Read more about our content writing process Last Reviewed: January 14, 2022 A late effect is a side effect that is caused by cancer treatment but happens months to years after cancer treatment has finished. Some side effects that you develop during treatment can last for months to years after treatment is completed (for example, fatigue or neuropathy). These are called long-term side effects. Late effects can be health issues or psychological, emotional, and practical challenges. Late Effects After Radiation for Lung CancerThe physical side effects of radiation treatment are directly related to the area of the body being treated. Any area in the treatment field has a risk of being damaged, causing side effects. As radiation techniques have improved over the years, the risk of late effects has decreased. Lung ProblemsRadiation that includes your lung(s) can lead to scarring (fibrosis), inflammation (pneumonitis), and restrictive or obstructive lung disease.
Swallowing ProblemsRadiation to your chest can cause scar tissue in your throat and esophagus (the tube from the mouth to the stomach). This can happen many years after radiation treatment. This scar tissue can make the throat or esophagus narrow, making it hard to swallow or cause heartburn. If you develop these issues, you should see your provider. You may benefit from seeing a gastroenterologist (GI doctor) or surgeon. They may be able to use a stent or balloon to stretch the scar tissue and open the throat/esophagus. Heart ProblemsRadiation treatment to your chest can affect your heart. This can lead to different types of heart problems, including heart failure, high blood pressure, valve problems, and scarring or inflammation of the heart tissue.
Damage to the Bones
Skin ProblemsRadiation can lead to permanent changes in the skin.
Sun SafetyAfter radiation, the skin in the treated area is more sensitive to sunlight. This sensitivity will last for your lifetime. Practice sun safety, use plenty of sunscreen, wear a wide-brimmed hat, and keep skin in the treated area covered with clothing. Try to avoid being out in the sun between the hours of 10 am-4 pm when it is the strongest. If you notice any new or worsening skin issues anywhere on your body, you should contact your provider for an assessment. Thyroid ProblemsYour thyroid gland is in your neck, just below the larynx (voice box). Radiation fields that include the thyroid gland can lead to thyroid problems, including hypothyroidism, hyperthyroidism, and thyroid nodules or tumors. Most often, thyroid issues caused by radiation happen 2-5 years after treatment. Thyroid nodules are most often seen 10 years or more after treatment. Risk is higher with higher doses of radiation.
If you notice any of these signs, you should contact your care provider. Spinal Cord DamageOccasionally, the spinal cord is in the field of lung radiation treatment. This can cause damage to the nerves in the spine.
Radiation can also cause damage to the bones of the spine. This can result in being shorter or a change in the curvature (shape) of the spine. Radiation to these bones can also put them at risk for fracture. If you have any new back pain, you should call your provider right away. You may need x-rays or other imaging tests. Nerve DamageSurvivors who received radiation to the chest or underarm area can experience nerve damage (brachial plexus nerve). This damage is often a result of scar tissue in the area compressing on the nerves or blocking the blood supply to the muscles served by these nerves.
Managing Late EffectsIf you experience any concerning or lasting symptoms, contact your care team. Some side effects require specialized care from healthcare providers experienced in working with cancer survivors. Interdisciplinary survivorships clinics are available at many cancer treatment sites. If a clinic is not available near you, talk with your oncology care team about resources for managing your late effects. After treatment, talk with your oncology team about receiving a survivorship care plan, which can help you manage the transition to survivorship and learn about life after cancer. You can create your own survivorship care plan using the OncoLife Survivorship Care Plan. American Thyroid Association, http://www.thyroid.org/ Boerma, M., Sridharan, V., Mao, X.-W., Nelson, G. A., Cheema, A. K., Koturbash, I., … Hauer-Jensen, M. (2016). Effects of ionizing radiation on the heart. Mutation Research/Reviews in Mutation Research, 770, 319–327. https://doi.org/10.1016/j.mrrev.2016.07.003Feuerstein, M., & Nekhlyudov, L. (2018). Handbook of Cancer Survivorship, 2nd. Ed. Springer, https://doi.org/10.1007/978-3-319-77432 Cella, L., D’Avino, V., Palma, G., Conson, M., Liuzzi, R., Picardi, M., ... & Pacelli, R. (2015). Modeling the risk of radiation-induced lung fibrosis: Irradiated heart tissue is as important as irradiated lung. Radiotherapy and Oncology, 117(1), 36-43. Giridhar, P., Mallick, S., Rath, G. K., & Julka, P. K. (2015). Radiation-induced lung injury: prediction, assessment, and management. Asian Pac J Cancer Prev, 16(7), 2613-7.Koontz, B. F. (2017). Radiation Therapy Treatment Effects: An Evidence-based Guide to Managing Toxicity. Springer Publishing Company. Stephenson, R.O (2019). Radiation-induced brachial plexopathy treatment & management. Retrieved from: https://emedicine.medscape.com/article/316497. Dec. 12, 2019. Stubblefield, Michael Dean. (2017). Neuromuscular complications of radiation therapy. Muscle & Nerve, 56(6), 1031–1040. https://doi.org/10.1002/mus.25778 Taunk, N. K., Haffty, B. G., Kostis, J. B., & Goyal, S. (2015). Radiation-Induced Heart Disease: Pathologic Abnormalities and Putative Mechanisms. Frontiers in Oncology, 5. https://doi.org/10.3389/fonc.2015.00039 Wei, J., Meng, L., Hou, X., Qu, C., Wang, B., Xin, Y., & Jiang, X. (2018). Radiation-induced skin reactions: Mechanism and treatment. Cancer Management and Research, 11, 167–177. https://doi.org/10.2147/CMAR.S188655 |