Stomach cancer: Understanding late effects of radiotherapy
Late side effects may happen a few months or years after treatment. They might happen once, carry on over the long term or come and go. Sometimes they cannot be cured, but it might be possible to manage them.
You might have late effects not listed here, because everyone is different. They may also be caused by a different part of your cancer treatment. It is not possible to predict if you will get them and when they might happen, which can be difficult to come to terms with. Research and support for late effects of radiotherapy is growing.
Joining a support group can be a positive way to share your experiences, feel less alone, and come to terms with the physical and emotional impact of treatment. Ask your clinical team if you need more support or have any late effects at all.
This page looks at late 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. It’s important to know what you are consenting to and can help to take someone with you.
You can read different radiotherapy consent forms (HERE) based on the specific area being treated. These consent forms are packed with useful information about early and late side effects.(1)
When you consent to treatment, you are saying you understand that you have a chance of getting late side effects. Your team will use words like Expected, Common, Less Common and Rare.
This table shows what these words mean.
| Wording on the consent form | % chance of side or late effect | How many patients will get this? |
|---|---|---|
| Expected | 50 to 100% | Between half and all patients |
| Common | 10 to 50% | Up to half of all patients |
| Less common | Less than 10% | Fewer than one in ten patients |
| Rare | Less than 1% | Fewer than one in 100 patients |
Possible late side effects
- Chronic heartburn and indigestion: If you are having heartburn, you can get prescribed medications to lower the amount of acid being made or to coat and protect your stomach. You may need to see a gastroenterologist (GI doctor) to assess your symptoms if this does not help.
- Changes in bowel habits: Scarring cause by the radiation can cause a blockage where the normal movement of poo through the bowel is affected. Diarrhea can also be a problem if it causes severe weight loss. You may need medication to help with this. Speak to your medical team.
- Lung Inflammation or Scarring: This can cause coughing and shortness of breath, but it only happens if part of your lungs are in the treatment area. Ask your treatment team for more details if you think this might be you.
- Cancer-Related Fatigue: You might feel tired even after treatment ends. For some, this can last for months or even years.
- Malabsorption: Difficulty digesting or absorbing nutrients from food, which can affect your nutrition.
Rare and less common late effects
- Skin Changes: Sometimes, after radiation treatment, your skin might look different and even change colour. The skin in the treated area could look and feel different, and blood vessels might become more visible.
- Oesophageal Fistula: This is an abnormal connection between the food pipe (oesophagus) and the airways.
- Reduced Spleen Function: This can increase the risk of infections. Report any sign of infection to your medical team immediately.
- Narrowing of the Food Pipe: This can make eating difficult and may need additional treatment to correct. The stomach or intestines might also narrow, causing a blockage.
- Ulcers in the Food Pipe, Stomach, or Small Bowel: These can lead to bleeding.
- Feeding Tube: Some patients may need long-term nutrition through a feeding tube.
- Stomach bleeding: If you notice black in your poo or red blood in your sick speak to your medical team as this could be a sign of bleeding. It may require endoscopic treatment or surgery to stop it.
- Bone Damage: Some people have an increased risk of rib or spine fractures and will need to take extra care.
- Kidney Function: Some people have a long-term decline in kidney function.
- 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?
- 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 medical team for advice; and learn more about managing cancer-related fatigue.
- Monitoring rare side effects: Talk to your medical team as soon as you notice any changes, this can help catch and treat any serious problems early.
- 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.
- Drinking fluids: Drinking plenty of fluids such as water and squash can help with fatigue and tiredness caused by your treatment. You can try diluted juice if you don’t like water.
- Keeping active: Gentle movement can help you feel better, both during and after treatment. Your medical team can tell you what is safe for you to do.
- 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.
Always talk to your doctor or clinical 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.
(1) Royal College of Radiologists consent forms
Always talk to your doctor or clinical team about any side effects, even if they aren’t listed here. Everyone experiences treatment differently, and they can help you manage any symptoms.
Further information
Support for patients and families • Radiotherapy UK
