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Leg swelling after radiation therapy

12 Aug 18

Leg swelling after radiation therapy

As a rule, radiation therapy is one of the methods of treating tumor diseases using ionizing radiation. The main goal of radiation therapy is to have the maximum effect on the cancer tumor while minimizing its effect on healthy tissue.

Side effects on the skin

Mostly the skin reaction to radiation therapy manifests itself as a sunburn, that is, in the form of redness, burning sensation, itching, soreness and peeling. The difference is that the skin's reaction to radiation appears gradually and in certain areas of the skin.

During radiation therapy, the first thing that occurs is a change in the color of the irradiated skin area from pink to reddish. However, some areas may have a more intense color: this is the area near the armpit, the upper inner part of the chest and the fold under the breast. Usually the skin reaction may be limited to just these areas of the skin, but sometimes the skin reaction can cover a larger area of ​​the chest and be more severe.

To reduce skin side effects you should:

  • wear loose, non-fitting cotton clothing;
  • wear a loose cotton bra;
  • if the skin is especially sensitive and irritable, then you can temporarily not wear a bra at all.
  • Areas of new skin gradually appear in the irradiated area. New skin is usually pink and very tender. It can grow either under a blister or under old flaky skin. It is strictly forbidden to cut off blisters or scrape off old skin.

    If the problem becomes extremely severe, the doctor may take a short break from radiation therapy to allow the skin to recover.

    Skin irritation from radiation is usually temporary. In addition, the doctor will recommend certain ointments, creams, and medications to alleviate side effects on the skin.

    Side effects from the breast

    In most cases, patients who undergo radiation therapy for breast cancer note that the breasts become dense and swollen.

    Swelling of the mammary gland combined with skin irritation causes pain in this area. One of the most sensitive parts of the breast is the nipple, which becomes extremely irritable during radiation.

    As the irradiation is completed and the swelling subsides, the breasts become firmer, take on shape, and look “rejuvenated.” Such changes are often associated with the fact that scar tissue forms in the thickness of the mammary gland and fluid is retained.

    The patient may also notice that the breasts seem to have become smaller. The reason is that after a lumpectomy, biopsy, and other surgical procedures, a certain amount of tissue is removed from the breast. Between surgery and radiation exposure, your breasts may be slightly numb and tender, but this will gradually subside.

    Discomfort in the armpit area

    Many patients, after surgical removal of the axillary lymph nodes, experience some discomfort in this area, which is aggravated after radiation therapy.

    The operation may cause discomfort for the following reasons:

  • numbness of the skin due to damage to the cutaneous nerves;
  • when removing lymph nodes, the outflow of lymph can sometimes be disrupted, resulting in swelling;
  • swelling as a reaction of the skin directly to surgical trauma;
  • feeling of pain because there was an incision in this part.
  • During radiation therapy, these sensations of discomfort may intensify during 3-4 weeks of the course. In addition, due to sweat in the armpit area and constant rubbing of the arm, skin irritation also increases.

    In this case, we can advise:

  • use powder instead of deodorants/antiperspirants;
  • do not use scented soap;
  • Use an electric razor to shave the armpit.
  • Fatigue during radiation therapy

    Often the cause of fatigue during radiation is a combination of the following factors:

  • the effects of radiation on the body;
  • effects of previous chemotherapy;
  • emotional experiences, stress;
  • changes in diet due to treatment.
  • Fighting cancer is usually a very difficult process. Therefore, every third patient notes predominantly fatigue among the side effects of radiation therapy.

    What will help reduce fatigue:

  • rest whenever possible;
  • do not engage in strenuous exercise;
  • avoid physically strenuous work;
  • limit your fat intake;
  • increase your consumption of fresh vegetables and fruits.
  • Pain in the pectoral muscles

    Shooting pain may occur during and after radiation therapy treatment. The cause of such pain is swelling, as well as irritation of nerve fibers directly in the breast tissue.

    These pains can be relieved with anti-inflammatory drugs. At the end of the course of radiation therapy, the pain gradually disappears.

    During radiation therapy, over time, patients sometimes notice that the muscles in the chest area become denser and stiffer. The most commonly observed tightening of the pectoralis major muscle, which connects the shoulder directly to the anterior chest wall.

    The reason for this thickening of the muscles is the formation of scar tissue due to exposure to radiation. The occurrence of this side effect is mild and decreases when taking painkillers.

    REMEMBER – timely consultation with a doctor will save your life! Diagnostics and consultation are carried out only during an appointment with a doctor in the clinic. Absentee diagnosis by telephone or email is not provided.

    Doctors' visiting hours are from 10.00 to 15.00.

    Saturday - from 10.00 to 13.00

    E-mail: This email address is being protected from spambots. You must have JavaScript enabled to view it.

    The material was prepared by Natalya KOVALENKO. Website illustrations: © 2013 Thinkstock.

