Side effects of radiation therapy for soft tissue sarcoma
Side effects can happen with any type of treatment for soft tissue sarcoma, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. Damage to these healthy cells may cause side effects. Side effects can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of radiation therapy will depend mainly on the:
- size of the area being treated
- specific area or organs being treated
- total dose
- treatment schedule
Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
The following are common general side effects of radiation therapy that you may have no matter which area of the body is treated.
Skin reactions occur because external beam radiation travels through the skin to reach the area being targeted for treatment. The skin in the treated area may become red or dry. It can also change colour, becoming darker or tanned looking. Most skin reactions occur within the first 2 weeks of receiving radiation therapy. They usually go away a few weeks after treatment. Some skin changes, like skin darkening or scarring, can last a long time or be permanent.
Find out more about skin problems.
Fatigue is one of the most common side effects of radiation therapy. Fatigue may be caused by anemia, poor appetite or depression. It may also be related to toxic substances that are produced when cancer cells break down and die.
During radiation therapy, the body uses more energy to heal itself, so fatigue will not always be relieved by rest. Making daily trips for radiation treatments can also be tiring. Radiation therapy to any area of the body can make you feel more tired than usual, but fatigue is more common when larger areas of the body are treated.
Fatigue usually occurs during or after the second week of radiation therapy. You may develop more symptoms of fatigue, or they may become more severe, over the course of treatment. Fatigue usually goes away gradually after treatment has ended, but some people continue to feel tired for several weeks or months after radiation therapy.
Swelling usually only occurs if a large area of an arm or leg is treated. Swelling may be caused by inflammation of the radiated cells. It can also be due to a buildup of fluid caused by damage to blood vessels, lymph vessels and lymph nodes in the area. This buildup of lymph fluid is called lymphedema.
The initial swelling should go away after radiation therapy is completed and the healthy cells have a chance to heal. It is more often linked with radiation therapy to the lower limbs than to the upper limbs. In some cases, swelling can become a long-term problem and this can be a difficult problem to treat.
Find out more about lymphedema.
Pain may be a result of inflammation and swelling caused by radiation therapy. Pain should go away once radiation therapy is finished and the area has a chance to heal. Find out more about pain.
Weakened muscles and less range of motion
Joints and muscles may be affected by radiation. Tendons and muscles in a joint can become shorter and lose their elasticity. As a result, the joint can’t move through its normal range of motion. Muscle tissues can become toughened and scar-like. This could result in a loss of muscle strength. Loss of range of motion and muscle strength could become long-term problems.
Sometimes bone within the radiation treatment area will become fragile and can break, or fracture, years after treatment. Bone fractures are more likely to occur when higher doses of radiation are used.
Nausea and vomiting
Nausea and vomiting are more common if a large area of the upper abdomen is treated with radiation. About 1–2 weeks into therapy, you may feel nauseous about 1–3 hours after your daily treatment. The potential for nausea and vomiting depends on the dose and how often radiation therapy is given. Report nausea and vomiting to the radiation therapy team. Once treatment is finished, symptoms usually go away.
Find out more about nausea and vomiting.
Diarrhea is frequent and very loose, or watery, stools. Abdominal cramping may occur with diarrhea. Diarrhea often begins 2–3 weeks into radiation therapy. It usually goes away once radiation therapy treatments are completed. Report diarrhea to the radiation therapy team. They may recommend a change in diet and can suggest over-the-counter or prescription medicines to help relieve diarrhea.
Find out more about diarrhea.
Radiation therapy to the pelvis can affect and cause problems with the reproductive organs in men and women. This can include fertility problems in both men and women. It can also cause specific reproductive organ problems for men and women.
For men, these problems can include:
- erectile dysfunction, or impotence
- ejaculation problems
For women, these problems can include:
- treatment-induced menopause
- vaginal dryness
Find out more about managing these side effects.
The intestines are very sensitive to the effects of radiation. Radiation to the pelvis can cause radiation enteritis, which is irritation or inflammation of the large and small intestines.This can cause bloody stools and a frequent urge to have a bowel movement.
Radiation can also cause a variety of digestive problems, including:
- pain or itching when having a bowel movement – if the rectal area is irritated
- narrowing, or stricture, of the rectum
- bowel obstruction, which is when the colon is partially or completely blocked
- rectal spasms
- some loss of bowel control (called partial incontinence)
- rectal bleeding
- flare-up of hemorrhoids – especially if you had them before treatment
Symptoms go away and bowel habits usually return to normal after treatment is finished. However, some symptoms may continue or develop after treatment is over. Some types of chemotherapy given at the same time as radiation therapy tend to make digestive problems worse in people with soft tissue sarcoma.
The radiation therapy team can suggest ways to help you manage digestive problems. This may include recommending a change in diet or prescribing medicines to control diarrhea and inflammation. Some people may need surgery if digestive problems are severe.
Radiation therapy to the pelvis can irritate the bladder and cause it to become inflamed. This is called cystitis. Symptoms of bladder irritation or inflammation include:
- bladder spasms
- burning or pain during urination
- intense need to urinate (called urgency)
- need to urinate often (called frequency)
- blood in the urine (called hematuria)
- urinary tract infection
- loss of bladder control (called incontinence)
Symptoms usually occur 3 to 5 weeks after radiation therapy is started and gradually go away 2 to 8 weeks after it is completed. Some symptoms, like cystitis or incontinence, may continue or develop after treatment is over.
Nausea and vomiting
Nausea and vomiting are more common if a large area of the lower chest area is treated with radiation. About 1–2 weeks into therapy, you may start to feel nauseous about 1–3 hours after your daily treatment. The potential for nausea and vomiting depends on the dose and how often radiation therapy is given. Report nausea and vomiting to the radiation therapy team. Once treatment is finished, symptoms usually go away.
Find out more about nausea and vomiting.
Difficulty swallowing is a common side effect of radiation to the head, neck and upper chest area. Swallowing may be painful because of the inflammation of the mucous membranes lining the mouth, throat and esophagus. Radiation to the mouth may cause a dry mouth, which makes swallowing difficult.
Difficulty swallowing usually starts 2–3 weeks into radiation therapy. Swallowing usually becomes easier in about 5–8 weeks, once radiation therapy is finished and the tissues have had a chance to heal. A dry mouth can become a long-term problem, which may lead to long-term swallowing problems.
Find out more about difficulty swallowing.
Lung problems can occur when the trachea and bronchi are in the radiation therapy treatment field. Common symptoms of lung damage to the trachea and bronchi include coughing and mucus in the throat and chest. Report these symptoms to the radiation therapy team.
Radiation pneumonitis is inflammation of the lung due to radiation therapy. It is more likely to occur if a large part of one lung or both lungs are treated with radiation. It sometimes starts during radiation therapy, but usually occurs about 1–3 months after treatment is completed. Find out more about radiation pneumonitis.
Pulmonary fibrosis is when lung tissue scars or stiffens due to radiation therapy. Many people don’t have symptoms with pulmonary fibrosis, but some have shortness of breath and trouble doing physical activity. Pulmonary fibrosis can occur months or years after radiation therapy.
A reduction in the number of healthy red blood cells.
The thin, moist layer of tissue that lines some organs and body cavities, including the nose, mouth, lungs, airways, vagina and gastrointestinal (GI) tract.
Glands in the mucous membrane make mucus (a thick, slippery fluid).
Also called mucosa.
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