According to the National Cancer Institute (NCI), about 60 percent of all cancer patients need radiation therapy. Radiation can be external (through the skin) or internal (placed inside the body). Complications from radiation therapy depend on the part of the body being treated. The high doses of radiation used to kill cancer cells and shrink tumors can also hurt healthy cells. Treatments are carefully planned to limit damage, but sometimes side effects occur. Side effects usually go away in two months, but late complications can occur six months or more after finishing therapy.
Skin Complications
Redness that looks like sunburn or a tan, itching (pruritis), dryness, swelling, and sores or ulcers at the site the radiation enters the body often occur. Infection may develop if the skin breaks down. Skin changes are very common. Schnur and colleagues say that skin changes also cause emotional distress in some people. Radiation sites are marked with permanent marks that can cause embarrassment.
Fatigue
Fatigue, or a feeling of tiredness, is usually the most common side affect of radiation therapy according to the American Society of Radiation Oncology (ASTRO). When patients are getting cancer drugs (chemotherapy) along with radiation, the fatigue is even greater. Fatigue may also be caused by stress, other cancer-related factors or anxiety and depression.
Diarrhea
Soft, watery or loose bowel movements occur when the stomach, small intestine, colon or rectum (the gastrointestinal (GI) tract) are being treated. Tissues in the GI tract are very sensitive to radiation.
Hair Loss
Hair loss (alopecia) occurs at the site of radiation. When the head is treated, hair loss may be patchy or all the hair may fall out. Any hair on the body such as eyebrows and lashes, hair on the chest, arms and legs and hair in the pubic area can fall out from the treatment. If the radiation is in the abdomen, for example, the hair on the head will not fall out.
Head and Neck Complications
Radiation to the head and neck areas can cause dizziness, dry mouth, sore throat (esophagitis), trouble swallowing or choking, dental problems such as loose teeth or tooth decay (caries or cavities) and changes in taste. Weight loss occurs due to problems with swallowing or sore throat. If swelling of the brain occurs, pain, headache and even loss of consciousness can occur.
Nausea and Vomiting
Nausea and vomiting can happen with radiation to the abdomen area or certain parts of the brain. Dry heaves, or a vomiting like action without actually throwing up, can occur. If high doses of radiation are used, the chance of nausea and vomiting increases.
Fertility and Sexual Changes
Problems with fertility and sexual relations can be caused by radiation to the pelvic or groin areas. Women may have itching, burning or dryness in the vagina, symptoms of menopause when not in the menopause age range (hot flashes or no menstrual period) and not being able to get pregnant. Men may experience erectile dysfunction or impotence and may not be able to get a woman pregnant, as sperm production can suffer from radiation.
Bladder and Kidney Problems
Trouble going to the bathroom (urination), pain and burning, blood in the urine, a need to empty the bladder often, incontinence, cystitis (swelling or inflammation in the urinary tract) and spasms (cramps) are seen when radiation is used in the lower part of the abdomen and pelvis. Incontinence means an inability to control urine flow or leakage, often when coughing or sneezing.
Late Complications
Late side effects may occur six months or more after the course of radiation therapy is finished. Swelling (lymphedema) may occur in the arms or legs when radiation causes fibrosis (hardening of the connective tissue) and interrupts the normal flow of lymph fluid in the body. Brain changes such as forgetfulness, confusion, loss of balance and personality changes may occur. Mouth and throat problems may persist. Rarely, a second cancer may form.
References
- Journal of the American Medical Association: Patient-reported long-term outcomes after conventional and high-dose combined proton and photon radiation for early prostate cancer
- Physics in Medicine and Biology: The minimum knowledge base for predicting organ-at-risk dose-volume levels and plan-related complications in IMRT planning
- Psychooncology: A qualitative analysis of acute skin toxicity among breast cancer radiotherapy patients
