RADIATION THERAPY SIDE EFFECTS

Radiation Therapy Effects

Radiation therapy can cause side effects by damaging normal, healthy cells near the cancer. Follow the links below to learn about the most common side effects from radiation therapy.

Taking care of yourself during radiation therapy

Radiation therapy can damage healthy body tissues in or near the area being treated, which can cause side effects. Many people worry about this part of their cancer treatment. Before treatment, talk with your cancer care team about what you might expect.

You need to take special care of yourself to protect your health during radiation treatment. Your cancer care team will give you advice based on your treatment plan and the side effects you might have.

Here are some general tips:

• Be sure to get plenty of rest. You may feel more tired than normal. Try to get good, restful sleep at night. Severe tiredness, called fatigue (fuh-TEEG), may last for several weeks after your treatment ends. See “Fatigue” in the “Common side effects of radiation therapy” section for more information.
• Eat a balanced, healthy diet. Depending on the part of your body getting radiation, your cancer care team may suggest changes in your diet. You can learn more about eating well in our booklet Nutrition for the Person With Cancer During Treatment: A Guide for Patients and Families.
• Tell your cancer care team about all medicines and supplements you are taking. Give your team a full list of everything you take and how often you take it, even things like aspirin, vitamins, or herbs. Don’t forget those you take only when you need them, such as sleep aids, antacids, headache remedies, and antihistamines.
• Take care of the skin in the treatment area. If you get external radiation therapy, the skin in the treatment area may become more sensitive or look and feel sunburned. Ask your cancer care team before using any soaps, lotions, deodorants, medicines, perfumes, cosmetics, powder, or anything else on the treated area. Some of these products may irritate sensitive skin. See “Skin problems” in the “Common side effects of radiation therapy” section for more on this.

How will I feel emotionally?

Many patients feel tired during radiation therapy, and this can affect emotions. You also might feel depressed, afraid, angry, frustrated, alone, or helpless.

We have a lot of information that can help you understand and manage the emotional changes that often come with cancer and cancer treatment. You can read more on website, www.cancer.org,

Getting involved with a support group and meeting other people with cancer may help you. Ask your cancer care team or call the American Cancer Society to learn more about ways to connect with others who share your problems and concerns.

Will side effects limit my activity?

Side effects might limit your ability to do some things. But what you can do will depend on how you feel. Talk to your cancer care team about this. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and can’t do as much. Your team may suggest you limit activities that might irritate the area being treated.

Side effects can vary.

Your cancer care team can tell you about your treatment, likely side effects, and things you need to do to take care of yourself. They can also talk to you about any other medical concerns you have. Tell them about any changes in the way you feel and any side effects you have, including skin changes, tiredness, diarrhea, or trouble eating. Be sure that you understand any home care instructions and know whom to call if you have more questions. Also be sure you know what to do if you need help after office hours, in case you have problems at night or on the weekend.

Side effects vary from person to person and depend on the radiation dose, the part of the body being treated, and other factors. Some people have no side effects at all, while others have quite a few. There’s no way to know who might have side effects.

How long do side effects last?

Radiation therapy can cause early and late side effects.

• Early side effects are those that happen during or shortly after treatment. They’re usually gone within a few weeks after treatment ends.
• Late side effects can take months or even years to develop. They’re often (but not always) permanent.

The most common early side effects are fatigue (feeling tired) and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to the head.

Most side effects go away in time. In the meantime, there are ways to reduce the discomfort they may cause. If you have bad side effects, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment you’re getting. Tell your cancer care team about any side effects you notice so they can help you with them. The information here can serve as a guide to handling some side effects, but it can’t replace talking with your team about what’s happening to you.

People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your cancer care team. If needed, they should be able to suggest ways to help you feel better.

Radioprotective drugs

Doctors look for ways to reduce side effects caused by radiation therapy while still using the doses needed to kill cancer cells. One way to reduce side effects is by using radioprotective (RAY-dee-o pro-TEK-tiv) drugs. These are drugs that 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.

Radioprotective drugs are an active area of research. At this time not all doctors agree how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.

CAUSES, RISK AND PREVENTION OF ADRENAL CANCER

what causes adrenal cancer?

We do not know exactly what causes most adrenal cortical tumors. Over the past several years, experts have made great progress in understanding how certain changes in a person's DNA can cause cells in the adrenal gland to become cancerous. DNA is the molecule that carries the instructions for nearly everything our cells do. We usually look like our parents because they are the source of our DNA. However, DNA affects more than the way we look. It also determines our risk for developing certain diseases, including some types of cancer.

