Radiation Fibrosis Syndrome
Radiation is a commonly used treatment in head and neck cancer patients. Radiation not only treats cancer, but can also affect healthy cells within the treatment field. Radiation can cause an increased production of fibrin. Fibrin is a protein found in the body that accumulates and causes damage in radiated tissue over time. Radiation fibrosis can affect any tissues in the radiation field. This damage can cause shortening of tissues, contracture and atrophy of muscle, cause bones to become weak and brittle, cause heart, lung and nerve damage (neuropathy) and lymphedema.
The signs and symptoms of radiation fibrosis are known as radiation fibrosis syndrome (RFS). Patients may notice signs and symptoms of RFS anywhere from a few weeks to years after treatment has ended. These symptoms will progress over time. Patients being treated with radiation for head and neck cancer are at a higher risk of developing radiation fibrosis syndrome (RFS). This is because they often receive high doses of radiation to parts of the body with structures crucial to activities of daily living. Some of the side effects that encompass radiation fibrosis syndrome in the head and neck cancer population include:
- Decreased ability to fully open the mouth (trismus)
- Neck pain and tightness (cervical dystonia)
- Lymphedema (swelling)
- Difficulty with speech and swallowing
The treatment for RFS depends upon the symptoms and side effects the patient is having. Physical therapy, occupational therapy, speech and swallow therapy, and surgery may all play a part in treatment for RFS. Cancer rehabilitation specialists can be helpful in managing the complications of radiation fibrosis, though these specialists are not available everywhere. Speak with your provider regarding any symptoms you experience, at any time, after treatment with radiation for head and neck cancer.
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Murphy BA and Deng J. Advances in supportive care for late effects of head and neck cancer. Journal of Clinical Oncology. Oct 2015; 33(29): 3314-3321.
Stubblefield MD. Radiation fibrosis syndrome: neuromuscular and musculoskeletal complications in cancer survivors. PM&R. Nov 2011; 3(11): 1041-1054.