- Many patients are very surprised to find that after pain-free (albeit not stress-free) radiation treatments, that later-on, involved tissues can begin to become inflamed and may “break down”. These are known as latent radiation effects.
- How much later depends upon the tissue type, dose and power and type of the radiation beam dictating its depth of penetration and how many tissues it encounters overall.
- What does this tissue break-down mean? Perceptually it means the skin become erythematous (red) with associated pain or neuropathy. Tissues beneath the skin can be similarly involved, such as lung, etc.
- On a cellular and biochemical level, the tissue breakdown involves several processes triggered by radiation. The first is a process we all know as inflammation. Early inflammation is an essential survival response. But in late radiation, the inflammatory process often becomes abnormal and feeds upon itself cyclically.
- This latent abnormal-ized inflammation can proceed to a) heal itself , b) continue low-grade inflammation with scarification (known as latent radiation fibrosis) with an increased cancer risk or c) it can lead to apoptosis. Apoptosis (pronounced ‘ah-pah- toe-sis’) is the triggered and deliberate suiciding of cells which are damaged beyond a point of repair. Cells undergoing apoptosis go through a regulated set of steps resulting in their disintegration. Apoptosis is different from necrosis. When radiation treatment is given to cancerous tissues, apoptosis is the intended goal. Casualty normal-tissue involvement may proceed to apoptosis of these cells.
- The eventual evolution of inflammation in normal tissues into apoptosis initiates an entirely new set of problems. This is visually seen as tissues “dissolving” leaving open burn wounds. Apoptosis can remove mutated cells but leave large wounds.
- Once the cells have died, then stem cells will divide and begin to replace the vacated tissues.
- Stem cell replacement can be assisted. With skin wounds, sterile and occlusive bandaging assists in cell movement and replacement and faster healing. This can be accomplished with Aquaphor cream or other barrier ointments for light wounds, or a water-barrier bandaging which traps moisture.
- Stem-cell spraying involves light maceration of some normal skin tissue and its suspension into sterile saline buffer. This solution will contain skin stem cells. By spraying the wound and utilizing a sterile occlusive bandage, healing time and scarring may be significantly reduced.
- There are no approved FDA treatments for late post-radiation fibroses. However in general, with physician approval and a wait of about 5 days post-irradiation (so as not to interfere with the intended therapy effect), the patient can begin a regimen of antioxidants including vitamin C and vitamin E and beta carotene, and NSAIDs such as aspirin or naproxen. These have been shown in animal studies to help close down the degradative abnormal inflammatory cycling in fibrotic tissues. Potentially this therapy may help in humans as well.
- For more information please see, Radioprotection, Radiomitigation and Radiorecovery by Dr. S.J. Paxton Pierson.
Keywords: Radiotherapy , inflammation, redness, erythema, pain, wounds, burns, treatment, therapy, healing, anti-inflammatories, non-steroidal anti-inflammatories, antioxidants, vitamin C, vitamin E, stem cell, Radioprotection, Radiomitigation and Radiorecovery (607 pages), Dr. S.J. Paxton Pierson.
Next Article: Can Radiation Cause Heart Disease?
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