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Late Side Effects Of Radiotherapy For Breast Cancer

Association Of Antihormonal Therapy With Long

Late effects of radiotherapy for breast cancer

Compared to patients who did not receive endocrine therapy, those who used antihormonal drugs more often reported hot flashes and vaginal dryness , while hair loss was less common . Dry eyes and visual disturbances were experienced by roughly one-third of patients taking these drugs.

Among the subclasses of antihormonal drugs, aromatase inhibitors were associated with a relatively high prevalence of joint pain, whereas loss of libido was prevalent with gonadotropin-releasing hormone analogs .

Early And Late Effects Of Radiation Therapy

  • Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. Theyre usually gone within a few weeks after treatment ends. The most common early side effects are fatigue and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.
  • Late side effects can take months or even years to develop. They can occur in any normal tissue in the body that has received radiation. The risk of late side effects depends on the area treated as well as the radiation dose that was used. Careful treatment planning can help avoid serious long-term side effects. Its always best to talk to your radiation oncologist about the risk of long-term side effects.

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How Long Side Effects May Last

Radiation therapy can cause side effects during and just after treatment. These are called short-term or acute effects. It can also cause long-term or late effects months or years down the track. Most side effects go away after treatment. But sometimes radiation therapy can cause long term or late effects months or years down the track.

During treatment, tell your radiation therapy team about any side effects, as side effects can usually be controlled with the right care and medicine.

Learn more about:

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If Youre Getting Radiation Therapy To The Chest

Radiation treatment to the chest may cause side effects such as:

Radiation can also cause other problems in the heart or lungs.

Heart complications

Getting radiation to the middle portion of the chest can raise your risk of heart disease. This risk increases with higher radiation doses and larger treatment areas in this part of your body. Radiation can also cause hardening of the arteries , heart valve damage, or irregular heartbeats.

Radiation pneumonitis

Radiation pneumonitis is inflammation of the lungs that can be caused by radiation treatment to the chest . It may occur about 3 to 6 months after getting radiation therapy. Its more likely if you have other lung diseases, like emphysema . Common symptoms of radiation pneumonitis include:

  • Shortness of breath that usually gets worse with exercise
  • Chest pain, which is often worse when taking in a deep breath

Sometimes there are no symptoms, and radiation pneumonitis is found on a chest x-ray.

Symptoms often go away on their own, but if treatment is needed, it is based on trying to decrease the inflammation. Steroids, like prednisone, are usually used. With treatment, most people recover without any lasting effects. But if it persists, it can lead to pulmonary fibrosis . When this happens, the lungs can no longer fully inflate and take in air.

Be sure you understand what to look for, and tell your cancer care team if you notice any of these side effects.

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What Is Brachytherapy Radiation

Cureus

Brachytherapy is a type of radiation therapy that generates radiation from within the body. In comparison with external beam radiation, which projects particles of radiation from outside the body, brachytherapy can deliver higher doses of radiation in a precise fashion, resulting in fewer side effects and shorter treatment times.

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If You Have Side Effects

Let your doctor or nurse know if you have side effects or are worried about anything.

When treatment ends you usually have regular appointments for about 5 years afterwards. You can talk to your doctor or nurse at these appointments. But you don’t have to wait for your next appointment if you get a new side effect or are worried about anything. You can bring the appointment forward.

  • National Institute for Health and Care Excellence June 2018

  • Treatment of primary breast cancerScottish Intercollegiate Guidelines Network, September 2013

  • Postoperative radiotherapy for Breast Cancer: UK consensus statement

    The Royal College of Radiologists, 2016

  • Early Breast Cancer: ESMO Clinical Practice Guidelines 2019F Cardoso and others

Long Term Effects On The Pelvis

The pelvis is the area between your hips. Radiotherapy to the pelvic area might cause:

  • changes to your bowel habit
  • bladder inflammation causing pain in your tummy and feeling like you need to pass urine more often
  • fine cracks in the pelvic bones
  • your digestive system to stop taking in vitamin B12 from the food you eat – this can cause a vitamin B12 deficiency
  • tingling, weakness or loss of sensation in one or both legs this is very rare and is called radiotherapy induced lumbosacral plexopathy
  • weaker pelvic bones – you might have a DEXA scan to check them

These changes can gradually appear over a long time, sometimes several years. Talk to your doctor if you had radiotherapy in the past and are worried about side effects.

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What Are Late Effects Of Cancer Treatment

Late effects are problems caused by cancer treatment that may not show up for months or years after treatment. These problems are specific to certain types of treatments and the dose received. Like side effects that you may have during treatment, late effects differ greatly from person to person. You may have problems that are very different from someone elses, even if they had the same type of cancer and treatment. When you discuss follow-up care with your doctor, you may want to ask about which late effects to watch for. Early medical attention can prevent or help better manage late effects. See Follow-Up Medical Care to learn more.

