Long-Term Side Effects from Head and Neck Radiation (The James)

Long-Term Side Effects from Head and Neck Radiation (The James)

 

Side effects are problems caused by radiation therapy. Many of these problems get better after your radiation treatments are done, but some side effects may last longer or may not go away at all.

Common Long-Term Side Effects

Fatigue

  • Fatigue can last from 6 weeks to 12 months after your last treatment. Some people may always feel fatigue and may not have as much energy as they did before treatment.
  • If your fatigue gets worse, call your doctor. Your doctor may want to do some tests to see if there is another reason for your fatigue.

Dry Mouth and Thick Saliva

  • Your dry mouth and thick saliva usually start to get better 3 to 4 weeks after the end of treatment. Most of the improvement with a dry mouth will happen in the first 6 months after treatment, but it may continue to get better over time.
  • Keep doing your mouth care that you did during treatment. This will help keep your mouth moist and thin out your saliva.
  • Keep a water bottle with you at all times to help moisten your mouth. Drink plenty of water when you eat food.
  • Your doctor may order a medicine to help with your dry mouth.

Taste Changes

  • Problems with taste usually start to improve about a month after treatment ends. Most of the improvement with your sense of taste will happen in the first 3 to 6 months after treatments are done.
  • Most people who have radiation for head and neck cancer do not have their sense of taste return to the way it was before treatment. Some taste changes may be permanent.
  • Your taste may be duller than it was before treatment and may fade away after a few bites.
  • It is important to eat a healthy diet. Stay away from adding sugar or salt on foods to make them taste better.

Swallowing Problems

  • Mouth and throat sores caused by treatment are usually healed within a few months after treatment.
  • You may have a hard time swallowing because your mouth is so dry. Keep a water bottle with you at all times to help moisten your mouth. Drink plenty of water when you eat food.
  • Tell your doctor if swallowing suddenly gets worse or if it feels like food gets stuck in your throat when you eat. Your esophagus (food tube) may get smaller after radiation treatments and it may need to be stretched to help with this problem.

Skin Changes

  • Skin changes to the area that was treated will slowly get better within a few months after your last treatment. Your skin may be darker than it was before. If your radiation treatment caused your skin to blister, you may always have some lighter spots on these areas.
  • Your skin may feel different in the area that was treated. It may help to use creams or lotions each day to moisturize your skin.
  • You will need to protect your skin from the sun for the rest of your life. Your skin in the treated area will always be sensitive to sunlight and you will have a higher risk for skin cancer.
  • Do not spend long periods of time in the sun. Cover your skin when you are in the sun. Wear a big hat with a wide brim and use a sunscreen (SPF 30 or higher) on your skin.

Neck Changes

  • Fibrosis (scarring) is a common side effect. You may have less movement in your neck after radiation. Your neck may feel harder in the area that was treated. If you had both surgery and radiation, you are at a higher risk for this problem. Your doctor can show you stretching and massage exercises to help with this problem. Your doctor may also refer you to a physical therapist for help. 
  • Lymphedema (lim-fe-dee`-ma) is a build-up of fluid in the tissue under you chin and along your jawline. This swelling can happen if the lymph nodes in your neck have been removed or changed by radiation. Lymphedema often gets better within 1 to 2 years after treatment ends. You doctor may ask you to see a physical therapist to help manage this problem.
  • If you need head and neck surgery in the future, your healing will be slower because of the changes in your neck from radiation.
  • Every time you have surgery, it is very important to let your surgery doctor and anesthesiologist know that you had radiation in the head and neck area.

Mouth Care

  • Radiation to your head and neck puts you at a higher risk for having problems with your teeth and gums, including dry mouth, gum disease and cavities.
  • Brush and floss your teeth after each meal and use fluoride trays at night.
  • See your dentist every 3 months for a checkup. Your dentist will check your mouth, teeth and jaw for any changes.
  • You need to wait 6 to 12 months after your treatment is done before you have new dentures made.

Jaw Problems

  • Trismus is a problem that causes muscle spasms or tightening of your jaw. This condition will make it harder for you to open your jaw. Your doctor can give you jaw stretching exercises to help with this problem.
  • Radiation can cause bone loss in the jaw and problems with healing after dental work or surgery. It is important to have your dentist call your radiation oncologist before you have any extensive dental work or gum surgery, no matter how long it has been since your treatment ended. Your dentist may need more information about your radiation treatment to know the best way to care for your mouth and teeth.

Thyroid

  • Your thyroid is a gland located in the lower front part of your neck that makes and stores hormones. Radiation treatment may cause problems with how well your thyroid works or completely stop your thyroid from working. This may happen years after your treatment has ended.
  • If your thyroid gland is not working correctly, you may feel more tired, cold, gain weight or lose your hair.
  • Your primary care doctor will do a blood test 1 to 2 times a year to check your thyroid function. If your thyroid is not working properly, your doctor order medicine for you to take each day.

Less Common Long-Term Side Effects

Radiation to the head and neck can cause other long-term side effects such as:

  • Hearing problems
  • Spinal cord and nerve damage (problems with how your arms and hands work)
  • Blood vessels changes (may put you at a higher risk for stroke)
  • Secondary cancers. Radiation can cause a new cancer to develop many years after your treatment has ended. This does not happen very often, but it is important to keep your follow-up appointments after treatment has ended.

 

 

© July 25, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.