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    Radiation therapy - consequences and prevention

    Radiation therapy treatment is aimed at destroying cancer cells and preventing their further proliferation. Medicine, of course, does not stand still, and every year technologies and means of chemotherapy are significantly improved, but it is still not possible to make treatment narrowly targeted to this day. That is, healthy tissues always suffer along with infected cells.

    The consequences of exposure to radiation depend on its type, depth of penetration into tissue, and individual human reactions. The stronger and longer the exposure, the more noticeable the body’s reaction will be. Most often, complications occur in patients who undergo long-term treatment. The side effects of radiation therapy are not always severe; some patients tolerate such treatment quite easily. In some cases, the consequences develop immediately after the session, in others only after discharge from the hospital, because the therapeutic effect is realized even after the end of the course of radiation therapy.

    The most common side effects of radiotherapy include irritation or damage to the skin near the radiation area and fatigue. Skin manifestations include dryness, itching, peeling, or blistering or blistering. Fatigue for some patients means only mild tiredness, while others report extreme exhaustion and are asked to undergo post-radiotherapy recovery.

    The most common consequences of the method:

    •Weakness, headache, dizziness, chills, elevated body temperature.

    •Disturbed functioning of the digestive system – nausea, diarrhea, constipation, vomiting.

    •Changes in blood composition, decrease in platelets and leukocytes.

    •Increased number of heart contractions.

    •Swelling, dry skin, rashes in areas where radiation was applied.

    •Hair loss, hearing loss, vision loss.

    •Minor blood loss is caused by fragility of blood vessels.

    •Spend more time on rest and sleep. Treatment requires a lot of extra energy and you may become tired quickly. The state of general weakness sometimes lasts another 4-6 weeks after the treatment is completed.

    •Eat well, trying to prevent weight loss.

    •Do not wear tight clothing with tight collars or belts in areas exposed to radiation. It is better to prefer old suits in which you feel comfortable.

    •Be sure to tell your doctor about all the medications you are taking so that he or she can take this into account when treating you.

    Rehabilitation after radiation therapy

    In the majority of patients receiving radiation therapy, asthenic and anxiety syndromes and impaired communication skills in relationships with other people are detected at a borderline level. Local and general reactions of the body occur. A local reaction is usually manifested by redness of the skin of the irradiated area, swelling and itching, which usually disappear after a few days without any therapeutic effects. And the general radiation reaction can be expressed in weakness, dizziness, headache, drowsiness, nausea and vomiting.

    One of the negative consequences of this treatment procedure is that not only the malignant tumor is exposed to radiation, but also the tissues and organs adjacent to it. As a result, so-called radiation damage may develop.

    Exposure of the human body to ionizing particles cannot be without consequences. Therefore, radiation therapy is associated with a number of side effects. The recovery process in each individual case has its own characteristics. For example, recovery after radiation therapy to the prostate looks different than after treatment for a throat tumor. However, the general recovery complex has a number of common features.

    Proper nutrition after radiation therapy after undergoing radiation therapy can in some cases help prevent or reduce the severity of unwanted effects from treatment.

    The main actions immediately after a course of radiation therapy should be aimed at reducing intoxication that can occur during the breakdown of cancer tissue - which is what the treatment was aimed at.

    This is achieved using:

    1 Drink plenty of water while the excretory functions of the kidneys are intact.

    2 Meals with plenty of plant fiber.

    3 Use of vitamin complexes with sufficient amounts of antioxidants.

    Links to related pages

    Radiation therapy for oncology

    Radiation therapy (RT) involves the use of wide beams of ionizing radiation. Traditional RT usually takes place in several sessions. Now there are many implementations of this approach: irradiation technology is constantly being improved and has undergone many changes over time. Nowadays, RT is one of the most common methods of cancer treatment. It is used for many types of tumors and stages: either as an independent method of therapy or in combination with others (for example, radiochemotherapy). RT is also used for palliative purposes.

    In modern oncology, internal radiation therapy is widely used, which consists of exposure to highly active radiological rays that are generated in the patient’s body or directly on the surface of the skin.

    Radiation therapy (radiotherapy) is a generally safe and effective treatment for cancer. The advantages of this method for patients are undeniable. Radiotherapy ensures the preservation of the anatomy and function of the organ, improves the quality of life and survival rates, and reduces pain.

    Radiotherapy (radiation therapy) is a treatment method that uses a stream of ionized radiation. These may be gamma rays, beta rays or x-rays. These types of rays can actively influence cancer cells, leading to disruption of their structure, mutation and, ultimately, death.

