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Radiation damage

Radiation damage to cells in the body can happen after a person receives radiation therapy to treat cancer. It can also happen if a person is exposed to radiation through x-ray imaging, nuclear power, or fallout from nuclear weapons. If severe enough, radiation damage may cause cancer, birth defects, heart disease, and other serious health problems. Doctors try to protect people undergoing radiation therapy for cancer by using low doses, being precise about targeting the radiation, and minimizing side effects. Usually side effects go away after the treatment stops.

 

Signs and Symptoms

Radiation damage can cause a number of symptoms. These are common side effects when a person undergoes radiation treatment for cancer:

  • Hair loss
  • Stomach upset, nausea, vomiting, diarrhea
  • Low white blood cells (leucopenia)
  • Red and itchy skin at the site of the radiation
  • Sore mouth or mouth ulcers (oral mucositis)

Radiation sickness or radiation emergency happens after exposure to a large amount of radiation. Acute radiation sickness occurs within 24 hours of exposure. Chronic radiation syndrome is a range of symptoms occurring over a period of time. These symptoms can happen immediately or months or years after exposure to radiation:

  • Radiation syndrome includes fatigue, weight loss, nausea, vomiting, diarrhea, sweating, fever, headache with bleeding and complications affecting the digestive system, nervous system, heart, and lungs.
  • Central nervous system diseases
  • Kidney, liver, or gastrointestinal problems
  • Poor growth in children
  • Skin conditions
  • Pericarditis (inflammation of the sac around the heart)
  • Lung infections or conditions, respiratory failure
  • Vision problems, including cataracts
  • Problems with the reproductive organs
  • Heart disease

What Causes It?

Damage happens when radiation interacts with oxygen, causing certain molecules to form in the body. These molecules can damage or break strands of DNA in cells. The cells may die.

Who is Most At Risk?

People who have been exposed to radiation, and who also have the following conditions or characteristics are at risk for developing radiation damage:

  • High dose of radiation exposure
  • Young age at time of exposure
  • Use of chemotherapy, antibiotics
  • Exposure to radiation before birth (while in the womb)

What to Expect at Your Provider's Office

If you have symptoms of radiation damage, you should see your doctor right away. A physical exam, lab tests, pathology tests, and imaging procedures such as barium radiography or colonoscopy may be performed.

Treatment Options

Prevention

If you are receiving radiation treatment for cancer, your doctor will try to prevent or reduce the risk of radiation damage and radiation side effects. Your doctor may administer low-dose radiation, use chemicals to protect from radiation, and use special shields for other parts of your body. Some medications, supplements, vitamins, and minerals may help reduce side effects.

Treatment Plan

The treatment plan depends on the type of radiation damage. If a person is exposed to a high amount of radiation, they will need to be decontaminated and may need transfusions of fluids, red blood cells, white blood cells, and platelets. If you have radiation side effects from cancer treatment, your doctor may be able to give you medications and ointments to reduce them.

Drug Therapies

Your doctor may prescribe a variety of medications, depending on your symptoms. To treat side effects from radiation during cancer treatment, your doctor may prescribe antinausea medications, oral rinses for your mouth, and hydrocortisone cream for your skin. There is one drug, amifostine, that may be used to protect against radiation damage.

Surgical and Other Procedures

Surgery may be needed to stop more cell damage, or to graft healthy tissue onto a damaged area. Preliminary studies suggest that stem cell therapy may help reduce radiation induced salivary gland damage and improve quality of life for people.

Complementary and Alternative Therapies

A comprehensive treatment plan for managing the effects of radiation may include a range of complementary and alternative therapies (CAM). If you are receiving radiation therapy, taking prescription medications or have pre-existing medical complications, talk to your health care provider before using CAM therapies.

If you are undergoing radiation therapy for cancer treatment, ask your oncologist before taking any supplement or vitamin. While some supplements may help, others may be harmful or interfere with certain cancer treatments. Make sure all your doctors know about any treatments you are considering.

