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Complications from radiation.
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12/25/16 23:55
Angetori 
12/25/16 23:55
Angetori 
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
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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.

12/26/16 10:40
spanishbuddha 

Administrator

12/26/16 10:40
spanishbuddha 

Administrator

Re: Complications from radiation.

I think you need to discuss this with your radiologist. The common side effects of RT used when treating cancers, especially the ones you refer to here, do not usually occur with the low dose and depth used to treat LD and DD. Comparison of the treatment regimes using RT for cancer and LD/DD is really not helpful. But there are side effects using RT for LD and DD, short and long term, with some commonalities that affect people differently and you should have been given advice on what to look for and what to do. I was given a one page sheet and sure enough had some. I'm sorry to hear you are still having ongoing difficulties. It could be the RT has created inflammation or promoted some of the side effects. I think you were treated in September? That's still relatively early, but a hopefully reassuring discussion with your doctor and radiologist might be useful. Sadly the success rate is not 100% but it is still too early to say if your treatment is a failure.

Edited 12/26/16 10:41

12/26/16 15:53
Angetori 
12/26/16 15:53
Angetori 
Re: Complications from radiation.

Thanks for getting back to me SB,
I have an appointment with my radiologist on Thursday as a follow-up from my RT in September. I will be sure to ask him these questions and I will post any information that he gives me that I feel would be helpful to anyone else going through issues after RT .

12/31/16 05:13
Angetori 
12/31/16 05:13
Angetori 
Re: Complications from radiation.

Just a follow up: I saw my radiologist and he told me I have swelling all around the irradiated area in both feet and also confirmed that my nodules have progressed a bit. He put me on two weeks of anti inflammatories. I am also to massage 1%cortisone on my feet two times a day to help with swelling. And Continue icing two times a day.
If nothing gets better in two weeks I am to call him and he will put me on stronger anti inflammatories. My guess is a steroid... but hoping what he's got me on will take some of this swelling down.

01/04/17 13:02
LenaPippins 
01/04/17 13:02
LenaPippins 
Re: Complications from radiation.

Yes, radiation therapy has several side effects when high dose radiation is given. But if you go for proper treatments and therapies you will not face many problems. Low dose rate radiation therapy can also be given to the patient to cure the cancer. Moreover, it depends on how your body responds to the treatments and medicines provided by your doctor. You can check this out for your treatments and other radiation therapies. (http://www.advancedradiationcenters.com/)

01/04/17 13:03
LenaPippins 
01/04/17 13:03
LenaPippins 
Re: Complications from radiation.

Hope you recover soon and your body responds to the treatment positively.

01/04/17 13:27
Angetori 
01/04/17 13:27
Angetori 
Re: Complications from radiation.

Thank you Lena. That's was very helpful. I am keeping my fingers crossed that things calm down.
Any new developments I will post.
Jeanne

09/09/19 08:30
morgain 
09/09/19 08:30
morgain 
Re: Complications from radiation.

Hi, I live in UK and have recently finished 2nd round RT for my left foot, coming up to 8 weeks post RT. I have four known nodules, very small but very painful. After the first round of RT I did experience quite a lot of pain in the foot right up to going for the second round, however after that round I didn't get any pain hardly and found I was able to stand longer even and walk a bit longer. But last weekend the pain kicked in again, quite intense, and I am wondering even if a new nodule has started, its so difficult to locate where its coming as the whole foot is in pain. I know a new nodule can grow any time. My question is am I being too impatient, though its difficult not to, as I am not even 12 weeks post 2nd round RT, and I do know it takes a year really as the RT carries on working. Its just getting me down after having had 6 weeks of limited pain and more mobility. Any suggestions would be most welcome.

09/09/19 18:46
spanishbuddha 

Administrator

09/09/19 18:46
spanishbuddha 

Administrator

Re: Complications from radiation.

morgain:
Hi, I live in UK and have recently finished 2nd round RT for my left foot, coming up to 8 weeks post RT. I have four known nodules, very small but very painful. After the first round of RT I did experience quite a lot of pain in the foot right up to going for the second round, however after that round I didn't get any pain hardly and found I was able to stand longer even and walk a bit longer. But last weekend the pain kicked in again, quite intense, and I am wondering even if a new nodule has started, its so difficult to locate where its coming as the whole foot is in pain. I know a new nodule can grow any time. My question is am I being too impatient, though its difficult not to, as I am not even 12 weeks post 2nd round RT, and I do know it takes a year really as the RT carries on working. Its just getting me down after having had 6 weeks of limited pain and more mobility. Any suggestions would be most welcome.
The previous posts in the thread might be quite helpful? Have you asked the treating radiologist? It could be short term inflammation. Try soothing footbaths, keeping the foot high, etc. For DD in one of my hands it took 18 months or so before I was convinced RT had helped, and in that period I had ongoing symptoms. Many people report short term increase in pain, heat, symptoms after RT. But, consult with your radiologist.

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