Cancer diagnosis and its treatment themselves are painful process but unfortunately, there are also waiting some post treatment complications. Cancer treatment usually includes surgery, chemotherapy and radiation. These three steps are considered as 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. Radiation destroys not only the harmful material in the body but it destroys sometimes more than what it should.
Toxicity that induced in the body through radiation is a major cause of long-term disability after cancer treatment. Radiation fibrosis describes the insidious pathologic fibrotic tissue sclerosis that can occur in response to radiation exposure. Radiation-induced damage can include “myelo-radiculo-plexo-neuro-myopathy,” causing muscle weakness and dysfunction. In addition to these, it can also contribute to neuromuscular injury. Any tissue within the radiation field can be affected including nerves, muscles, blood vessels, bones, tendons, ligaments, heart or lungs. This damage can leads towards different complications in patient like long term disability in one or more parts of body.
Patients treated with cancer treatment can be classified into two groups i.e. HNC and HL survivors. HNC patients often develop complications after radiation therapy. HL survivors and other patients with RFS, the issues are generally dependent on the radiation field treated, the dose given, age and other medical condition of patient. Surgery is often used to resects HNC tumors and may contribute significantly to disabilities in this population. Even in this case, radiation is often the major source of long-term issues in this group.
Radiation Fibrosis Syndrome Symptoms and Treatment
Here you can find all relevant information about Radiation Fibrosis Syndrome and its possible Treatments.
Radiation Fibrosis Syndrome
As discussed above, radiation is one of the major treatment process of cancer. It is used to destroy the harmful cells within the infected area but unfortunately, normal cells are often affected by radiation in a variety of ways. major abnormality that occurs in some normal cells after radiation include the abnormal production of the protein, fibrin, which accumulates in and damages the radiated tissue. This process is known as radiation fibrosis (RF), while the clinical signs and symptoms that result from RF are called radiation fibrosis syndrome (RFS).
Radiation Fibrosis Syndrome Symptoms
It is important to mention here that not all patients treated with radiation develop clinically significant RFS. Radiation therapy, which is recommended for common disorders such as prostate and breast cancers use limited radiation fields. Usually such patients can tolerate the radiation effects excluding those, who are very sensitive to the effects of radiation will experience complications. Radiation treatment for all other types of cancer, however, may produce a much higher risk of developing RFS.
Symptoms of RF can occur a few weeks or months after radiation treatment. They can last as long as the patient life. These radiation can also take longer till they appear. The patient and their doctor may not notice RFS until years after treatment. It is really painful to write but there is no way to stop the progressive RF that occurs after radiation treatment. But there are some ways to treat the signs and symptoms of RFS and improve the quality of life of patient with this disorder. Close monitoring is recommended to help identify and manage problems early. Following effects can be there as result of this syndrome:
- A very high risk of secondary cancers and cardiac disease is there. Multiple cancers are seen including thyroid, breast and lung cancers as well as sarcomas.
- Cardiac disease including accelerated atherosclerosis, valvular heart disease, pericardial disease, cardiomyopathy, and arrhythmias can also occur.
- 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 symptoms include neck extensor weakness in which patient used to drop head, neck and shoulder pain, weakness, fatigue, gait and dexterity problems and difficulty performing activities of daily living.
- As discussed above, the group known as HNC group develops bit different symptoms than HL survivors. Common radiation-induced complications in HNC patients include trismus (decreased mouth opening), cervical dystonia (neck spasms, pain, and tightness), facial lymphedema (swelling), as well as difficulties with speech and swallowing.
Radiation Fibrosis Syndrome Treatment
Treatment of the complications of RFS vary from patient to patient because it depends entirely on the issue faced by the patient. The patient’s primary oncologists can usually direct the care of cancer-related medical issues that develop for at least the first few years after treatment. Unfortunately, but it’s true that even at the top cancer centers, there are not enough resources available to treat the rehabilitation issues faced by patients with RFS.
Due to many complications involved, it is highly challenging to prescribe a treatment plan that maximizes the function and quality of life of certain patient populations. While there is no cure, there are treatments that can improve the function and quality of life for most patients. They include:
- Physical, occupational, and lymphedema therapy are often major components of their rehabilitation program.
- Physical therapy is highly individualized to the patient and involves normalizing body balance. It involves stretching of tight structures, strengthening weakened muscles, and retraining the body’s sensory organs to re-establish coordination.
- In case of dropped head, orthotic collars such as the Headmaster™ cervical collar, are used. When necessary, nerve stabilizing and pain relieving medications are often needed to reduce neuropathic pain and muscle spasms associated with RFS.
- Trismus is another common problem in HNC patients. It is usually treated with physical therapy in mild cases but a jaw stretching device is necessary for most patients. But in case of more chronic trismus, a device called the Dynasplint is used, as it is customizable and uses a better mechanism of jaw opening that is much safer and more effective.
- Although the principles of treatment are similar in HNC patients, but the disorders they face are very different, like dropped head syndrome is less common but severe neck spasms are often seen. This can be treated effectively with specialized physical therapy and nerve stabilizing agents. In some cases, botulinum toxin injections are also used to treat it. Specialized clinical skills and experience is needed to perform this procedure safely and effectively in this high-risk population.