The surgical scar usually heals very rapidly and tends to fade as time passes. Sometimes the parathyroid glands are affected, and patients may need to take calcium for a while.
Radioactive iodine can potentially cause a dry mouth, but this is usually after repeated doses for widespread disease.
The side effects of using radiation therapy are similar to patients having head and neck radiation therapy.
Upper Gastro-Intestinal Cancer
Radiation therapy to the chest may be associated with significant side effects, depending on the dose of radiation used and the specific area of the chest receiving radiation dose. Side effects may include, but are not limited to:
Early side effects (usually occur in the second half of treatment, persisting for a few weeks)
Oesophagus: Also known as the “gullet”, this tube carries food from your mouth to your stomach. If this area receives radiation it can result in heartburn-type symptoms and pain when swallowing. This is usually managed with local anaesthetic liquids, soluble paracetamol or even liquid morphine. Rarely, patients have difficulty eating or drinking enough to meet their requirements and a fine nasogastric tube is inserted down the nose so that nutrition can be passed directly into the stomach, bypassing the sore area. This tube may be removed a few weeks after treatment.
Skin: Most patients experience at least some skin redness, usually on the back. Skin ulceration or breakdown is uncommon.
Heart/Lung: Inflammation of the heart (pericarditis) or lining of the lung (pleurisy) is rare but can result in sharp pain, worse when taking a deep breath. It is not dangerous and settles by itself.
If treatment includes the abdomen, nausea and vomiting can occur. This side effect can be prevented with anti-emetic drugs given before therapy. Almost all patients having radiation therapy complain of fatigue of some degree which can last for several months after therapy.
Patients should be encouraged to exercise within moderate limits but also rest where necessary during therapy.
Late or long-term side effects (side effects well after treatment)
Late side effects may occur a few months to years after treatment. Depending on the problem it may occur once and then go or may be more persistent over the long term or may come and go over time. The likelihood of developing late side effects from radiation treatment depends on the amount of radiation and the relationship of the tumour to important structures located nearby. Your Radiation Oncologist will explain the potential late side effects of your treatment and how to manage potential side effects in more detail.
Likely late side effects
Oesophagus: Narrowing due to scarring, which may cause difficulty swallowing. Dilatation of the oesophagus may be necessary.
Skin: There may be sustained discolouration of the skin where radiation was given. This can be permanent, though this is usually faint.
Thyroid: If your upper chest is being treated, this may result in your thyroid gland becoming underactive in the future. This can be detected on blood tests and addressed with hormone tablets if necessary.
Less likely late side effects
Lung: Inflammation of the lung (pneumonitis) is uncommon. It can cause a dry cough and usually settles by Itself. There may be permanent scarring (fibrosis) in the lungs which may reduce your ability to exercise.
Rare late side effects
Spinal cord: Spinal cord damage is very rare. It can cause tingling. Paralysis is almost never seen since utmost care is taken to keep the dose to the spinal cord low.
Second cancers: Any exposure to radiation increases the risk of a second cancer developing in that area, usually decades later. This risk is not entirely attributable to radiation received as part of your treatment. All X-rays and scans received over your lifetime contribute to this risk, as does unavoidable exposure to environmental radiation. The risk of a cancer being caused by radiation therapy is in the order of 0.5 – 1% at 10 years.
Females: Radiation can seriously harm an unborn baby. You must not commence treatment if there is a chance you are pregnant, and you must also take precautions to avoid falling pregnant during treatment. If there is a chance you may be pregnant, you must inform your doctor immediately.