Radiation Side Effects: What to Expect
- Radiation may be recommended alongside approaches like surgery and chemotherapy as part of the treatment path for glioma.
- The treatment, which involves applying high energy in a predetermined area of the brain and destroying malignant cells, can cause both short-term and long-term side effects.
- Potential short-term side effects include fatigue, hair loss, and sunburn-like symptoms on the scalp.
- Long-term, radiation could cause issue with vision, the brain stem, memory, and a condition known as radiation necrosis.
- It’s important to speak to your doctor about the risks vs. benefits of radiation treatment — and what sort of monitoring for side effects you should be doing.
The treatment works by applying high energy in a predetermined area of the brain and destroying malignant cells. On the one hand, it can help slow tumor growth, improve symptoms, and sometimes extend survival. On the other hand, it also carries the possibility of leading to short-term and long-term side effects.
Read MoreIs Radiation Therapy Right For Me?
Before looking into side effects, it’s important to understand why radiation is recommended for many patients with glioma. Traditional radiation therapy delivers radiation from external machines (external beam radiation therapy), while more advanced techniques — like stereotactic radiosurgery or proton therapy — deliver higher doses to the tumor while sparing nearby healthy tissue. The main goal in all cases is to eliminate or reduce tumor cells while minimizing damage to normal brain tissue.As Dr. Vempati mentioned, some symptoms like fatigue can appear during the initial phase of treatment, but fortunately, these can often be managed and are typically short-lived.
“You could have some hair loss, you could have some sunburn-like symptoms on your scalp. You could have other small side effects depending on where we are aiming the radiation,” Dr. Vempati explains.
Long-Term Complications of Radiation Therapy
It is worth knowing the potential long-term side effects of radiation therapy because it can minimize anxiety and guide you to mitigate its consequences as much as possible.
Some potential side effects include:
- Vision issues
- Brain stem issues
- Effects on memory
- Radiation necrosis (inflammatory reaction)
“Radiation therapy can cause long-term side effects depending on where we aim the radiation beams specifically,” Dr. Vempati says. “The things that I worry about are the optic nerves or optic apparatus which control your vision. There’s the brainstem, which is, I could say it’s the highway between the brain and the rest of the body. There’s also some memory structures that can be in your radiation field and they can cause some long-term memory problems.”
Radiation to areas near the optic nerve, around or pressing on the structures behind the eye, can sometimes lead to optic neuropathy. This condition may cause partial or complete vision loss in one or both eyes, and it can develop months to years after therapy. Its management includes regular eye examinations, corticosteroids, hyperbaric oxygen therapy, visual aids, and specialist support.
Addressing Side Effects
Not surprisingly, oftentimes long-term memory issues are what patients worry about the most. Thanks to research and better brain understanding, some therapies can be proposed to address this complication, including:
- Cognitive Rehabilitation: Neuropsychologists and occupational therapists can design cognitive exercises to help improve memory and attention.
- Medication: In some cases, medications that support memory and alertness may be recommended.
- Lifestyle Modifications: Stress management, adequate sleep, and engaging in mental exercises (puzzles, reading, etc.) can help optimize brain function.
Radiation Necrosis and Brain Damage
Over time, radiation can lead to scar tissue formation or necrosis (tissue death) in the brain. This can present with symptoms like headaches, seizures, or localized neurological deficits.
“There’s something called radiation necrosis. It’s where after a certain period of time, after radiation, some of the brain cells and the cancer cells, they die in the brain, and they can cause an inflammatory reaction where there are more inflammatory cells coming in,” Dr. Vempati explains. “So, there’s lots of swelling, there’s a lot of dead tissue that can cause a lot of symptoms, and that’s one of the long-term side effects of radiation that could happen.”
The current management involves high-dose corticosteroids that can reduce inflammation and swelling. Another possible option is offering hyperbaric oxygen therapy, which is sometimes used to promote healing in damaged tissue. In severe cases, neurosurgical intervention may be required to remove necrotic tissue.
Questions to Ask Your Doctor
- How can I best monitor and manage any cognitive changes I might experience?
- What steps should I take to protect my vision, and how often should I have my eyes checked?
- Do I need regular hormone level checks, and how often should they be done?
- What symptoms should prompt me to contact you immediately?
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