    Complications after radiation therapy:

    Pain, tissue swelling at the site of exposure,

    Shortness of breath and cough

    Reactions from the mucous membranes,

    Mood and sleep disorders

    Nausea, vomiting, disturbances in the gastrointestinal tract,

    Condition after radiation therapy

    When radiation ulcers occur, care is first required; ulcers should be systematically cleaned of necrotic debris to prevent the development of infection. It is recommended to apply bandages with syntomycin emulsion (5-10%) and penicillin ointment to the ulcer. In some cases, good results are achieved with the use of hydrocortisone or prednisolone ointment. After cleansing the bottom of the ulcer from necrotic deposits, it is recommended to use sea buckthorn oil. If conservative treatment is ineffective, the ulcer is removed surgically, followed by plastic closure of the defect. Necrotic masses covering the surface of a radiation ulcer inhibit the development of granulations, serve as a breeding ground for the development of infection and are characterized by a pungent putrefactive odor. In this regard, treatment of radiation ulcers must be carried out systematically 1-2 times a day.

    Radiation therapy effectiveness

    Since the course of radiation ulcers continues for years, the patient or his relatives must be taught the correct technique for caring for the affected area of ​​the skin. Cleaning of ulcerative surfaces is carried out by abundantly irrigating the ulcer with hydrogen peroxide or a solution of potassium permanganate (when treating ulcers in the oral cavity, it is better to use a weak solution of rivanol). It is advisable to rinse with disinfectant solutions using a strong jet from a syringe or a rubber bulb. After washing, the ulcer surface is dried, loose pieces of necrotic plaque are removed with tweezers, and then covered, as directed by the doctor, with an appropriate ointment. A ring-shaped cotton swab and then a bandage are applied to the skin surrounding the ulcerative surface. The application of such an annular roller prevents the bandage from coming into contact with the ulcerative surface, which reduces trauma to the latter. For severe pain in the area of ​​the ulcer, novo-caine blockade is recommended (infiltration of sclerotic tissues around the ulcer with a 0.25 percent novocaine solution).

    What to do after radiation therapy

    Radiation therapy for injuries to internal organs and the organization of appropriate care is critical. With radiation-induced pulmonary fibrosis, patients should be advised to stay in the fresh air, preferably in suburban conditions; Smoking is strictly prohibited. Gymnastic exercises in the form of walks in the forest and skiing are recommended. However, such a load should be very moderate so as not to cause shortness of breath in the patient. It is especially important that patients use medications that help remove mucus and reduce cough, carefully monitor their health, and avoid hypothermia and colds. With radiation fibrosis, even mild bronchitis takes a protracted course and intensifies sclerotic changes in the lungs. If bronchitis occurs, patients should be prescribed inhaled antibiotics, especially streptomycin.

    Radiation therapy for joints

    Radiation damage to joints is especially dangerous due to the possibility of fractures, and therefore care should be aimed at preventing this serious complication. Patients should carefully protect damaged areas from injury and excessive physical activity; correct gymnastic exercises are very appropriate and necessary. For fractures, which usually have a favorable course, it is necessary to wear appropriate corsets, splints and other fixing devices to prevent displacement of bone fragments and the occurrence of associated pain. In case of radiation damage to the bladder due to a decrease in its capacity, the patient's regimen should be structured in such a way that frequent urination is possible. In such cases, you should especially carefully monitor the cleanliness of the external genitalia in order to prevent the development of an ascending infection and prevent hypothermia. At initial signs of cystitis, patients should be immediately prescribed antibiotics.

    Radiation therapy for rectal cancer

    When conducting radiation therapy for rectal or cervical cancer, in order to reduce mechanical irritation of the rectal mucosa, it is necessary to systematically prevent constipation from the first days of treatment. In cases of prescribing radiation therapy for a tumor of the rectum, many authors even consider it useful to pre-impose an unnatural anal opening so that feces do not cause irritation of the rectal mucosa (intestines. In the absence of obstruction,

    which are observed only in cases of a massive tumor in the rectal cavity, prevention

    constipation is quite effective when organizing an appropriate diet. Such patients, in addition to the general diet, should be prescribed kefir, fruits, raw carrots or stewed cabbage, cabbage, tomato or grape juices, and prune infusion. If, despite following such a diet, there is stool retention for more than 1-2 days, enemas of peach and apricot oil (30-50 g) with the addition of glycerin (20 g) should be prescribed. It is recommended to prescribe cleansing enemas as rarely as possible.

    Radiation therapy in the treatment of cancer

    Irradiated tissues, due to sudden changes in their nutrition, metabolism and innervation, appear to be unusually sensitive to the most seemingly insignificant traumatic effects for a healthy organism. Even those effects that are usually not considered as trauma due to their not only non-harmful, but even beneficial effects, when applied to irradiated tissues, can turn out to be intolerable and lead to severe radiation damage. For example, insolation, heating with a Sollux lamp, diathermy, and the use of heating pads on areas of the skin damaged by radiation can lead to the development of an acute inflammatory process with the subsequent formation of areas of necrosis and the formation of radiation ulcers. Great importance should be attached to the prevention and elimination of mechanical injury, both one-time accidental and weak, but lasting for a long time. An accidental sufficiently severe injury poses a great danger mainly for the development of radiation damage to bones or areas of skin close to the bones, for example, on the anterior surface of the lower leg. The effects of weak, but frequent and prolonged irritations seem to be dangerous mainly only for irradiated skin. Such traumatization is most often caused by insufficiently comfortable clothing, shoes, or bandages. Thus, after radiation therapy for breast cancer, the resolving cause of the development of radiation ulcers may be a tight bodice, a tightly pressed button, or the collar of a shirt or dress.

