclusion of treatment. Effects that are most frequently occurring in this category include fatigue and visible changes in the skin. In addition to this, the other possible early effects are generally experienced in the area that is being treated with therapy – such as loss of hair and problems in the mouth.

Effects that may be experienced later may manifest in certain instances much later – many months or years after the conclusion of the therapy. These effects may be experienced or witnessed in normal tissue, and depends on the area being treated, apart from the amount of radiation. Radiation oncologists follow protocols to limit or reduce these effects by planning the therapy accordingly.

#1 Overall tiredness

This is essentially the most common radiation treatment side effects and most patients experience tiredness in a few weeks. The reason for this feeling of tiredness is the effect of the radiation that destroys healthy cells while targeting the cancerous cells. Consequently, individuals feel the effects of the destroyed healthy cells, through fatigue. This may aggravate as the therapy continues, and in most cases, also amplifies due to the stress associated with the procedure and the ailment. A distinct nature of fatigue from radiation therapy is that rest will not actually offer any relief. This is unlike the fatigue experienced routinely, or due to other reasons. Tiredness linked to cancer radiation therapy is known to last long and will impact routines. Relief from fatigue will start sometime after the therapy concludes.

#2 Skin related issues 

Another commonly observed, reported and documented effect of radiation therapy is problems with the skin. The skin in the area being treated is mostly likely to present clearly visible changes that are collectively known as radiation dermatitis. This includes a reddish appearance, the skin may be easily irritated, and appear swollen. Additionally, there is also the possibility of blisters forming on the skin, apart from effects similar to sunburned/tanned skin. This may slowly degenerate, and the patient may experience itching, in addition to other visible changes such as peeling skin, with a dry and flaky appearance.

Presently, protocols exist that help to lessen these effects to a certain extent, apart from measures to prevent infections in the skin. Most of the skin related effects are known to resolve a few weeks after the treatment concludes. However, depending on the condition and treatment, the color of the skin in some patients may remain darker than other areas of the body. In certain patients, the particular area of the skin may also end up being more sensitive than other areas.

#3 Loss of hair

Another commonly reported and documented effect of radiation therapy is loss of hair. This may be experienced either as loss of hair or thinning of the hair, and this depends on the area being treated. Therapy that is focussed on some other part of the body, may result in thinning of hair, while therapy that is focused on the head will result in loss of hair.  In most instances, hair loss is only for the period of treatment and hair is expected to grow back slowly. However, the hair that regrows may appear slightly different from the lost hair. The new hair may have slightly different texture to it, and the hair strands are typically thinner.

#4 Change in blood count

Blood count levels are also known to be affected as a result of radiation therapy. However, this is not frequent or common in occurrence and is limited to only rare instances. The right count of blood cells is necessary to fight infection and to ensure that the effects of bleeding are not severe. In a small number of therapy cases, low blood counts are a possibility as a result of the therapy. In such instances, the therapy is halted temporarily to help the blood counts to increase to normal or near normal, following which the therapy is continued. This may also occur when the patient is under chemotherapy.

Radiation treatment side effects when particular parts of the body are subjected to radiation

#1 Brain

Patients undergoing therapy for conditions diagnosed as brain tumors experience certain typical side effects. Short term effects include headaches, loss of hair, and possible feelings of nausea or vomiting. The patient may also experience fatigue as a result of radiation therapy to the brain. In a small section of individuals there is also the possibility of loss of hearing. The skin and the calp may witness some changes, and individuals are also likely to have memory related difficulties. There is also the possibility of patients experiencing some kind of challenges in articulating words clearly or coherently. Seizures are also possible outcomes of radiation therapy to the brain, and in most instances, this is because of the swelling in the brain.

Medications are intended to bring down the swelling in the brain, but the actual outcome may not be the same for all patients, with some responding favorably and experiencing lesser effects, while others may not respond as desired and experience stronger effects. In addition to the above short-term effects there is also the possibility of long-term effects that may be experienced later, many months or years after the conclusion of the treatment.

#2 Head and neck

Effects that are likely to be experienced when radiation therapy is targeted at the head or the neck includes formation of sores in the mouth or the throat. The patient may experience a dry mouth, and may have difficulty in swallowing. In addition to this, there may be an impact on taste, with patients experiencing come change in taste. Feelings of nausea and possible pain in the ear are also relatively common outcomes.

Dental issues such as tooth decay and abnormal swelling in the gums are also a possible effect of therapy. This swelling may also extend to the neck and the throat. Another common effect on hair may also be experienced as a result of radiation therapy. As outlined earlier, this is most likely to be thinning of the hair and not loss of hair. Other changes include possible changes in the appearance of the skin and an abnormal stiffness in the jaw.

#3 Breast

Patients undergoing therapy to the breast may experience effects that may also extend to the heart and lungs. Commonly reported effects of radiation therapy targeted at the breast include changes to the skin such as irritation to the skin and possible drying effect. The skin may appear with a different or subtle change in color. Effects also include sore breasts and swelling of the breast as a result of the build up of fluid. These effects are most likely to resolve in a few months after the therapy has concluded.

However, there are possible long-term implications on the breast. This includes change in sin color, where the breasts appear darker in complexion. The pores on the skin of the breast may appear large in size and may be easily visible or discernible. The skin may experience other changes, such as change in sensitivity, with the breast either more sensitive or less sensitive to the touch. While increase in size is relatively common because of the fluid build-up, there is also the possibility of reduction in size of the breast as a result of scar tissue. These effects are known to last longer than other effects.

This article is part of a two-piece article on the side effects of radiation therapy and simple tips on how to cope with the effects. The concluding part of this article will be published shortly.

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