Radiation therapy, or radiotherapy, uses high-intensity X-ray and gamma-ray energy to target cancer cells. Exposure to this energy damages and destroys DNA inside cancer cells, helping to remove cancer from the body. More than half of all cancer patients receive radiation therapy, often in combination with other treatment methods like chemotherapy.
Like many cancer treatment types, radiation therapy has potential side effects. The energy emitted by the linear accelerator cannot differentiate between healthy and cancerous cells. Well-functioning cells are often killed alongside cancerous cells during treatment. The intensity of the treatment can also cause fatigue, hair loss, lung damage and other kinds of cancer later in life.
Short-term side effects of radiation therapy
Some side effects of radiation therapy begin during or shortly after treatment. Side effects will depend on the type, intensity and location of treatment. In many cases, side effects subside after a set period of time. These short-term side effects typically grow less intensive in the weeks and months following treatment.
Fatigue
Radiation will often damage a selection of healthy cells in the body. Your body expends energy to repair the damage, which can sometimes leave cancer patients feeling fatigued after therapy. Levels of fatigue will often increase with ongoing treatment.
Handling fatigue is an important step in cancer management and recovery. Take naps, or breaks from your day, whenever necessary. Moderate exercise like walking or yoga can also help alleviate fatigue symptoms. Hydration, particularly with electrolytes, helps your body replace lost fluids and reduces heart strain.
Skin reactions
Skin redness, itching and peeling are also common reactions to radiation therapy. While typically mild, these reactions can be more intense if patients are also receiving treatments like immunotherapy. Some patients also experience skin darkening, rashes or sunburns during treatment.
Healthy skin care is particularly important during cancer treatment. Make sure to keep your skin moisturized with natural, fragrance-free products. Avoid synthetic lotions or any items that could cause allergic reactions. Keep skin out of the sun with protective clothing or hats.
Hair loss
The energy emitted in radiation can damage hair follicles and cause hair loss. In many cases, people only lose hair in places where they receive treatment. Hair should grow back approximately three to six months after treatment concludes, though sometimes thinner and with a different texture than before.
There are many different ways to manage hair loss during the cancer treatment process. Some patients shave their hair and use a hairpiece or wig. Others choose to cover their heads with scarves or hats. As hair loss can be a stressful process, many patients cope with emotional stress through counseling or therapy.
Long-term side effects of radiation therapy
Some patients experience long-term effects of radiation therapy during the months and years following treatment. Some side effects are caused by the cancer itself; others might be caused, or made worse, by previous radiation therapy. These long-term effects may include heart and lung damage, lymphedema, and secondary forms of cancer.
Secondary cancers
Secondary forms of cancer develop in areas not originally treated by radiation therapy. Radiation can elevate your risk of developing secondary cancer, sometimes years after treatment. Risk factors include your treatment dosage, length of treatment, age and form of cancer.
Common forms of secondary cancer include leukemia, sarcoma, lung cancer and breast cancer. The type of secondary cancer you develop sometimes depends on where you received your original treatment. For example, patients who receive chest radiation for Hodgkin lymphoma have an elevated risk for secondary breast cancer.
While the risk of secondary cancer is low, it’s still important to schedule follow-up visits with your doctor. These screenings can help identify and treat secondary cancers before they worsen.
Heart and lung damage
Radiation therapy can damage blood vessels and healthy heart cells, increasing your risk of developing heart disease. Many patients are also at an elevated risk for coronary artery disease and heart attack.
The same radiation therapy can negatively impact lung health. Scarring from radiation can lead to lung fibrosis and swelling. Over time, patients might experience coughing, wheezing, or trouble catching their breath.
The risk of both heart and lung issues will depend on patients’ radiation dosage and intensity. Doctors recommend regular screening to monitor both heart and lung health, to stop any problems before they evolve.
Lymphedema
Lymphedema — tissue inflammation in arms or legs caused by lymph fluid — is another common radiation therapy risk. Patients with lymphedema can experience discomfort when moving. They might also feel anxiety or emotional distress from their uneven physical appearance.
Patients should combine practical and clinical steps to manage lymphedema. For example, regular exercise and weight management can help reduce the pressure on limbs affected by lymphedema. Doctors also recommend regular lymphatic drainage massages to relocate fluid away from arms or legs. Only licensed healthcare professionals should perform these massages.
Site-specific side effects
Many side effects of radiation therapy are specific to the site where treatment is applied. For example, radiation applied to the head or neck area can affect oral health. Nausea and diarrhea can sometimes result from treatment applied near a patient’s abdomen or gastrointestinal tract. Treatment for these side effects is often applied on, or near, the site experiencing discomfort.
Oral complications
Doctors sometimes use radiation therapy and chemotherapy to treat cancer near the head or neck area. Patients exposed to treatment in these areas might experience changes in their oral health.
Here are some ways radiation can complicate patients’ oral health:
- Dry mouth: A decrease in saliva amount or quality that creates an unusually dry mouth.
- Loss of taste: A decrease in the ability to taste foods, or an otherwise negative change in the patient’s overall sense of taste.
- Tooth decay: Loss of enamel that leaves teeth prone to bacteria, plaque and illness.
- Gum disease: Inflammation that affects gum health, bone health and teeth.
- Jaw stiffness: Limited flexibility in the jaw, usually related to the muscles responsible for moving the jaw.
- Mouth sores: Open sores on lips, gums or other oral areas that compromise the patient’s ability to eat, speak or even breathe without pain.
Patients should not attempt to handle oral challenges on their own. Treatment for these complications often requires coordination between a dentist, oncologist or other healthcare professionals. Schedule an appointment with a dentist to coordinate a treatment plan specifically for your oral health.
Gastrointestinal issues
Nausea, diarrhea and other gastrointestinal issues sometimes arise after radiation therapy near the abdomen. Most of the time, gastrointestinal symptoms are not life-threatening. However, they are often irritating and can slow the overall recovery process.
Hydration is an easy way to soothe an upset stomach. Clear broths, fruit juice and drinks with electrolytes help patients overcome dehydration caused by radiation therapy. It’s also important to avoid beverages with alcohol, carbonation or caffeine. These liquids can trigger further gastrointestinal problems.
Many patients also lean on rest and medication to overcome gastrointestinal problems. Rest helps reset your body’s internal clock and support healing. Your primary care doctor might also prescribe anti-nausea medication to curb symptoms.
Cognitive changes
Radiation can also affect the way the brain works and reacts to input. Some patients experience brain fog, or “chemo brain.” You might notice problems concentrating, recalling memories, or paying attention to objects or speakers. Fortunately, there are several ways to address these cognitive changes.
Schedule a visit with a psychiatrist or other medical professional if you notice cognitive issues after radiotherapy. A psychiatrist will assess your cognitive function and prescribe medication or treatment to help you handle mental health challenges. They may also refer you to a psychologist who can better help you understand how radiation affects your thoughts, feelings and emotions.
The importance of follow-up care
No matter your side effects, follow-up care is critical for short- and long-term health. Follow-up appointments allow doctors to identify any changes in patient conditions and provide treatment. They also allow patients to ask questions, get answers and understand any necessary changes to their treatment plans.
Follow-up care after cancer includes regular health screenings. Screenings help monitor for common side effects like secondary cancer and heart disease. They also shed light into the effectiveness of past treatment methods. Patients who participate in follow-up appointments give themselves the best chance to embrace a happy, healthy future.