Side effects of radiation therapy

Breast changes

Patients may experience breast heaviness, tenderness, itchiness and swelling during radiation therapy. This typically occurs towards the end of treatment and may continue for a few weeks once radiation therapy has been completed.

Fatigue

Fatigue is a common side-effect of radiation therapy and it will differ in duration and severity. While many patients will be able to go about their daily life as normal, fatigue may persist for a few weeks after treatment completion.

Skin irritation

Radiation-induced dermatitis can range from mild ‘sunburn’ to peeling or blistering. It is usually at its most severe for 1-2 weeks then settles over the following 3-4 weeks. However, skin irritation may not develop until treatment has finished. Mepitel film may be used to reduce the skin reaction; patients should speak to their radiation oncologist about this product, as well as the use of appropriate topical creams. Patients can also reduce the risk of skin breakdown or blistering with the following strategies:

• Wear loose, light clothing (preferably non-synthetic materials) over the area being treated to reduce friction between skin and clothing.
• Avoid irritants on the treated skin (e.g. hot water, lotions). Use gentle soaps suited to sensitive skin.
• Avoid heat in the treated area (e.g. hair dryers, electric hot pads, hot water bottles, sun)
• Do not use adhesive tapes or sticking platers on the skin in the treated area.

Brachial plexopathy

This is a rare side effect from radiation therapy, caused by damage to the brachial plexus. Symptoms include burning, tingling or numbness in the shoulder, arm or hand. Treatment involves physiotherapy, pain management or surgical repair.

Breast changes

Radiation therapy can cause the breast to feel firmer or slightly smaller in volume. Patients may experience some permanent discolouration of the skin in the area and the formation of visible small red blood vessels.

Heart disease

Radiation therapy to breast cancers occurring in the left breast will result in the potential for a small area of the heart to be exposed to the radiation field. The risk of heart disease will increase depending on the volume of heart treated and the dose delivered to the heart.

Radiation pneumonitis

Radiation therapy can cause inflammation and scarring of the lung, resulting in radiation pneumonitis. Onset is from two to three months after treatment completion. Symptoms are similar to pneumonia (e.g. breathlessness, dry cough, chest pain), but do not resolve with antibiotics. Patients can be treated with steroids, which usually resolves the condition.

Tissue damage

There may be a small risk of long-term damage to tissue in the treatment area ( e.g. changes in the lungs underlying the chest wall, rib fracture).