Living a healthy lifestyle can help you feel better overall and manage certain late effects, such as heart and lung problems. See Guidelines for a Healthy Lifestyle to learn more.

Can Radiation Therapy Cause Breast Cancer

Having radiotherapy for breast cancer – Part Three: Side Effects and Support

Radiation therapy can cause harm to normal tissue during and after treatment in people who have certain inherited gene mutations. In some women at higher risk of breast cancer recurrence, radiation therapy may still be used. Past radiation therapy to the same breast or to the same side of the chest.

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When Should I Call The Doctor

You should call your healthcare provider if you experience:

  • Severe skin or breast inflammation.
  • Signs of infection, such as fever, chills or weeping skin wounds.

A note from Cleveland Clinic

Radiation therapy can lower the risk of cancer recurrence and cancer spread. The treatment affects everyone differently. Most side effects go away in a few months after treatments end. Some problems last longer. You should tell your healthcare provider about any problems you have while getting treatment. Your provider may change the therapy slightly to minimize issues while still effectively treating the cancer.

Last reviewed by a Cleveland Clinic medical professional on 03/19/2021.

References

Late Complications Of Radiation Therapy For Breast Cancer: Evolution In Techniques And Risk Over Time

Zachary Brownlee1, Rashi Garg1, Matthew Listo1, Peter Zavitsanos1, David E. Wazer1,2, Kathryn E. Huber1

1Department of Radiation Oncology, Tufts Medical Center and Tufts University School of Medicine , Rhode Island Hospital and Brown University School of Medicine , , USA

Contributions: Conception and design: DE Wazer, KE Huber Administrative support: KE Huber Provision of study materials or patients: None Collection and assembly of data: None Data analysis and interpretation: None Manuscript writing: All authors Final approval of manuscript: All authors.

Correspondence to:

Abstract: Radiation therapy in combination with surgery, chemotherapy, and endocrine therapy as indicated, has led to excellent local and distant control of early stage breast cancers. With the majority of these patients surviving long term, mitigating the probability and severity of late toxicities is vital. Radiation to the breast, with or without additional fields for nodal coverage, has the potential to negatively impact long term cosmetic outcome of the treated breast as well as cause rare, but severe, complications due to incidental dosage to the heart, lungs and contralateral breast. The long-term clinical side-effects of breast radiation have been studied extensively. This review aims to discuss the risk of developing late complications following breast radiation and how modern techniques can be used to diminish these risks.

Keywords: Radiation breast cancer late toxicity

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What Is Radiation Recall

Radiation recall is a rash that looks like a severe sunburn. It is rare but it can happen when certain types of chemotherapy are given during or soon after external-beam radiation therapy.

The rash appears on the part of the body that received radiation therapy. Symptoms may include redness, tenderness, swelling, wet sores, and peeling skin.

Typically, these effects start within days or weeks of starting radiation therapy. But they can also appear months or years later. Doctors treat radiation recall with medications called corticosteroids. Rarely, it may be necessary to wait until the skin heals to continue with chemotherapy.

Does Radiation Cause Pain In The Shoulder Area

Pin on Fighting the fight

Pain: Some people experience mild discomfort or pain around the breast, or stiffness in the shoulder area. Over time, treatments should become less uncomfortable. Skin changes: Skin damage is a common side effect of radiation therapy, and having a good skin care routine is essential during treatment.

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Nerve Damage Around The Treatment Area

Scaring from radiotherapy may cause nerve damage in the arm on the treated side. This can develop many years after your treatment. Symptoms include tingling, numbness, pain, and weakness. In some people, it may cause some loss of movement in the arm and shoulder.

Speak to your doctor if you notice any of these symptoms.

What Are Common Side Effects Of Radiation Therapy

Radiation therapy is called a local treatment. This means that it only affects the area of the body that is targeted. For example, radiation therapy to the scalp may cause hair loss. But people who have radiation therapy to other parts of their body do not usually lose the hair on their head.

Common physical side effects of radiation therapy include:

Skin changes. Some people who receive radiation therapy experience dryness, itching, blistering, or peeling. These side effects depend on which part of the body received radiation therapy and other factors. Skin changes from radiation therapy usually go away a few weeks after treatment ends. If skin damage becomes a serious problem, your doctor may change your treatment plan. Lotion may help with skin changes, but be sure to check with your nurse or other health care team about which cream they recommend and when to apply it. It is also best to protect affected skin from the sun. Learn more about skin-related side effects.

Fatigue. Fatigue is a term used to describe feeling tired or exhausted almost all the time. Many patients experience fatigue. Your level of fatigue often depends on your treatment plan. For example, radiation therapy combined with chemotherapy may result in more fatigue. Learn how to cope with fatigue.

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How Long Will My Follow

You will have follow-up appointments for some time after your treatment. Exactly how long will depend on your cancer, any side effects of treatment and the services in your area. You will usually have appointments for several years.