Nutrition and Supplements

These nutritional tips may help reduce side effects from radiation therapy:

  • People undergoing radiation should maintain a healthy diet. It is best to work with a nutritionist who understands the unique needs of people with cancer and people receiving radiation therapy.
  • Use healthy cooking oils, such as olive oil or coconut oil. Avoid cooking olive oil at high temperatures to prevent carcinogens from forming.
  • Reduce or eliminate trans fatty acids, found in commercially-baked goods, such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.

Certain nutritional supplements and botanical medicines may be helpful in terms of managing the side effects of radiation therapy while others may interfere with the effectiveness of certain cancer treatments. Work with your doctor to determine which supplements are best for you. Preliminary studies suggest that vitamin E supplements may protect organs from radiation damage.

Another supplement you may want to consider is a probiotic supplement containing 5 to 10 billion CFUs (colony forming units) a day. Probiotics may help reduce diarrhea in people receiving radiation therapy for cancer in the pelvis or abdomen. Some acidophilus products require refrigeration. Check labels carefully. Probiotics may not be appropriate for severely immunocompromised person. Speak with your doctor.

Herbs

Herbs are generally available as standardized, dried extracts (pills, capsules, or tablets), teas, or tinctures/liquid extracts (alcohol extraction, unless otherwise noted). Mix liquid extracts with your favorite beverage. Dose for teas is 1 to 2 heaping tsp. per cup of water, steeped for 10 to 15 minutes (roots need longer).

If you are undergoing radiation therapy for cancer, ask your oncologist before taking any herb.

  • Milk thistle ( Silybum marianum ) standardized extract, 80 to 200 mg, 1 to 3 times a day, may offer some protection from radiation damage, although more research is needed. Milk thistle may interact with a variety of medications, and may even have estrogen-like effects in certain people. Speak with your doctor.
  • Green tea ( Camellia sinensis ) standardized extract, 250 to 500 mg daily, for antioxidant effects. You may use caffeine-free products. You can also prepare teas from the leaf.
  • Panax ginseng ( Panax ginseng ) standardized extract, 100 to 200 mg, twice daily, may offer some protection from radiation, although more research is needed. Some studies show that ginseng may reduce fatigue, which is a common side effect of radiation therapy. Ginseng may interact with a number of medications, so ask your doctor before taking it. You should not take ginseng for more than 3 months. If you have diabetes, heart disease, an autoimmune disease, insomnia, or schizophrenia, you should avoid ginseng.
  • Holy basil ( Ocimum sanctum ) standardized extract, 400 mg daily, may offer some protection from radiation, although more research is needed. You can also prepare teas from the root. Holy basil may increase the risk of bleeding if you take blood-thinning medications, such as warfarin (Coumadin) or aspirin.
  • Chamomile oral rinse (Kamillosan), used 3 to 4 times daily, for mouth soreness or ulcers due to radiation therapy.
  • Calendula ( Calendula officinalis ) topical cream, apply externally to irritated skin, 2 to 3 times daily. One study of women undergoing radiation therapy for breast cancer found that using calendula ointment at least 2 times a day reduced skin irritation, pain, and redness.
  • Aloe vera ( Aloe vera ) topical gel or cream, applied externally to irritated skin, 2 to 3 times daily. Studies are mixed about whether aloe helps reduce skin irritation and pain from radiation.

Homeopathy

Radium bromatum is specific for radiation poisoning, especially followed by arthritic complaints. Acute dose is 3 to 5 pellets of 12X to 30C every 1 to 4 hours until symptoms are relieved.

Prognosis/Possible Complications

The prognosis depends on the level of radiation exposure, how quickly the person can be treated, and how detailed the follow up is. Long-term complications may include cancer, liver failure, infertility, and thickening and scarring of lung, liver, and kidney tissue.

Supporting Research

Baliga MS, Katiyar SK. Chemoprevention of photocarcinogenesis by selected dietary botanicals. Photochem Photobiol Sci . 2006;5(2):243-53.

Bolderston A, Lloyd NS, Wong RD, et al. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer . 2006;14(8):802-17.

C Jagetia G. Radioprotective Potential of Plants and Herbs against the Effects of Ionizing Radiation. J Clin Biochem Nutr . 2007 Mar;40(2):74-81.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr . 2006;25(2):79-99.

Coppes RP, Stokman MA. Stem cells and the repair of radiation-induced salivary gland damage. Oral Dis . 2011;17(2):143-53.

