Radiation Fatigue: How to Manage This Common Side Effect of Cancer Treatment

It's very important to remember that every person reacts differently to treatment. Any side effect you might have depends on the type and location of cancer, the dose of radiation being given, and your general health. Some people have few or no side effects, while others have quite a few.

Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.

Radiation fatigue

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One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.

Fatigue felt during radiation treatment is different from the fatigue of everyday life, and it might not get better with rest. It can last a long time and can get in the way of your usual activities. But it will usually go away over time after treatment ends.

Only you know if you have fatigue and how bad it is. No lab tests or x-rays can diagnose or describe your level of fatigue. The best measure of fatigue comes from your own report to your cancer care team. You can describe your level of fatigue as none, mild, moderate, or severe. Or you can use a scale of 0 to 10, where a 0 means no fatigue, and a 10 is the worst fatigue you could imagine.

People with brain tumors often get stereotactic radiosurgery (radiation given in one large dose) if the cancer is in only one or a few sites in the brain. Side effects depend on where the radiation is aimed. Some side effects might show up quickly, but others might not show up until 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call your doctor.

If you wear dentures, they may no longer fit well because of swollen gums. If your dentures cause sores, you may need to stop wearing them until your radiation therapy is done to keep sores from getting infected.

Your dentist may want to see you during your radiation therapy to check your teeth, talk to you about caring for your mouth and teeth, and help you deal with any problems. Most likely, you will be told to:

Breast soreness, color changes, and fluid build-up (lymphedema) will most likely go away a month or 2 after you finish radiation therapy. If fluid build-up continues to be a problem, ask your cancer care team what steps you can take. See Lymphedema for more information.

Rib fractures: In rare cases, radiation therapy may weaken the ribs, which could lead to a fracture. Be sure you understand what to look for and tell your cancer care team if you notice any of these side effects.

If your treatment includes brachytherapy (internal radiation implants), you might notice breast tenderness, tightness, redness, and bruising. You may also have some of the same side effects that happen with external radiation treatment. Let your cancer care team know about any problems you notice.

Getting radiation to the middle portion of the chest can raise your risk of heart disease. This risk increases with higher radiation doses and larger treatment areas in this part of your body. Radiation can also cause hardening of the arteries (which can make you more likely to have a heart attack later on), heart valve damage, or irregular heartbeats.

Many people have diarrhea at some point after starting radiation therapy to the abdomen. Your cancer care team may prescribe medicines or give you special instructions to help with the problem. Diet changes may also be recommended, such as:

Depending on the radiation dose, women getting radiation therapy in the pelvic area sometimes stop having menstrual periods and have other symptoms of menopause. Report these symptoms to your cancer care and ask them how to relieve these side effects.Sometimes menstrual periods will return when radiation therapy is over, but sometimes they do not.

For women: During radiation treatment to the pelvis, some women are told not to have sex. Some women may find sex painful. Treatment can also cause vaginal itching, burning, and dryness. You most likely will be able to have sex within a few weeks after treatment ends, but check with your doctor first. Some types of treatment can have long-term effects, such as scar tissue that could affect the ability of the vagina to stretch during sex. Again, your cancer care team can offer ways to help if this happens to you. You can also get more information in Sex and Women With Cancer.

American Society of Clinical Oncology (ASCO). Side effects of radiation therapy. Accessed at -cancer-care/how-cancer-treated/radiation-therapy/side-effects-radiation-therapy on December 26, 2019.

A team led by scientists at Massachusetts General Hospital (MGH) recently found that the skin produces the hormone β-endorphin in response to radiation therapy, and that elevated β-endorphin levels contribute to fatigue after treatment. The research, which is published in Science Advances, suggests that inhibiting this hormone might benefit patients.

The likely evolutionary explanation for this response was subsequently seen to involve ultraviolet-mediated maintenance of vitamin D levels. It is also known that opiate drugs can cause sedation, a common symptom associated with fatigue.

These insights prompted Fisher to wonder whether ultraviolet radiation-induced increases in β-endorphin might apply to other forms of radiation, such as ionizing radiation, which is often employed in cancer treatment.

Exposure of skin during therapeutic radiation treatment is common, leading to the question of whether skin-derived b-endorphin may help to explain the fatigue that is associated with radiation therapy.

Over the course of six weeks of radiation in rats, blood levels of β-endorphin increased, and the animals exhibited characteristics associated with opiate use (such as elevated pain thresholds) and demonstrated fatigue-like behavior. These effects were absent in rodents genetically altered to lack β-endorphin.

Many people who get radiation therapy have fatigue. Fatigue is feeling exhausted and worn out. It can happen all at once or come on slowly. People feel fatigue in different ways and you may feel more or less fatigue than someone else who is getting the same amount of radiation therapy to the same part of the body. See Fatigue and Cancer Treatment to learn more.

Other radiation therapy side effects you may have depend on the part of the body that is treated. To see which side effects you might expect, find the part of your body being treated in the following chart. Many of the side effects in the list link to more information in the Side Effects section. Discuss this chart with your doctor or nurse. Ask them about the side effects that you might expect.

Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is over. But sometimes people may have side effects that do not improve. Other side effects may show up months or years after radiation therapy is over. These are called late effects. Whether you might have late effects, and what they might be, depends on the part of your body that was treated, other cancer treatments you've had, genetics, and other factors, such as smoking.Ask your doctor or nurse which late effects you should watch for. See the section on Late Effects to learn more.

Cancer-related fatigue (CRF, sometimes simply called "cancer fatigue") is one of the most common side effects of cancer and its treatments. Many people who are chronically ill feel tired. But cancer-related fatigue goes beyond the usual tiredness. People who experience cancer fatigue often describe it as "paralyzing." Usually, it comes on suddenly and is not the result of activity or exertion. With this type of fatigue, no amount of rest or sleep helps. You feel physically, emotionally and mentally exhausted most of the time.

The exact reason for cancer fatigue is unknown. Cancer fatigue may be related to both the disease process and treatments, including surgery, chemotherapy, radiation therapy and immunotherapy. Cancer treatments commonly associated with cancer fatigue are:

Your healthcare provider will assess your symptoms. You may be asked to complete a questionnaire or rate your fatigue level. Your provider may ask you to keep a journal to track your level of fatigue and factors that might contribute to fatigue.

The best way to combat fatigue is to treat the underlying cause. Unfortunately, the exact cause may be unknown, or there may be multiple causes. There are treatments to reduce certain causes of cancer fatigue, such as anemia or hypothyroidism. Other causes must be managed on an individual basis.

The first step in treating fatigue is knowing the problem exists. Many people don't bother to mention fatigue to their doctors because they believe it is normal. It's vital that you discuss this and all symptoms or side effects with your healthcare provider. Then, efforts can be directed at determining the cause of the problem and prescribing appropriate treatment. Your particular cancer treatment regimen, with its known side effects, may provide clues for your doctor or health care professional. A simple blood test, for example, can determine if you are anemic.

Cancer fatigue may be worse if you're not eating enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy. The following strategies can help you improve your nutritional intake. 2ff7e9595c