Radiation Fibrosis Syndrome
Radiation is commonly used to treat head and neck cancer patients. Radiation kills cancer cells and 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 builds up 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.
- Bones to become weak and brittle.
- Heart, lung, and nerve damage (neuropathy).
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 get worse 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 that are used for activities of daily living. Some of the side effects of 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 radiation fibrosis, though these specialists are not available everywhere. Speak with your provider about any symptoms you are having so that a treatment plan can be made.
American Head and Neck Society. Radiation Fibrosis. Found at https://www.ahns.info/survivorship_intro/radiation-fibrosis/
Hojan K and Milecki P. Opportunities for rehabilitation of patients with radiation fibrosis syndrome. Reports of Practical Oncology and Radiotherapy. Jan 2014; 19(1):1-6.
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.