Radiotherapy and Its Side Effects: Chapter 2 - Side Effects of Radiotherapy

PART II

Chapter 2

Side Effects of Radiotherapy (Cont'd)

2. Damage to cell renewal

      The following side effects are under a class called cell renewal effects.

Damage to bone marrow 

Bone marrow is the flexible tissue in the hollow interior of bones. It is responsible for the production of blood cells, including RBCs, WBCs, and platelets. If a person is exposed to a high dose of radiation for too long (especially on pelvis, chest and other bones), one can suffer bone marrow damage. As a result of radiotherapy, a patient may suffer from low WBC count (neutropenia or leukopenia), low RBC count (anemia), and/or low platelet count (thrombocytopenia). As explained in the previous chapter, neutropenia may increase a patient’s chance of infection, anemia may cause fatigue, and thrombocytopenia can increase a patient’s risk of bruising and bleeding.

 On the other hand, radiation damage to bone marrow is not completely negative. For patients that require bone marrow transplantation, a high dose TBI becomes a positive tool in that unhealthy bone marrow cells are “wiped out” by high-dose radiation before a patient receives healthy bone marrow cells or cord blood cells. 

Hair loss (alopecia)

        Radiotherapy often causes hair loss on the body part being treated [35, 36]. However, hair loss from radiotherapy is usually limited to the area treated by the radiation. For patients who receive radiotherapy for brain cancer, the most pronounced side effect may be hair loss. In this case, radiation-induced hair loss could be permanent; this is different from chemotherapy on other part of the body wherein hair loss is more likely temporary.

Anemia  

        Depending on the dose and the time of treatment, radiotherapy may or may not cause anemia for cancer patients. Many patients experience anemia at some point during treatment; in serious situations, it may cause aplastic anemia.

 Aplastic anemia is when the hematopoietic stem cells in bone marrow are seriously damaged. As a result, all blood cells are not adequately produced, and could be fatal in some cases. One of the most important pioneers in radioactivity, Marie Curie, died from aplastic anemia which was believed to have resulted from her long-term exposure to the radioactive materials she studied.

Diarrhea

 

  When the lining of mouth, stomach, and intestines are injured by radiotherapy, it may cause diarrhea. It is common to have diarrhea during or after radiotherapy treatment on the stomach or abdomen. The diarrhea can gradually get worse as the treatment goes on.  Once the treatment ends, the diarrhea normally goes away gradually over a couple of weeks, but for some people it may take a little bit longer.

Skin damage

        Radiotherapy can induce tanned (hyperpigmentation), irritated, peeling or burned skin. Because recent radiotherapy technology utilizes higher radiation doses, skin damage becomes a problem that happens more often. On the other hand, in the most recent radiosurgery, such as stereotactic radiotherapy, because radiation is applied from different direction, skin damage is significantly reduced.  

© Jiajiu Shaw, 2021

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen.