Researchers identified 78 patient deaths (0.55%) associated with radiation treatment. Deaths occurred during actual treatment or during the treatment period. The annual mortality range was two to 12 patients (median, four). Radiation therapy damages cancer cells, but it can also damage healthy cells in the treatment area.
Damage to healthy cells causes side effects. Side effects depend on which part of the body is receiving radiation therapy. Different cells and tissues in the body support radiation differently. Rapidly dividing cells are the most affected.
These include skin cells, cells that line the mouth and gastrointestinal (GI) tract, and bone marrow blood cells. Radiation therapy used to treat cancer can cause problems with the heart and vascular system (circulation). Cardiotoxicity can develop days or months after radiation, but often develops years later. Cardiotoxicity can reduce the patient's quality of life and increase the risk of death from heart-related causes.
Heart disease is a very important and not uncommon long-term side effect of radiation therapy. Radiation therapy to the chest area is often part of the treatment of Hodgkin lymphoma and cancers of the lung, esophagus, or breast. It is estimated that 50% of people diagnosed with cancer will receive radiation therapy at some point during their trip. The goal, he explained, is to understand a patient's risk of suffering from cardiovascular disease when cancer is diagnosed and then to control that risk throughout cancer treatment and after.
Skin problems are common with external radiation therapy because radiation travels through the skin to the area where the treatment is being directed. Radiation therapy, especially radiation to the brain, base of the skull, and neck, can cause cognitive problems, such as memory loss and difficulty concentrating. Radiation therapy to treat lymphoma and cancers of the lung, esophagus, spinal cord, and breast often targets structures in the chest. These side effects, such as high blood pressure, abnormal heart rhythms, and heart failure, can be caused or exacerbated by chemotherapy and radiation therapy, as well as newer forms of cancer treatment, such as targeted therapies and immunotherapies.
In recognition of the risk of cardiotoxicity from radiation, newer radiation techniques have been developed that minimize radiation to the heart. A cardiologist and an oncologist working together can determine a patient's individual risk of cardiotoxicity by performing certain tests and images before starting radiation therapy. For example, in patients with Hodgkin's disease receiving radiation therapy (which is not so common now), the leading cause of death is cardiovascular disease, not cancer. A special group of at-risk patients are younger, otherwise healthy patients treated for early-stage breast cancer and Hodgkin lymphoma who are cured of cancer and live for many years after treatment.
Radiation can also cause lymphedema, swelling that occurs as a result of damage to the lymphatic channels, such as swelling of the arm seen in some women who have had breast cancer. While some treatments for breast cancer, such as therapies targeting HER2, doxorubicin and radiation therapy, are known to cause cardiac side effects, other factors can also affect the patient's cardiovascular health, said Dr. Armenian, who treats children with cancer at the City of Hope Comprehensive Cancer Center. that when a patient develops cardiac side effects during treatment, the physician may modify the dose of a therapy or discontinue therapy altogether.
Radiation oncologists now frequently treat people with a medication (one commonly used for Alzheimer's) during radiation therapy, and this has been found to reduce cognitive problems later. .