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Radiation therapy is a common treatment for cancer, but it can also have several side effects. These side effects can be physical, emotional, or a combination of both. The side effects of radiation therapy vary from person to person and depend on factors such as the part of the body being treated, the type of radiation therapy, and the dose of radiation. Some common side effects include skin irritation, hair loss, fatigue, and loss of libido. In addition, radiation therapy can cause muscle stiffness and joint pain in the area being treated. This can usually be managed through exercise and stretching, but in some cases, a referral to a physiotherapist may be necessary.
| Characteristics | Values |
|---|---|
| Muscle Stiffness | Radiotherapy can make the muscles in the treated area feel stiff and uncomfortable. |
| Cause | Radiation affects healthy cells and can cause an increased production of fibrin, which accumulates and causes damage over time. |
| Treatment | Exercising and stretching regularly can help prevent stiffness. Physiotherapy may also be recommended. |
| Other Side Effects | Hair loss, skin irritation, soreness, discolouration, dryness, itchiness, blistering, peeling, low blood count, infertility, loss of libido, erectile dysfunction, pain during ejaculation, fatigue, and diarrhoea. |
| Radiation Fibrosis Syndrome (RFS) | Progressive condition that may manifest years after treatment, causing muscle weakness and dysfunction, and contributing to neuromuscular injury. |
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What You'll Learn
Radiation fibrosis syndrome (RFS)
RFS refers to the signs and symptoms of soft tissue injury resulting from radiation therapy. All soft tissues within the field of radiation can be affected, including skin, connective tissue, muscles, nerves, and blood vessels. The likelihood of developing RFS and the severity of the condition increases with higher doses of radiation therapy and when radiation therapy is combined with chemotherapy and/or surgery.
The neuromuscular complications of RFS stem from the direct and indirect effects of progressive fibrotic sclerosis on neural structures, including the brain, spinal cord, nerve root, plexus, and all components of the peripheral nerve. Any nervous system structure can be affected by RFS, and it can result in muscle weakness and dysfunction, contributing to neuromuscular injury.
Some common symptoms of RFS include tightness, pain, and/or spasms (cervical dystonia) of the neck, head and neck lymphedema (swelling), and impairments in swallowing function (dysphagia). RFS can also cause shortening of tissues, contracture and atrophy (wasting) of muscles, bones becoming weak and brittle, and nerve damage (neuropathy).
Management of RFS is a complex process that may include medication, education, rehabilitation, physical therapy, and occupational therapy. Cancer rehabilitation specialists can help manage RFS, but these specialists may not be available everywhere. It is important to speak with a healthcare provider about any symptoms to develop an appropriate treatment plan.
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Muscle weakness and dysfunction
Radiation therapy is an effective method of killing cancer cells, but it can also damage healthy cells and nearby body parts such as blood vessels, skin, ligaments, tendons, muscles, nerves, bones and lungs. The side effects of radiation therapy vary from person to person and depend on factors such as the body part being treated and the type of therapy.
Radiation therapy can cause muscle weakness and dysfunction, including muscle atrophy and contracture. Patients may experience neck extensor weakness, shoulder pain and dystonia, and pain in the trapezius, rhomboids, and cervical paraspinal muscles. These issues can be treated with physical therapy, including postural retraining, core strengthening, and flexibility exercises. Radiation can also cause joint and muscle stiffness, which can be prevented with regular exercise and stretching.
Radiation fibrosis syndrome (RFS) is a serious and progressive condition that can develop as a late complication of radiation therapy. It can affect any tissue type, including skin, ligaments, tendons, muscles, nerves, lungs, and bones. RFS can cause functional and cosmetic impairments, and it may lead to death or a significant decline in quality of life. Patients being treated with radiation for head and neck cancer are at a higher risk of developing RFS due to the high doses of radiation to crucial parts of the body.
Radiation therapy can also cause skin irritation, hair loss in the treated area, low blood count, and changes in sex life and fertility. These side effects usually improve after treatment ends, but some may persist or develop months or years later. It is important to consult a healthcare professional about any concerns related to radiation therapy and its potential side effects.
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Joint stiffness
Radiation therapy can cause joint and muscle stiffness in the area being treated. This can lead to a loss of flexibility and a reduced range of motion. The stiffness may be accompanied by swelling and discomfort. Regular exercise and stretching can help prevent this. In some cases, a doctor may refer the patient to a physiotherapist for further treatment.
Radiation fibrosis syndrome (RFS) is a serious and progressive condition that can develop as a late complication of radiotherapy. It can affect any tissue type, including muscles, ligaments, tendons, and nerves. RFS can cause muscle weakness and dysfunction, as well as neuromuscular injury. Patients with RFS may experience neck extensor weakness and shoulder pain and dystonia. Treatment for RFS typically involves physical therapy, occupational therapy, and medications.