    Application of radiotherapy

    In cases of irradiation of the skin of the abdomen, the provoking moment may be a tight belt, squeezing tissue areas that are already insufficiently well supplied with blood. Often, after irradiation of the skin in the foot area, radiation ulcers occur, undoubtedly caused by constant trauma to the irradiated areas with tight, uncomfortable shoes. Elimination of constant long-term irritations is achieved primarily through the manufacture and constant use of special therapeutic underwear, which does not cause either compression of the irradiated areas or injury to them due to friction. Such underwear should also facilitate good ventilation or air access to damaged skin. Finally, an indispensable condition is neatness, the use of only clean linen, since otherwise any high-quality fabric, soaked in sweat, loses its elastic properties, becomes stiff and will injure the skin when rubbing.

    What is radiation therapy and what are the consequences after it?

    Radiation therapy (radiotherapy) is the effect on the patient’s body of ionizing radiation from elements that have pronounced radioactivity for the purpose of treating cancer. Many people deliberately choose this method of treatment, but it is worth remembering that radiation therapy not only destroys cancer cells, it also causes damage to healthy tissues. The consequences of such exposure may appear immediately after the procedures or within six months after the end of treatment.

    Radiation irradiation is used as an independent method in the treatment of cancer:

  • skin, lips;
  • nasopharynx and oral cavity;
  • tonsils;
  • larynx;
  • cervix (as the main method of treatment, radiation therapy is used only in the early stages of tumor development);
  • at the initial stage of development of lymphoma, sarcoma.
  • To treat other types of cancer, radiation therapy is used only in combination and cannot be used as an independent method. Also, radiation therapy is not used separately in the treatment of cancer in children, but only as part of a comprehensive course of treatment.

  • Cachexia (rapid weight loss).
  • Anemia (if it is caused by the effect of cancer on the hematopoietic system).
  • Reduced levels of leukocytes in the blood, lymphocytes and platelets.

  • There are two different types of radiotherapy, depending on what particles are used to irradiate the tumor: corpuscular and photon. The first type of irradiation uses alpha and beta particles, as well as beams of neutrons, electrons and protons. Photon irradiation is carried out by exposure to gamma rays and x-rays. For example, electrons are used to destroy tumors located close to the skin, and protons are used for deep tumors (proton therapy).

    According to the method of influence they are distinguished:

  • Contact method. It is used quite rarely and only in cases where malignant neoplasms are on the surface. In this case, the radiation source is applied directly to the tumor. The main advantage of the contact method is that it has virtually no effect on nearby tissues.

    There are also conformal, stereotactic, adjuvant, intraoperative, and interstitial radiation therapy.

    Treatment with radiation therapy is carried out in several stages, the first of which is called planning (pre-radiation). At this stage, several specialists (oncologist, radiotherapist, dosimetrist) calculate the correct doses of radiation, choose the best way to introduce it into tissues during brachytherapy (in this case, the brachytherapist is also involved), determine the permissible load and reserve capacity of nearby tissues that may be exposed to radiation .

    Next, the doctor, based on the results of radiography, CT and MRI, makes markings on the patient’s body, that is, he marks the boundaries of the irradiated area.

    The second stage (radiation period) consists of the irradiation itself according to the scheme developed earlier. The course of radiotherapy lasts up to 7 weeks, and in the preoperative period up to 3 weeks. Sessions are held 5 days a week, with a break of 2 days.

    The procedure is carried out in a special isolated room. Doctors place the patient on a table or chair, place the radiation source on the marked area, and cover other areas of the body with protective blocks that will protect the skin and body from radiation. A session of exposure to ionizing rays is painless and usually lasts from 1 to 5 minutes.

    Complications of radiation techniques appear at different stages of treatment of malignant tumors, including after completion of the procedures. From the first sessions, many patients complain of redness and dryness of the skin. A little later, peeling and cracks may begin in these areas. Skin pigmentation and burns are also possible.

