Radiotherapy side effects: integrating survivorship clinical lens to better serve patients
The Canadian Cancer Society estimated 220,400 new cases of cancer would be diagnosed in 2019. Of these, over 60% will survive for 5 years or more after cancer diagnosis1. Furthermore, nearly 40% of cancer patients receive at least one course of radiotherapy (RT)2. RT is utilized for both curative and palliative intents, to treat early stage or locally advanced tumors and for symptom management in advanced disease, respectively. RT can be delivered systemically, referred to as external-beam RT, or internally via brachytherapy3.
Although technique improvements have drastically reduced RT-related toxicity3, most patients still experience burdensome RT side effects (SE)4. RT SE are local or loco-regional, and manifest in tissues or organs that were radiated. SE manifesting during within weeks following RT completion are defined as early SE, whereas those occurring after months or years are defined as late SE4. In addition to radiation oncologists, general practitioners in oncology and primary care providers are involved in survivorship care and management of RT SE5. This article presents an overview of common SE and respective management: anxiety, depression, fatigue, and SE related to these treatment sites: head and neck, thoracic, and pelvic.