12/25/2016 21:55
Angetori
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Complications from radiation.
I have been posting recently that I have been having some complications since my radiation for my LD on both feet. I am definitely noticing some inflammation and progression in the nodules on my feet. I came across this article and was concerned that this might be something that's happening to me. For some reason I never heard of radiation fibrosis nor was I told about it prior to my radiating my feet.
Has anybody heard about this? Radiation Fibrosis Syndrome: What It Is and How to Treat It Thumbnail
SEE MORE EXPERT SPEAKS CANCERFORWARD | BY MICHAEL D. STUBBLEFIELD, MD Radiation therapy, like surgery and chemotherapy, is a mainstay of cancer treatment. The reason radiation is used to treat cancer is that it is usually toxic to the fast growing cancer cells while supposedly having little adverse effects on the slow growing and relatively radiation resistant normal body cells. Unfortunately, normal cells are often affected by radiation in a variety of ways, especially over time. One of these changes is the abnormal production of the protein, fibrin, which accumulates in and damages the radiated tissue. This process is known as radiation fibrosis (RF).
Any tissue within the radiation field can be affected including nerves, muscles, blood vessels, bones, tendons, ligaments, heart or lungs. The clinical manifestations (i.e., signs and symptoms) that result from RF are called radiation fibrosis syndrome (RFS). RF can occur a few weeks or months after radiation treatment and continues for the duration of a cancer survivor’s life. The patient and their doctor may not notice RFS until years after treatment. Unfortunately, there is no way to stop the progressive RF that results from radiation treatment. There are, however, ways to treat the signs and symptoms of RFS and improve the quality of life of most patients afflicted by this disorder.
Not all patients treated with radiation develop clinically significant RFS. Standard therapy for common disorders such as prostate and breast cancers use limited radiation fields (the part of a person’s body treated with radiation) in doses that are generally well tolerated. Only patients who are very sensitive to the effects of radiation will experience complications. Radiation treatment for other types of cancer, however, may produce a much higher risk of developing RFS. Patients treated with mantle field, periaortic, inverted-Y, or total nodal radiation therapies for Hodgkin lymphoma (HL), especially if given before the 1990’s, are at particular risk of developing RFS since much higher doses of radiation were generally used. Similarly, patients with head and neck cancer (HNC) may also have a higher risk for developing RFS due to the high doses of radiation they receive and the critical structures that are often included in the radiation treatment field.
The clinical complications of RFS vary greatly from patient to patient and depend upon a number of factors. These factors include the type and dose of radiation given, how the radiation was delivered (i.e., how many treatment sessions), and perhaps most importantly, the radiation field. Other critically important determinates of how the radiation is tolerated include the age of the patient, their overall health, and any medical co-morbidities such as diabetes, heart disease, and arthritis. Radiation issues tend to worsen over time; the more time that has elapsed since treatment, the more likely a patient is to develop RFS. This tends to cause much confusion for both patients and their physicians who often have difficulty believing that a new symptom they develop could be due to in whole or in part to radiation they received years or even decades ago.
It is impossible to cover all the potential complications resulting from radiation in a short article since literally every organ system in the body can be affected. If a large area of the body is affected, as in the case of HL survivors, then very significant side effects can result. The two most ominous late-term effects faced by many HL survivors treated with mantle and other types of radiation are a greatly elevated risk of secondary cancers and cardiac disease. Multiple cancers are seen including thyroid, breast and lung cancers as well as sarcomas. Cardiac disease not only includes accelerated atherosclerosis, but valvular heart disease, pericardial disease, cardiomyopathy, and arrhythmias. Close monitoring is recommended to help identify and manage problems early.
Neuromuscular and functional problems are also very common in HL survivors. The spinal cord, nerve roots, plexus, peripheral nerves, and muscles within the radiation field can be affected. Common manifestations of radiation treatment in HL survivors include neck extensor weakness (a.k.a., dropped head sydrome), neck and shoulder pain, weakness, fatigue, gait and dexterity problems, numbness, tingling, and difficulty performing activities of daily living.
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