    When irradiating the pelvis, the following are observed:

  • Vomiting and nausea.
  • Disorders of the intestines and bladder.
  • Indigestion.
  • In women - impaired functioning of the ovaries, and, consequently, disruption of the menstrual cycle or complete cessation of menstruation, dryness and itching in the vagina.
  • During pregnancy, radiation therapy has a negative effect on the fetus; the results of such radiation cannot be predicted.
  • In men, there is a decrease in the number of active sperm.
  • For breast cancer:

  • Cough.
  • Dyspnea.
  • Difficulty breathing and swallowing.
  • Chest pain.
  • Inflammation of the mucous membrane of the esophagus, which manifests itself in the form of pain when swallowing, heartburn, and the feeling of a lump in the throat.
  • In women - swelling and hardening of the mammary glands.
  • For brain cancer:

  • Hair loss.
  • The appearance of small wounds on the scalp.
  • High body temperature.
  • Nausea, vomiting.
  • Drowsiness.
  • For basalioma (malignant skin tumor):

  • Swelling and peeling of the skin.
  • Severe skin itching and burning.

    For prostate cancer:

  • Irritable bowel syndrome - constipation, diarrhea, bloating.
  • Cystitis.
  • Urinary incontinence.
  • Erection problems that can lead to impotence.
  • Narrowing of the urethra.
  • For cervical cancer:

  • Redness and peeling of the skin.
  • Hair loss in the pubic area.
  • Narrowing of the vagina.
  • Dryness and burning in the genital area.
  • For acoustic neuroma:

    Other possible consequences of radiation treatment:

  • Increased fatigue, weakness.
  • Mental changes: depression, sleep disturbances, irritability, frequent mood swings, apathy, depression;
  • Dizziness and headaches.
  • Belching.
  • Flatulence.
  • Weight loss.
  • Increased salivation or dry mouth.
  • Stomach ache.
  • Constant thirst.
  • Hematopoietic disorders: decreased levels of leukocytes and red blood cells in the blood, decreased hemoglobin.
  • Decreased immunity.
  • to contents ^

    Recovery after therapy

    Rehabilitation begins immediately after the radiation sessions and consists of the following:

  • Gentle mode.
  • Ensuring adequate sleep and rest.
  • Rejection of bad habits.
  • Frequent walks in the fresh air.
  • Regular moderate exercise.
  • Healthy eating.
  • Wearing loose clothing of natural fabrics.
  • Taking vitamins.
  • After radiation therapy sessions, patients are advised to use oxygen cushions and frequently ventilate the room. Oxygen suppresses the symptoms of the body's general reaction to radiation.

    After radiotherapy, it is forbidden to heat the irradiated area, put cold compresses on it, wash it with hot water, comb it, lubricate it with iodine and other alcohol tinctures. To restore the skin, you must use products recommended by your doctor.

    One of the side effects of radiotherapy is loss of appetite, but despite this, it is necessary to eat enough food for a speedy recovery. Diet during radiation treatment involves avoiding dairy products and foods that increase gas formation - legumes (beans, peas, etc.) and all types of cabbage. You should also exclude from your diet:

    Useful during irradiation are:

    After radiation therapy, you can gradually include low-fat cheese, pumpkin, boiled low-fat fish, white meat (chicken or rabbit), vegetable soups and dairy products in your diet. You need to eat food often and in small portions.

    In addition, during and after radiotherapy you need to drink as much fluid as possible, giving preference to still water, green tea, non-acidic compotes and diluted light juices.

    Swelling after radiation therapy. Could this be radiation fibrosis?

    Swelling after radiation therapy. Could this be radiation fibrosis?

    My husband had two surgeries for laryngeal cancer. After all, the diagnosis is as follows: moderately differentiated squamous cell carcinoma with keratinization. The larynx, trachea, cervical part of the esophagus and lymph nodes on the right neck were removed. After the second operation - extended lymphadenectomy on the right - radiation therapy was prescribed. We completed 15 sessions of 2.4 g. There were painful sensations and redness of the skin. But after the end of radiation therapy, severe swelling of the face began. Presumably fibrosis. We cannot see our own doctor (on vacation). Has anyone encountered similar effects of radiation? Thank you.

    Registration: 04/14/2007 Messages: 657

    Or give a link to your topic to the moderators of the section V.V. Baryshev and Filimonov A.V. to the forum section "Nota Bene!" http://www.oncoforum.ru/forumdisplay.php?f=32511

    Perhaps there will not be enough information to answer - how long after the end of the course did the swelling begin, how long does it last, who suggested fibrosis and based on what data?

    Thank you for the consultation, but I wrote in the Radiotherapy section, but so far my message is not there. Thank you again.

    I would assume it's a radiation burn.

    For me, the real effects of radiation began already at home, almost a week after discharge. the so-called "accumulation effect".

    Talk to radiologists.

    Thanks for the answer. My husband’s swelling also began a few days after discharge. But at the moment I cannot consult with radiologists, because... We live in Anapa, and the treatment took place at the Rostov Oncology Institute. Go only at the end of the month. Did your swelling last for a long time and what did you do?