In the case of head and neck cancer treatment, RFS can lead to fibrosis of the temporomandibular joint, ligaments, and adjacent muscles. This can result in a loss of flexibility and a reduced ability to open the mouth, known as trismus. Trismus can cause difficulties in feeding, oral hygiene, speech, and weight loss.
Radiation therapy can also affect the heart and lungs, leading to conditions such as radiation pneumonitis and pulmonary fibrosis. Radiation pneumonitis involves inflammation of the lungs, which may resolve on its own or with treatment. Pulmonary fibrosis, on the other hand, is a more serious condition where the lungs become scarred and stiffened, making it difficult to breathe.
It is important to note that side effects of radiation therapy can vary from person to person and may not appear until months or even years after treatment. Patients should consult their cancer care team about any concerns and to discuss ways to manage and prevent these side effects.
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Skin irritation
Radiation therapy can cause skin irritation, including redness, peeling, itching, blistering, and dryness. The skin may also become darker or more sensitive than it was before. This usually starts 1-2 weeks after treatment begins, and the treated skin may feel like it is sunburned.
To care for your skin during radiation therapy, it is important to be gentle with it. Here are some ways to do this:
- Wear loose clothing made from soft, smooth fabrics like cotton or silk. Avoid tight, rough-textured, or stiff clothes, including anything tight or elastic that squeezes the treatment area.
- Do not starch your clothes.
- Avoid rubbing, scrubbing, scratching, or using adhesive tape on the treated skin. If your skin must be covered or bandaged, use paper tape or tape for sensitive skin and try not to put the tape in the same place each time.
- Avoid heat or cold on the treatment area without first consulting your cancer care team.
- Avoid skin products on the area during treatment and for several weeks afterward. This includes powders, creams, perfumes, deodorants, body oils, ointments, lotions, hair-removal products, or home remedies. Many skin products leave a coating on the skin that can cause irritation and may affect how much radiation enters your body.
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Hair loss
Radiation therapy can cause hair loss in the area being treated. For example, radiation to the head may cause hair loss on the head, including the eyebrows and lashes. However, radiation to the hip will not cause hair loss on the head. Hair loss from radiation therapy usually starts to grow back a few months after treatment ends, but it may be thinner and have a different texture or colour. In some cases, hair growth after radiation therapy can be patchy or permanent hair loss can occur. The extent of hair loss depends on the total dose of radiation administered, the area of the body being treated, the frequency and duration of treatment, and individual differences among patients, such as their overall health and the sensitivity of their hair follicles to radiation.
Radiation therapy can damage the hair follicles in the treated area, disrupting their normal cycle of cell division, which is necessary for hair growth. This damage can make it difficult for healthy cells in the hair follicles to recover and resume producing new hair. Higher doses of radiation are more likely to cause significant damage and potentially longer periods of hair loss. Permanent hair loss is more likely with higher doses of radiation therapy and is more common with treatment to cure a brain tumour.
If you are experiencing hair loss from radiation therapy, there are some things you can do to manage it. You may want to cover your head with a hat, scarf, or wig to protect your scalp from the sun and keep your head warm. It is recommended to choose a wig that is comfortable and adjustable and to make an appointment with a wig stylist before your hair loss begins so that they can match the colour, style, and texture of your hair. You can also try scalp cooling or cold caps to help prevent hair loss during cancer treatment, but it is important to discuss this with your oncology team first to understand its potential benefits and limitations. Additionally, ensuring adequate nutrition with a balanced diet rich in essential vitamins and minerals, such as biotin, zinc, iron, and vitamin D, can support overall hair health and contribute to the strength and vitality of new hair growth once the follicles recover. Gentle scalp massages may also help to stimulate blood circulation in the scalp and encourage hair follicles as they recover.
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Frequently asked questions
Radiation treatment can cause muscle stiffness, but it is not common. Radiation fibrosis syndrome (RFS) is a rare but serious complication of radiotherapy that affects muscles, causing muscle weakness and dysfunction, and contributing to neuromuscular injury.
Radiation fibrosis syndrome (RFS) is a progressive condition that can develop years after radiation treatment. It causes damage to healthy tissue, including skin, ligaments, tendons, muscles, nerves, bones, and lungs.
RFS can cause muscle pain, cervical dystonia, trismus (difficulty opening the mouth), painful muscle spasms, spasticity, and focal neuropathic pain.
Treatment for RFS typically involves a combination of physical therapy, occupational therapy, orthotics, and medications. Botulinum toxin injections may also be beneficial for specific complications of RFS.
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