Some genes (parts of our DNA) control when our cells grow and divide. Some genes that promote cell division are called oncogenes. Other genes that slow down cancer cell division or make them die are called tumor suppressor genes. We know that cancers can be caused by DNA mutations (changes) that turn on oncogenes or turn off tumor suppressor genes. Some people with cancer have DNA mutations they inherited from a parent, which increase their risk for developing the disease. But most DNA mutations that are seen in cancers happen during life rather than having been inherited. These mutations may result from exposure to radiation or carcinogens (cancer-causing chemicals). But most of these mutations happen for no apparent reason.

The DNA mutations that cause tumors in people with the genetic syndromes discussed in the previous section have been identified. Overall though, these rarely cause adrenal cortical cancer. However, because adrenal cancer is so rare, if you have adrenal cancer, it may be worthwhile to consider genetic testing to find out if you have one of these syndromes. If you do, you (and your family members) may have an increased risk to develop other cancers also.

The Li-Fraumeni syndrome is caused by inherited mutations that inactivate the p53 tumor suppressor gene. This syndrome causes few cases of adrenal cancer in adults (1 of every 20), but is often the cause of adrenal cancer in children. In fact, about 8 of every 10 cases of adrenal cancer in children are caused by Li-Fraumeni syndrome. Many other adrenal cancers have also been found to have abnormal p53 genes that were acquired after birth (not inherited).

risk factors for adrenal cancer?

A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

Scientists have found few risk factors that make a person more likely to develop adrenal gland tumors. Even if a patient does have one or more risk factors for adrenal gland tumors, it is impossible to know for sure how much that risk factor contributed to causing the cancer.

But having a risk factor, or even several, does not mean that you will get the disease. Many people with risk factors never develop adrenal cancer, while others with this disease may have few or no known risk factors.

Genetic syndromes

The vast majority of adrenal cortex cancers are sporadic (not inherited), but some (up to 15%) are caused by a genetic defect. This is more common in adrenal cancers in children.

Li-Fraumeni syndrome

The Li-Fraumeni syndrome is a rare condition which is most often caused by a defect in the TP53 gene. People with this syndrome have a high risk of several types of cancers, including include breast cancer, bone cancer, brain cancer, and adrenal cortex cancer.

Beckwith-Wiedemann syndrome

People with this problem have large tongues, are large themselves, and have an increased risk for developing cancers of the kidney, liver, and adrenal cortex.

Multiple endocrine neoplasia (MEN1)

People with MEN1 have a very high risk of developing tumors of 3 glands: the pituitary, parathyroid, and pancreas. About one-third to one-half of people with this condition also develop adrenal adenomas or enlarged adrenal glands. These usually do not cause any symptoms. This syndrome is caused by defects in a gene called MEN1. People who have a family history of MEN1 or pituitary, parathyroid, pancreas, or adrenal cancers should ask their doctor if they might benefit from genetic counseling.

Familial adenomatous polyposis (FAP)

People with this syndrome develop hundreds of polyps in the large intestine. These polyps will lead to colon cancer if the colon is not removed. FAP also increases the risk of other cancers, and may increase the risk for adrenal cancer. Still, most adrenal tumors in patients with FAP are benign adenomas. This syndrome is caused by defects in a gene called APC.

Hereditary nonpolyposis colorectal cancer

Patients with hereditary nonpolyposis colorectal cancer (HNPCC, also called Lynch syndrome) have a high risk of colorectal cancer as well as, in women, endometrial cancer. They also have an increased risk of some other cancers, including cancer of the adrenal cortex.

In most cases, this disorder is caused by an inherited defect in either the gene MLH1 or the gene MSH2, but other genes can also cause HNPCC. HNPCC is discussed in more detail in our document Colorectal Cancer.

Lifestyle and environmental factors

Risk factors such as a high-fat diet, smoking, sedentary lifestyle, and exposure to cancer-causing substances in the environment have a great impact on a person's risk of developing many types of cancer. Although none of these factors has been definitely found to influence a person's risk of developing adrenal cancer, smoking has been suggested as a risk factor by some researchers.

prevented adrenal cancer 

Since there are no known preventable risk factors for this cancer, it is not now possible to prevent this disease, specifically. Not smoking is a way to lower the risk for many cancers, and perhaps even adrenal cortical cancer.