    Didn’t the doctors tell you about Dimexide compresses? I did it for burns, it helped, and I also applied methyluracil ointment, although they say it’s better to eat.

    No, they didn’t talk about dimexide. They prescribed Actovegin (ointment), olazol and rinses with malavit. We were not even warned about possible complications! What can we say about drugs!

    Radiation reactions, both early and late (fibrosis), occur only in places exposed to radiation. During postoperative radiation therapy, the face is not exposed to the radiation zone. Accordingly, this edema cannot be post-radiation fibrosis, not to mention the fact that fibrosis after irradiation develops only after several months. It can be assumed that the edema is associated with a violation of lymph outflow. The reasons may be extended lymph node dissection + radiation therapy to the lymphatic drainage areas. Treatment is drugs that improve microcirculation (Detralex, Trental).

    It’s difficult to judge anything else without examining the patient.

    Registration: 06/13/2007 Messages: 93

    Whether or not a person falls into the irradiation zone is determined. It could have hit.

    During my time, a woman’s larynx was irradiated - by the middle of the course she was already walking around with a red and swollen face.

    Perhaps the lymph nodes were irradiated.

    Registration: 12/16/2005 Messages: 944

    fishka: A radiologist once told me, “even if you smear it with gold, it’s all useless,” and only recommended baby cream and powder. I was treated with a spray for burns with sea buckthorn oil - it relieves pain and heals.

    By the way, for burns on the skin, some people applied Panthenol and quite successfully, I just wasn’t aware that methyluracil ointment was applied last century)

    Radiation epidermatitis and post-radiation fibrosis are completely different complications. Radiation epidermatitis is associated with the death of cells in the germ layer of the skin during irradiation. Accordingly, the treatment is local and aimed at suppressing infection, pain relief and stimulating cell growth. Your radiologist is basically right: it has not yet been possible to significantly stop the death of cells (there are no sufficiently effective radioprotectors yet), we can only create conditions for accelerating the division and growth of the survivors (by the way, about gold... maybe she meant something else).

    The situation with fibrosis is completely different. The changes are associated with vascular damage in the subcutaneous tissue and associated hypoxia. The fibrous tissue does not thin out, but rather grows. When the process is severe, the blood supply to the epidermis begins to suffer. Accordingly, treatment is aimed at improving blood supply and stopping the growth of fibrous tissue (antioxidants, dimexide). Dimexide is a rather unique drug; it penetrates well into tissues with a low level of blood supply.

    Yeees. I’m shocked))) how can it be that the same thing is explained in completely different ways. Thank you Alexander Vyacheslavovich for the enlightenment!

    Registration: 07/06/2007 Messages: 54

    Is it impossible to avoid the appearance of fibrosis? I’m terrified.. I also have to undergo radiation.

    The devil is not as scary as he is painted.

    The tolerable dose for connective tissue is 60 Gy. That is, the risk of fibrosis increases significantly with radical courses, when the dose in the subcutaneous tissue exceeds this level. At doses of about 30 - 40 Gy, the risk of severe fibrosis is not so great.

    If a radical course is planned, and this is especially true for tumors of internal organs, treatment with linear accelerators is more profitable. Unlike cobalt, the maximum dose on these devices is deeper than the subcutaneous tissue.

    Thank you very much to everyone who is taking part in this conversation!

    Alexander Vyacheslavovich, how long does this period usually last, during which a person experiences pain and the consequences of radiation (burn, redness, blisters)? My husband finished radiation on July 20. During the irradiation there was swelling, then it spread to my face. On the 21st we arrived home in Anapa (we were treated in Rostov) and the swelling began to increase. In Rostov we visited a neuro-oncologist. He made the following diagnosis: neuropathy of the auriculotemporal nerve (if I understood the Latin correctly). Recommended Finlepsin, Movalis, Ketonal. Then the radiologist prescribed diuretics. After them, the swelling subsided a little. At home, I continued to give my husband Diacarb with Panangin. And a neurologist in Anapa recommended us aescusan. Once the swelling practically subsided, but then my ear began to hurt wildly and the swelling came back.

    Perhaps you should consult a neurologist about Detralex or Trental? Neither the Rostov Research Institute nor Anapa told us anything about this. Thank you!

    Registration: 08/05/2007 Messages: 0

    Today I learned that in case of oncology, drugs to improve microcirculation (Trental, Detralex) are prescribed with great caution. The motivation is as follows: if there are cancer cells left, then with the help of these drugs they will spread through the blood “at the speed of light.” What to do then?

    Registration: 04/20/2007 Messages: 347

    Metastasis is a very complex process. This is not just a mechanical “detachment” of cells from the tumor and “attachment” to organs. This process involves not only tumor cells, but also many tissue factors and mediators of the body; blood elements (in particular, platelets) play a major role in metastasis.