Devi PU, Ganasoundari A. Modulation of glutathione and antioxidant enzymes by Ocimum sanctum and its role in protection against radiation injury. Indian J Exp Biol . 1999 Mar;37(3):262-8.

Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther . 2006;4(2):261-75.

Dryden GW Jr, Deaciuc I, Arteel G, McClain CJ. Clinical implications of oxidative stress and antioxidant therapy. Curr Gastroenterol Rep . 2005;7(4):308-16.

Fallahi B, Beiki D, Abedi SM, et al. Does vitamin E protect salivary glands from I-131 radiation damage in patients with thyroid cancer? Nucl Med Commun . 2013;34(8):777-86.

Jeggo P. The role of the DNA damage response mechanisms after low-dose radiation exposure and a consideration of potentially sensitive individuals. Radiat Res . 2010;174(6):825-32.

Johnson MA. Nutrition and aging -- practical advice for healthy eating. J Am Med Womens Assoc . 2004;59(4):262-9.

Katiyar SK. Silymarin and skin cancer prevention: anti-inflammatory, antioxidant and immunomodulatory effects (Review). Int J Oncol . 2005;26(1):169-76.

Kelemen LE, Cerhan JR, Lim U, et al. Vegetables, fruit, and antioxidant-related nutrients and risk of non-Hodgkin lymphoma: a National Cancer Institute-Surveillance, Epidemiology, and End Results population-based case-control study. Am J Clin Nutr . 2006;83(6):1401-10.

Kim K, McBride WH. Modifying radiation damage. Curr Drug Targets . 2010;11(11):1352-65.

Koukourakis MI. Radiation damage and radioprotectants: new concepts in the era of molecular medicine. Br J Radiol . 2012;85(1012):313-30.

Lee TK, Johnke RM, Alllison RR, O’Brien KF, Dobbs LJ Jr. Radioprotective potential of ginseng. Mutagenesis . 2005;20(4):237-43.

Lee TK, O'Brien KF, Wang W, Johnke RM, Sheng C, Benhabib SM, Wang T, Allison RR. Radioprotective effect of american ginseng on human lymphocytes at 90 minutes postirradiation: a study of 40 cases. J Altern Complement Med . 2010 May;16(5):561-7.

MacLean CH, Newberry SJ, Mojica WA, et al. Effects of omega-3 fatty acids on cancer risk: a systematic review. JAMA . 2006;295(4):403-15. Review.

Malhomme de La Roche H, Seagrove S, Mehta A, Divekar P, Campbell S, Curnow A. Using natural dietary sources of antioxidants to protect against ultraviolet and visible radiation-induced DNA damage: an investigation of human green tea ingestion. J Photochem Photobiol B . 2010;101(2):169-73.

McNally . GI/Liver Secrets Plus . 4th ed. Philadelphia, PA: Elsevier Mosby; 2010.

Peterson C, Menias C, Katz D. Radiation-induced Effects to Nontarget Abdominal and Pelvic Viscera. Radiologic Clinics of North America . Philadelphia, PA: Elsevier Saunders. 2014;52(5).

Pradat F, Maisonobe T, Psimaras D, et al. Radiation-induced neuropathies: collateral damage of improved cancer prognosis. Rev Neurol . 2012;168(12):939-50.

Rodeiro I, Delgado R, Garrido G. Effects of a Mangifera indica L. stem bark extract and mangiferin on radiationinduced DNA damage in human lymphocytes and lymphoblastoid cells. Cell Prolif . 2014;47(1):48-55.

Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin . 2001;17(1):239-47.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr . 2002;21(6):495-505.

Stewart FA, Seemann I, Hoving S, Russell NS. Understanding radiation-induced cardiovascular damage and strategies for intervention. Clin Oncol (R Coll Radiol) . 2013;25(10):617-24.

Wan XS, Ware JH, Zhou Z, Donahe JJ, et al. Protection against radiation-induced oxidative stress in cultured human epithelial cells by treatment with antioxidant agents. Int J Radiat Oncol Biol Phys . 2006;64(5):1475-81

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          Review Date: 1/5/2015  

          Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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