Head And Neck Radiation Side Effects

Radiation therapy is a treatment for cancer that uses high-energy particles to kill cells. The most common form of this type of radiation comes from radioactive materials called x-rays. However, there are other forms, too, including protons, neutrons, electrons, and photons. People can be treated with these various types of radiation by themselves or through a machine. In some cases, they may need to go into a specific room within an accelerator where a particle beam is generated. This room is known as a synchrotron.

In general, radiation therapy kills tumors using two methods. One method involves targeting tumor cells directly. A second method aims at killing all the cells around the tumor. The latter, also known as “scatter” radiation, can come from outside the body. It works because it kills normal cells along with cancerous ones. Scatter radiation is often used when doctors want to destroy tumors without destroying surrounding healthy tissue. When scatter radiation reaches the skin, it causes damage to cells underneath the surface.

With proper care, people can usually recover fairly quickly after receiving radiation treatments. But sometimes they do not fully recover and experience long term complications instead. With radiation directed at the head and neck area, people may experience certain side effects, such as dry mouth, trouble swallowing, changes in taste, nausea, ear aches, tooth decay, swelling in the gums, throat, or neck, and more. If you are considering getting radiation therapy to treat your head and neck, talk to your doctor about how likely you are to develop these possible side effects before treatment begins.

What are some potential side effects of radiation therapy?
Soreness (or even open sores) in the mouth or throat. Dry mouth. Trouble swallowing. Changes in taste. Nausea.Earache. Tooth decay. Swelling in the gums, throat, or neck.

What happens during radiation therapy?
During radiation therapy, patients lie on their backs. Their heads and necks rest inside lead shields. These shields protect them from scattered radiation beams. The patient’s entire body is wrapped in sheets soaked in glycerin — this helps reduce friction between the sheet and the body. Patients wear masks while lying down so that their airways remain clear. They breathe through small plastic tubes that bring fresh oxygenated air into their lungs. Special machines help move their bodies inside the radiation treatment room. Some machines use magnetic fields or inflatable cushions to keep the body from moving too much. Other machines use special wedges to immobilize the body.

How does radiation therapy work?

The goal of radiation therapy is to deliver enough radiation to kill cancer cells while keeping doses low enough to avoid damaging noncancerous tissues. There are three ways to control the dose of radiation:

1. Dose limitation – Doctors set a maximum dosage limit per fraction (the time the radiation beam stays active). For example, if there is one thousand times less radiation than what would cause severe injury to someone’s eyes, then the radiation dose will be limited to 3 milliGrays (mGy), which equals 0.3 Gy.

2. Beam shaping – Doses can be controlled throughout the course of treatment by directing different parts of the beam at different areas. For instance, doctors may decide to direct part of the radiation toward only one eye, rather than both eyes, to minimize the risk of retinal damage. Or they may choose to spread out the beam over the whole face to increase the amount of radiation reaching the tumor.

3. Targeting – Different areas of the body receive higher concentrations of radiation. For instance, the brain has very little blood flow, making it difficult for any kind of drugs to reach it. Therefore, doctors typically target the brain with high-dose radiation. However, the lining of the esophagus has lots of blood vessels, making it easier for chemotherapy drugs to attack cancer cells here. As a result, doctors give the esophagus lower doses of radiation than the brain receives.

When should I call my doctor?

Call your doctor right away if you notice any of the following symptoms:
1. Pain or tenderness in the area where you received radiation therapy. This could indicate infection due to damaged tissue. You should see your doctor immediately to find out whether you developed an infection.
2. Fever. If you got radiation therapy and feel unusually warm, especially if you’ve been taking fever reducers, you may have a fever. Call your doctor if your temperature rises above 100 degrees Fahrenheit (38 degrees Celsius). Your doctor may prescribe medicine to relieve your fever.
3. Red streaks or spots near the site of the radiation therapy. See your doctor right away if you notice red lines or patches near the area where you got radiation. These could mean several things but generally aren’t serious. Your doctor can determine exactly what caused them.
4. Open sore(s) in the area where you got radiation. You may think that you are healing fine, but a small opening means that bacteria was able to enter your wound. Get medical attention right away if you start seeing the edges of a wound separating or pus forming.
5. Stitches. Rarely, stitches may become infected. Check with your doctor if you notice any signs of infection, such as redness, drainage, pain, or odor, after surgery.
6. Slurred speech. Slowed speech may occur in people who had radiation therapy to the nerves that affect the voice box. Talk to your doctor about how to handle this problem.
7. Hoarseness or loss of vocal cords tone. Loss of vocal cords tone may happen in people who had radiation therapy to the larynx (voice box). Discuss with your doctor how to handle this problem.
8. Difficulty breathing. Breathing problems may occur in people who had radiation therapy to the chest. See your doctor right away if you notice difficulty breathing or shortness of breath.
9. Swollen glands. Enlarged lymph nodes may appear under the arm or around the collarbone. See your doctor right away if you notice swollen glands anywhere in your body. Lymph node swelling can be caused by many conditions and needs to be investigated further.
10. Weight gain. You may put on more weight after radiation therapy. Make sure that you eat extra food to compensate for lost appetite.
11. Feeling tired or weak. Feeling fatigue or weakness may occur during or after radiation therapy. This may happen because of lowered blood counts or liver toxicity. Seek medical attention if you notice any of these symptoms.
12. Diarrhea. Irritable bowel syndrome can make diarrhea worse. Call your doctor if you notice persistent diarrhea.
13. Headaches. Usually headaches improve after the radiation stops.
14. Mouth sores. Soreness (or even open sores) in the mouth or throat may last longer than expected. If this occurs, contact your doctor right away.
15. Eye disorders. Blurring vision, double vision, itching, burning, tearing, or sensitivity to light may occur soon after radiation therapy ends. Contact your doctor if you notice any of these symptoms.
16. Skin rashes. A variety of rashes can show up on the skin shortly after radiation therapy ends. If this happens, discuss with your doctor how to best care for yourself.
17. Itching. Persistent itching may occur in people who had radiation therapy to the scalp. See your doctor right away if you notice itching.
18. Hair loss. After radiation therapy, hair may fall out. Don’t worry; it will grow back.
19. Tender breasts. Women may find that their breast becomes sensitive after radiation therapy.
20. Vaginal discharge. Discharge may occur in women who got radiation therapy to the vagina. This is usually minor and temporary.
21. Menstrual cramps. Menstrual cramps may worsen during or after radiation therapy. Talk to your doctor about this problem.
22. Abdominal bloating. Abdomen may swell during or after radiation therapy. Avoid constricting clothing.
23. Chest tightness. Chest tightness may occur during or after radiation therapy. Keep your distance from smoke and fumes.
24. Difficult urination. Urinating may become painful or harder during or after radiation therapy. Try walking in a warm shower or bath prior to going to bed. Also try drinking fluids.
25. Change in sexual ability. Sexual function may change during or after radiation therapy. Discuss with your doctor about this problem.
26. Swelling in the groin. Swelling in the groin may occur during or after radiation therapy. Discontinue wearing tight fitting underwear.
27. Leg edema. Edema may occur in the legs during or after radiation therapy. Wear comfortable shoes.
28. Pregnancy-related issues. If you’re pregnant, ask your health provider about the risks associated with radiation therapy.
29. Bleeding gums. Gums may bleed during or after radiation therapy. Use dental floss or gauze to stop bleeding.
30. Shortness of breath. Shortness of breath may occur during or after radiation therapy. Consult your doctor right away if you notice this symptom.

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