Radiation therapy is a common and effective treatment for throat cancer, utilizing high-energy beams to destroy cancer cells by damaging their DNA. While radiation therapy is precise, targeting the tumor while minimizing harm to surrounding healthy tissues, it often leads to a range of side effects.
Common Acute Side Effects
Patients undergoing radiation therapy for throat cancer frequently experience acute side effects, which typically manifest during or immediately after treatment. Oral mucositis, characterized by painful inflammation and ulceration of the mouth and throat lining, is a common reaction. This occurs because radiation damages rapidly dividing cells, leading to painful sores.
Difficulty swallowing, known as dysphagia, often accompanies mucositis. Radiation can cause swelling and soreness in the throat, making it challenging to consume solid foods and sometimes even liquids. Radiation therapy can also damage the salivary glands in the treatment area, leading to xerostomia, or dry mouth. Reduced saliva production can make chewing, swallowing, and speaking more difficult, and it can also increase the risk of dental problems.
Changes in taste, medically termed dysgeusia, are prevalent. Radiation can damage taste buds, thin the epithelial lining of the tongue, and reduce salivary flow, contributing to altered or diminished taste perception. Patients may report a metallic taste or a general loss of taste. Skin reactions in the treated area are another expected side effect, resembling a sunburn with redness or darkening, itching, and peeling. These skin changes usually begin a few weeks into treatment and can persist for several weeks after completion.
Fatigue is common during and after radiation therapy. This tiredness often results from the body expending energy to repair cells damaged by radiation, coupled with the overall stress of treatment. Voice changes, such as hoarseness, can also occur if the voice box (larynx) is in the radiation field. This happens because radiation can affect the delicate vocal cords, impacting their ability to vibrate properly.
Managing Side Effects During Treatment
Managing acute side effects is important for patient comfort and treatment adherence. Pain management involves various prescribed pain relief medications. Maintaining adequate nutrition is also important, as pain and swallowing difficulties can lead to reduced food intake and weight loss. Soft foods, liquid diets, and nutritional supplements are often recommended, and some patients may require temporary feeding tubes to ensure they receive sufficient nutrients.
Good oral hygiene practices help prevent infections and manage oral mucositis. Regular mouthwashes can help soothe the mouth and reduce the risk of complications. For dry mouth, strategies include frequent sips of water, using saliva substitutes, and avoiding dehydrating substances like caffeine and alcohol. Specific skin care recommendations for the irradiated area involve gentle cleansing, avoiding harsh soaps, and using prescribed creams or dressings to protect the skin and promote healing.
Energy conservation techniques can help patients cope with fatigue. Balancing rest with light activity, such as short walks, can often improve energy levels. Planning daily tasks for times of peak energy and allowing others to assist with demanding activities are also helpful. Patients should work closely with their medical team, including dietitians, speech-language therapists, and nurses, to develop a management plan for these side effects.
Long-Term and Late-Onset Side Effects
Some side effects from radiation therapy for throat cancer can persist for an extended period or develop months to years after treatment concludes. Persistent xerostomia, or chronic dry mouth, results from permanent salivary gland damage. This increases the risk of dental decay and gum disease, requiring consistent dental care.
Chronic dysphagia, or difficulty swallowing, may occur. Radiation can lead to scarring and stiffness of the muscles and tissues in the throat and esophagus, impairing their function. This can make eating and drinking challenging, sometimes requiring speech-language therapy. Changes in voice quality, such as hoarseness or a weaker voice, can also be long-lasting if the vocal cords were significantly affected by radiation. While some voice recovery occurs, it may not return to its pre-treatment state.
Neck stiffness and fibrosis, a hardening of the underlying tissues, can develop in the irradiated area. This can limit range of motion and cause discomfort. Lymphedema, which is swelling due to fluid buildup, may also occur in the head and neck region if lymphatic vessels are damaged by radiation. Radiation to the throat can affect the thyroid gland, leading to hypothyroidism years after treatment, which requires hormone replacement therapy. Regular monitoring for these late effects is advised.
Recognizing When to Seek Medical Care
While many side effects are expected and manageable, certain symptoms indicate a need for immediate medical attention. Severe or uncontrolled pain that is not alleviated by prescribed medications should be reported to the healthcare team promptly. An inability to eat or drink, or significant, rapid weight loss, warrants immediate contact with a medical professional, as these can lead to dehydration and malnutrition.
Fever, especially if accompanied by chills or other signs of infection like worsening redness or swelling around the treated area, requires urgent medical evaluation. Sudden worsening of swallowing or breathing difficulties, including coughing or choking during meals, also necessitates immediate care. New or unusual lumps, sores, or any symptom causing extreme distress should prompt a call to the medical team.