Radiotherapy Side Effects

Radiotherapy Side EffectsWhat Is Radiotherapy

Radiotherapy or radiation therapy (XRT or DXT) is the use of ionizing radiation, for the treatment of cancer and tumors. Radiotherapy mechanism of action is the damaging of the DNA of the cancerous cells, leading to cellular death.

Radiotherapy can be curative (aiming to cure cancer completely) or palliative (in cases where cure isn’t possible, it’s recommended symptomatic relief and control). Radiotherapy is often combined with chemotherapy for the cure of cancer, but treatment of various cancers may require different combinations of hormone therapy, immunotherapy, chemotherapy, surgery and radiotherapy.

Since radiotherapy damages other tissues and organs, the shaping of the radiation beams is required. Usually, a tumor or cancerous tissue is hit with radiation beams from different angles, focusing or intersecting on the desired area, to provide a better dose of radiation there, and to minimize the impact on other organs and tissues of the body.

A form of radiotherapy is brachytherapy (or internal radiotherapy), where the radiation source (usually small radioactive rods) is placed inside or close to the cancerous tissue minimizing the exposure of other tissues, and aiming to destroy only the cancerous cells.

Radiotherapy comes with side effects, side effects that patients must be prepared or informed about.

Radiotherapy Side Effects

Radiotherapy in low doses does not cause any side effects, or in the worst case scenario, these are minimal. The radiation process is painless, however, edema might occur in the treated area afterwards, and sometimes it might compress the nerves and cause mild pain. In general, radiotherapy side effects interest only the treated are of the body.

Most radiotherapy side effects are expected or predictable, and patients must be instructed how to deal with them. Alternative treatment can be also prescribed for the alleviation of the radiotherapy side effects.

Acute radiotherapy side effects usually occur in case of higher doses. Depending on the area that was treated and the dosage, side effects can occur in short term, after a few months or even after a few years. Re-treatment or cumulative side effects, which can be different from the initial radiotherapy side effects, may also be experienced, if the cancer recurs and the patient must undergo another radiation treatment.

Generally, common side effects associated with radiotherapy are fatigue, sun burn-like skin irritation in the area that was treated, nausea and vomiting. Depending on the zone or organ of the body that undergoes or has undergone radiation treatment, side effects may occur as it follows:

1. Infertility. The gonads are very sensitive to radiation and radiotherapy can render them unable to produce gametes. However, this condition can be avoided if one of the gonads is spared from radiation.

2. Edema. Especially soft tissues swell after radiotherapy, and especially in case of radiotherapy for brain tumors inflammation can become a problem because it increases the intracranial pressure.

3. Throat and mouth sores. These radiotherapy side effects may show up in case the mouth or neck area has been treated with radiation. Ulcerations in the mouth, throat or esophagus can appear. Also, in case of lung cancer radiotherapy, the esophagus usually receives a lower dose of collateral radiation and may become sore.

4. Gastrointestinal discomfort. These side effects can be experienced by the patients treated for anal, rectal or colon cancer for example, or cancer that affects other organs in the pelvic area (i.e. prostate cancer, female genital tract cancer, bladder cancer etc.). These side effects are usually accompanied by nausea, soreness or diarrhea.

5. Damage to the epithelial surfaces. In general skin becomes pink and sore after radiotherapy and moist desquamation occurs, which is rather uncomfortable but it indicates quick recovery. Epithelial damage does not involve only skin, it may also concern the oral, pharyngeal and bowel mucosa for example, depending on the area that has undergone radiotherapy.

Late radiotherapy side effects may be: fibrosis (rigidity and scarring of the tissue that’s been irradiated), lymphedema (tissue fluid retention due to damage to the lymphatic system), dryness (concerning the sweat glands and the activity of the salivary glands), hair loss, heart disease (especially after radiotherapy on the chest area, for lung or breast cancer), cognitive decline (in case of radiation treatment applied in the head area), and even cancer.

Radiotherapy side effects induce death to the fetus within the first two weeks of fertilization. From there on, radiation treatment to the mother during pregnancy induces impaired growth, mental retardation, leukemia or tumors to the developing human being.

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