After your follow-up appointments finish, you may continue to have PSA tests. Speak to your GP if you have any problems or concerns they can refer you back to the hospital. Make sure you remind them about your prostate cancer, especially if its been a while since you had treatment or a PSA test.

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When Does Someone With Breast Cancer Get Radiation Therapy

Late effects of pelvic radiotherapy – Macmillan Cancer Support

The timing for radiation therapy depends on several factors. The treatment may take place:

  • After a lumpectomy: A lumpectomy removes the cancerous tumor, leaving most of the breast. Radiation therapy lowers your risk of cancer coming back in the remaining breast tissue or nearby lymph nodes as well as reduces your chance of passing away of breast cancer.
  • After a mastectomy: Most people dont get radiation therapy after a mastectomy . Your provider may recommend radiation if the tumor was larger than 5 cm if theres cancer in surrounding lymph nodes, skin tissue or muscle or if all the cancer cant be removed .
  • Before surgery: Rarely, healthcare providers use radiation to shrink a tumor before surgery.
  • Instead of surgery: Sometimes, providers use radiation therapy to shrink a tumor that they cant surgically remove . A tumor may be unresectable due to its size or location. Or you may not be a candidate for surgery because of concerns about your health.
  • To treat cancer spread: Stage 4 breast cancer is cancer that spreads to other parts of the body. Your provider may use radiation therapy to treat cancer that spreads to other parts of the body.

If you had surgery, radiation therapy typically starts about one month after the incision heals if chemotherapy is not received. Some individuals receive chemotherapy after surgery, followed by radiation therapy. You may get the two treatments at the same time.

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Concentration And Memory Problems

After treatment for breast cancer, some women have difficulties concentrating and remembering things. Doctors call this cognitive impairment.

It is also sometimes called chemo brain or chemo fog. But these changes can also happen with other cancer treatments, such as hormonal therapy.

An early menopause may result in similar symptoms, or make them worse.

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Intensity Modulated Radiation Therapy

IMRT, an advanced form of 3D-CRT therapy, is the most common type of external beam radiation therapy for prostate cancer. It uses a computer-driven machine that moves around the patient as it delivers radiation. Along with shaping the beams and aiming them at the prostate from several angles, the intensity of the beams can be adjusted to limit the doses of radiation reaching nearby normal tissues. This lets doctors deliver an even higher radiation dose to the cancer.

Some newer radiation machines have imaging scanners built into them. This advance, known as image guided radiation therapy , lets the doctor take pictures of the prostate just before giving the radiation to make minor adjustments in aiming. This appears to help deliver the radiation even more precisely and results in fewer side effects.

A variation of IMRT is called volumetric modulated arc therapy . It uses a machine that delivers radiation quickly as it rotates once around the body. This allows each treatment to be given over just a few minutes. Although this can be more convenient for the patient, it hasnt yet been shown to be more effective than regular IMRT.

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If Youre Getting Radiation Therapy To The Abdomen

If you are getting radiation to your stomach or some part of the abdomen , you may have side effects such as:

Eating or avoiding certain foods can help with some of these problems, so diet planning is an important part of radiation treatment of the stomach or abdomen. Ask your cancer care team about what you can expect, and what medicines you should take to help relieve these problems. Check with your cancer care team about any home remedies or over-the-counter drugs youre thinking about using.

These problems should get better when treatment is over.

Managing nausea

Some people feel queasy for a few hours right after radiation therapy. If you have this problem, try not eating for a couple of hours before and after your treatment. You may handle the treatment better on an empty stomach. If the problem doesnt go away, ask your cancer care team about medicines to help prevent and treat nausea. Be sure to take the medicine exactly as you are told to do.

If you notice nausea before your treatment, try eating a bland snack, like toast or crackers, and try to relax as much as possible. See Nausea and Vomiting to get tips to help an upset stomach and learn more about how to manage these side effects.

Managing diarrhea

Many people have diarrhea at some point after starting radiation therapy to the abdomen. Your cancer care team may prescribe medicines or give you special instructions to help with the problem. Diet changes may also be recommended, such as:

What Should You Avoid During Radiation

Radiation Therapy For Breast Cancer Side Effects

Spicy Foods Radiation often causes nausea, loose stools, or constipation. Spicy foods can further irritate the stomach and the rectum and cause discomfort. Raw Fish/Shellfish Radiation therapy kills healthy cells in addition to cancerous cells, which could reduce the strength of your immune system.

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Will Radiation Therapy Cause My Hair To Fall Out

Only people who get radiation to the scalp or the brain may have hair loss. Others won’t. If it does happen, itâs usually sudden and comes out in clumps. In most cases, your hair will grow back after therapy stops, but it may be thinner or have a different texture.

Some people choose to cut their hair short before treatment begins to make less weight on the hair shaft. If you lose hair on top of your head, be sure to wear a hat or a scarf to protect your scalp from the sun when you go outside. If you decide to buy a wig, ask the doctor to write a prescription for one and check to see if it’s covered by your insurance or is a tax-deductible expense.

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