Possible late or long-term side effects may happen months or years following radiotherapy treatment, and in some cases may be permanent. They may happen once, continue for a long time, or come and go. While some late effects cannot be cured, they may be managed
You might experience late effects not listed here since everyone’s experience is different. They could also be caused by other parts of your cancer treatment. It can be hard to predict if and when these effects will occur, which can be challenging to accept. However, research and support for managing late effects from radiotherapy are improving.
Support Groups: Joining a support group can be helpful for sharing your experiences and feeling less alone. It’s a way to cope with the physical and emotional impacts of treatment.
If you have concerns or experience any late effects, please reach out to your clinical team for more support.
This page looks at late side effects.
- You might also have side effects that depend on which part of your body is being treated, the type of radiotherapy you are having, and what tissues or organs are going to be impacted by the radiotherapy.
- For example, you might have treatment for skin cancer on your upper back, and so the radiotherapy might have some effects on your lungs. It’s good to remember that your treatment team will carefully plan your radiotherapy to lower the chance of side effects.
How likely am I to get late side effects?
Before treatment you will discuss and sign a consent form with your clinical oncologist or therapeutic radiographer. They will tell you what to expect, and you can ask questions and discuss any concerns you have about late effects.
By signing the consent form, you are saying you understand that you might get early and late side effects. Your team will use words like Expected, Common, Less Common and Rare.
This table shows what these words mean.
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Possible late side effects
- Skin and soft tissue changes: You might have permanent skin changes caused by treatment in the area where you have radiotherapy. Your skin colour might change and you might see tiny blood vessels become swollen and easier to see. Your skin might become thinner and injure more easily: or it become harder and feel tighter. The skin in the treatment area will always be more sensitive to the sun and changes in temperature.
- Permanent hair loss: Hair loss might be permanent in the treatment area. If hair starts to grow back it can remain patchy.
- Eyes and nose: If the treatment is over the nose area you may start to notice a dry or runny nose. The hair inside the nose can also be lost. If treatment is around the eye area you may get a dry or watery eye. Treatment can sometimes cause clouding of the lens in the eye (cataract). This can be repaired with surgery.
Rare late effects
- Skin ulceration: This is a rare side effect where the skin breaks down and has difficulty healing. It can be painful and uncomfortable. This can sometimes need further treatment, such as surgery.
- Bone damage: Permanent damage to the bone or cartilage in the treatment area.
- Skin graft failure: If you have had previous surgery including a skin graft to remove the cancer the treatment can cause the graft to fail.
- Second Cancer: There is a very small chance that you could develop another type of cancer. This is rare, and depends on lots of different factors like age, area treated and radiation dose.
What can help with these late effects?
- Monitoring rare side effects: Talk to your treatment team as soon as you notice any changes, this can help catch and treat any serious problems early.
- Keeping active: Gentle movement can help you feel better, both during and after treatment. Your treatment team can tell you what is safe for you to do.
- Managing cancer-related fatigue: Food and drink, keeping active, keeping a fatigue diary, medicine like steroids and physiotherapy may all be options for managing fatigue. Speak to your doctor or clinical team for advice.
- Drinking fluids: Drinking plenty of fluids such as water and squash can help with fatigue and tiredness caused by your treatment. It can also help flush out toxins in your body caused by treatment. You can try diluted juice if you don’t like water.
- Skin care: The skin in the treatment area will always be more sensitive to the sun. Always protect it by covering up and use a high factor sunblock.
- Massage and Physiotherapy: This can help skin and tissue that has become harder, tighter or both.
- Surgery: In rare cases you may get a skin ulcer that cannot heal without help. Surgery can repair the skin.
- Alcohol use: Please follow the NHS guidelines on safe drinking levels and any instructions you get from your team on what is right for you, your diagnosis and your treatment. If in doubt, please ask your team.
- Stop smoking: If you are looking to stop or reduce smoking, there are services available to help you. Please see the links at the bottom of this page for more information.
Always talk to your doctor or treatment team about any late effects you have. Even if they are not mentioned here. Everyone is different and experiences treatment differently. There may be ways they can help you reduce or manage symptoms.
Further information
Look at radiotherapy consent forms here:
https://www.rcr.ac.uk/our-services/management-service-delivery/national-radiotherapy-consent-forms/
Learn more about radiation skin reactions here:
Learn more about managing cancer fatigue:
Managing and treating cancer fatigue | Cancer Research UK
Cancer-related fatigue | NHS inform
Advice on reducing alcohol use:
Drink less – Better Health – NHS (www.nhs.uk)
NHS stop smoking services:
NHS stop smoking services help you quit – NHS (www.nhs.uk)
