Alberta Cancer Foundation

Radiation may pose side effect risks in the long-term

In our last Survivorship column, we focused on one of the long-term effects of cancer treatment that patients must monitor, the risk of second cancers. We continue discussion of these long-term effects by focusing on the risk for side effects of radiation treatment that may occur months or even years after your treatment has ended. Not everyone will experience these problems, but it is good to be aware of the kinds of symptoms to look for.

Your radiation treatments focused on specific areas of your body near the site of your cancer. Those are the areas most likely to be affected by late and long-term effects. However, radiation can also impact your overall function. Many survivors report ongoing problems with fatigue following radiation. This more general symptom can occur due to the impact of radiation, combined treatments, and the difficulty recovering to a new normal following treatments. Depression and anxiety combined with poor sleep can make problems with fatigue much worse.

If you are feeling enough fatigue that you are not able to enjoy pleasurable activities you used to enjoy, or not able to get back to work or routines you value seeking treatment can help you. There are treatments to improve your sleep, increase your ability to exercise very gently and gradually, and begin to recover lost activities. On we have resources listed within our live calendar. Access them by clicking on “fatigue” in the word cloud on the right side of the webpages. Talking with your medical team is crucial.

We have listed some of the kinds of long-term effects of treatment to watch for based on the site of your radiation. How much radiation you received and how focused the radiation was to a small field of your tissue will determine how likely you are to experience these symptoms. If your radiation covered a larger field, you may find that your long-term effects are listed under a different “site of radiation.” For instance, you may have had a head and neck cancer that because of its location required radiation that might also impact your chest or another part of your body.

It is important to have your nurse of doctor explain the kind of side effects you might have long into survivorship even if you have had no side effects like these during your active treatment. Sometimes it takes many years for these difficulties to occur. It is also important to alert your family doctor, who can help you monitor these symptoms.

It is true that everyone wishes that when they finish active treatment, they could be completely finished, and have cancer and treatment-related side effects out of their lives for the foreseeable future. Unfortunately, radiation works by eliminating the more rapidly reproducing cells in your body. Because cancer is one of the most rapidly reproducing cells, radiation successfully eliminates cancer cells. However, it also can affect other important cells that also reproduce more rapidly. This is the reason cancer patients undergoing treatment lose their hair, eyelashes, and have skin and bone changes. During active treatment, clinicians and patients sometimes fail to discuss the longer-term symptoms to monitor.

What can you do to cope? Talking with other cancer survivors can help you to compare symptoms and create strategies to adjust to these changes. Take action to make sure your health care providers are aware and able to refer you to specialists for help if you need it. Visit for updates on new information about late and long-term effects.

Site Of RadiationTissues Where Late Effects Can Be a ProblemLate or Long-Term Effect to Watch For
BrainBrain, eyesCognitive difficulties, vision changes, cataracts, “brain fog” or memory problems
Head and NeckOral soft tissues, salivary glands, skinDry mouth, cavities and tooth decay, skin fibrosis, tightening of the jaw, tingling in arms and legs
Chest or BreastEsophagus, lung, heart, skinLung scarring, esophageal stricture, heart problems, lymphedema of the arm, decreased mobility of the shoulder joint
AbdomenIntestine, pancreas, liver, etc.Intestinal obstruction, liver scarring
PelvisBladder, rectumIncontinence, ulceration, sexual dysfunction , infertility