    Trental prevents the aggregation (sticking together) of platelets and the release of certain tissue inflammatory factors, thereby reducing metastasis. This has been confirmed in animal experiments.

    There is clinical data indicating that radiation therapy in combination with trental and α-tocopherol (vitamin E) is more effective. One study in non-small cell lung cancer showed a 2-fold increase in two-year overall survival in the group of patients who received trental and tocopherol during treatment and 3 months. after him. Researchers associate the effect of pentoxifylline and tocopherol with a decrease in the processes of fibrosis of lung tissue

    Diagnosis of laryngeal edema on CT and MRI images of the neck

    What you need to know about throat swelling

  • Hereditary angioedema is quite rare (frequency is about 2-10-6).
  • Laryngeal edema (angioedema, Quincke's edema ) is common
  • Causes of swelling of the larynx and adjacent structures:

  • Trauma (tracheal intubation)
  • Infection with viruses or gram-negative bacteria (epiglottis)
  • Allergic reactions (for example, to radiocontrast agents)
  • Tumors (especially if infected)
  • Up to 50% of cases of chronic laryngeal edema develop after radiation therapy for cancer of the hypopharynx or larynx. It is associated with hyalinosis, which leads to obstruction of the veins or lymphatic vessels of the larynx.
  • Chronic hyperplastic laryngitis (Reinke's edema): most often occurs in smokers with constant vocal strain.
  • Acquired angioedema (caused by ACE inhibitors) or hereditary angioedema (associated with C1-esterase inhibitor deficiency, inherited in an autosomal dominant manner, manifested by periodic angioedema). Predisposing factors: Local trauma, hormonal changes, stress, certain foods and medications.
  • Reflux laryngitis: Caused by gastroesophageal reflux.
  • Acute damage to the larynx with edema in a child is one of the most common causes of respiratory failure. The cause may be narrow airways, loose tissue in the laryngeal space, a predisposition to laryngospasm, and weakness of the respiratory muscles.
  • Clinical manifestations

  • With hereditary angioedema, swelling of the lips, intestines (acute abdomen), urinary tract and genitals (difficulty urinating) is often observed.
  • Age peak: 10-30 and after 50 years
  • Edema associated with an infectious process, angioedema or acute allergic edema of the larynx has acute symptoms of its manifestation
  • Edema associated with a tumor or radiation therapy causes chronic symptoms. Acute and chronic symptoms include inspiratory stridor, rough voice, hoarseness, cough, dysphagia, foreign body sensation and/or shortness of breath
  • If infection occurs, fever appears.
  • Signs of laryngeal edema on CT and MRI images with contrast

    • CT with contrast
    • Is CT used to diagnose swelling of the throat?

    • The affected part of the larynx usually appears as a thickening with reduced density
    • The lesion is usually symmetrical if caused by an allergic reaction, angioedema, infectious laryngitis or radiation therapy
    • Often asymmetrical when caused by a tumor
    • Reinke's edema is characterized by unilateral or bilateral polypoid thickening of the vocal folds
    • An increase in the signal from the mucosa is observed mainly in the presence of an inflammatory process or tumor
    • In the case of chronic laryngeal edema after radiation therapy, there is often an increase in the density of the tissue located near the larynx and vocal folds, as well as subcutaneous tissue in combination with thickening of the subcutaneous muscle of the neck and skin (difficult to distinguish from local recurrence).
    • What MRI images of the throat will show with swelling

    • Thickening of the affected laryngeal mucosa
    • Low signal intensity on T1-weighted image, high signal intensity on T2-weighted image
    • If the swelling is associated with an inflammatory process or tumor, it increases after the administration of gadolinium
    • In chronic laryngeal edema after radiation therapy, a decrease in signal intensity in the periglottic space is observed on a T1-weighted image.
    • Features

      — Reinke's edema : Unilateral or bilateral thickening of the vocal folds.

      — Quincke's edema : Diffuse swelling of the larynx; may also affect the epiglottis, subglottis, and esophagus.

      — Reflux laryngitis: Swelling of the supraglottic, folded and subglottic sections, pronounced thickening of the mucous membrane of the posterior commissure (area of ​​the arytenoid cartilage).

      — Chronic laryngeal edema after radiation therapy : Thickening of the epiglottis, aryepiglottic fold, vestibular fold, posterior pharyngeal wall, anterior and posterior vocal commissures and subglottic mucosa. Swelling of the retropharyngeal space.

      What the attending physician would like to know

    • Changes to surrounding structures
    • Prevalence of edema
    • The presence of asymmetry, which may be a sign of a tumor or local recurrence of a malignant process (for example, after radiation therapy).
    • What diseases can laryngeal edema be confused with?

