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Radiation Fibrosis

Radiation therapy, either alone or in combination with chemotherapy and/or surgery, is a common treatment for many types of cancers.
While radiation therapy is effective at damaging cancer cells, it also damages the DNA of healthy tissue exposed to the radiation beam. This cell damage can cause fibrosis – the thickening and scarring of healthy connective tissue.

Radiation fibrosis, also called radiation fibrosis syndrome or radiation-induced fibrosis, has various symptoms that may arise during radiation therapy or appear years later. Symptoms and severity vary widely depending on the organ treated, additional therapies and genetic factors. Severe cases are rare, with most patients experiencing mild to moderate effects. But, as many as 1 in 5 patients – especially those who undergo both surgery and radiation – may develop severe fibrosis that impacts their quality of life.

Radiation fibrosis isn’t a disease itself. Instead, it is a group of side effects.
These effects can be acute, beginning during or shortly after radiation exposure, or delayed, sometimes not presenting until weeks, months or years after receiving radiation treatment. Acute symptoms may resolve for some patients, but radiation fibrosis can be a lifelong, chronic condition.

Physical effects of radiation fibrosis may include:

Fatigue
Weakness
Scarring
Skin darkening
Dry mouth
Hair loss
Pain
Difficulty speaking or swallowing
Difficulty breathing
Urinary urgency, frequency and/or difficulty
Loss of reproductive function
Nerve pain
Muscle spasms
Loss of elasticity in tendons and ligaments, causing shortening and contracture – which may lead to restricted mobility and loss of functionality
Osteopenia, which may progress to osteoporosis
Fracturing of weight-bearing bones
Fusing of skin, muscle, bone and connective tissue to underlying tissue.

Radiation fibrosis risk factors

Radiation fibrosis is an inflammatory response to the cell damage caused by radiation therapy. It’s unknown why certain people develop the condition and others don’t, but genetics is believed to play a role.

The effects of radiation are cumulative. Patients receiving higher doses of radiation, more doses of radiation and/or who have a higher volume of irradiated tissue have an increased chance of developing radiation fibrosis. The severity of their symptoms is also likely to be higher.

Preventing radiation fibrosis

Since radiation fibrosis cannot be cured and anyone who receives radiation treatment is at risk, prevention is key.

Advances in radiation therapy, such as the incorporation of advanced imaging and planning software, limit the amount of healthy tissue irradiated during treatment. This can reduce the likelihood of developing radiation-induced fibrosis, as well as the severity of its effects.