      Malignant tumors of the vocal folds and supraglottis

      - Difficult to distinguish from chronic laryngeal edema after radiation therapy

      — The most important criteria: asymmetric thickening of the mucous membrane in combination with infiltration or destruction of adjacent structures

      — Complication of laryngitis or injury

      — In the center there is a cavity with liquid contents

      — Strengthening the signal from the abscess wall

      - The paranasal sinuses are most often affected

      — B Possible concomitant damage to the hypopharynx or larynx

      — Inflammatory edema, often combined with destruction of cartilage tissue

    • Antibacterial therapy, glucocorticoids.
    • — Allergic reactions that cause swelling of the larynx have the same treatment:

    • Antihistamines
    • Infusion therapy.
    • — Acquired angioedema:

    • Antigen exclusion (ACE inhibitors)
    • Glucocorticoids
    • Antihistamines.
    • — Hereditary angioedema:

    • Replacement therapy with C1-esterase inhibitors
    • Tranexamic acid
    • Cyclic therapy with danazol
    • Antihistamines
    • Adrenaline is not effective!
    • Treatment of the underlying disease (H+-, K*-ATPase inhibitors, elevated position of the upper body, fundoplication).
    • First aid for Quincke's edema

      Since this is an acute condition, it is important to know what needs to be done before the MSP arrives.

      • Calling an ambulance
      • Remove the cause that caused the swelling (stop taking medications, stop eating food, liquids, or, if it is an insect bite, remove its sting)
      • It is necessary to reassure the patient
      • Loosen or remove constrictive clothing
      • To reduce the concentration of allergen in the blood, give a lot of water
      • If you have antihistamines on hand, give them a drink/injection.
      • Apply vasoconstrictor drops to the nose (for example, naphthyzin)
      • What specialties do doctors diagnose and treat laryngeal edema?

        — ENT (primary examination)

        — Allergist (selection of therapy)

        — Surgeon (performing tracheostomy, decortication of vocal cords)

      • With angioedema and allergic edema, rapid clinical improvement is observed during treatment
      • In patients with hereditary angioedema, the mortality rate is 12%, which is associated with asphyxia as a result of swelling of the vocal folds
      • Infectious forms and reflux laryngitis usually have a favorable course
      • Chronic laryngeal edema after radiation therapy is difficult to treat
      • An asymmetrical lesion should raise suspicion for the development of a local recurrence of a malignant tumor.
      • Possible complications and consequences

      • Acute respiratory failure
      • Hoarseness of voice
      • CT scan of a man who underwent radiation therapy and surgery on the right neck during treatment for tongue cancer. There is a heterogeneous increase in density and swelling of the soft tissues of the larynx and subcutaneous tissue as a sign of edema due to radiation exposure

        CT scan of a woman with laryngeal edema. Circular swelling of the mucous membrane with reduced density is observed.

        Complications of radiation therapy

        Radiation therapy is one of the forms of treatment of malignant tumors or other neoplasms not related to oncology, in which the main influencing factor is ionizing (radioactive) radiation. This treatment process is carried out using special devices that serve as a source of radioactive rays.

        As a rule, malignant cells cannot withstand the effects of ionizing radiation and die out. Treatment occurs in several stages, sometimes the tumor is irradiated from several sides. At the same time, the main task of doctors is to preserve healthy tissues from the adverse effects of radioactive rays. And yet, ionizing radiation cannot be considered completely safe, because in the process of such exposure complications of radiation therapy quite often arise.

        In most cases, complications during this treatment depend on the condition of the tissues being irradiated and the dose of radiation. They are early and late. Immediately after irradiation (sometimes during therapy), early complications occur. If systemic complications are observed, for example, severe fatigue, then poor health goes away on its own without interfering with further radiation therapy. But local complications are more serious. They are usually expressed by redness of the skin (erythema), up to detachment of the epidermis, or weeping erosion. This is due to impaired regeneration of irradiated tissue.

        Initially, the effects of radiation therapy cause redness, itching, and swelling of the irradiated tissue. These phenomena resemble a burn. However, radiation burns differ from thermal injuries in that they do not appear immediately, but after some time. Of course, the severity of the burn and the duration of rehabilitation recovery depend on the location of the tumor, the intensity of radiation, the depth and area of ​​exposure.

        Early acute burn skin lesions are divided into three main types. In the first case, the skin turns red, swells, and peels. This is dry epidermatitis. In the second type, the skin begins to itch, becomes red, and very swollen. This condition is called erythema. The third type is characterized by the appearance of a large number of papules filled with liquid mixed with pus. It is called moist epidermitis.

        In the case of irradiation of the abdomen or pelvic area, early complications make themselves felt by gastrointestinal disorders, expressed in nausea, vomiting, diarrhea, and dysphagia. Irradiation of the neck and head leads to inflammation of the pharynx and mucous membranes of the oral cavity. When a large volume of bone marrow is irradiated, the process of hematopoiesis may be disrupted, anemia, thrombocytopenia or leukopenia may occur. If severe consequences of radiation therapy occur, it is recommended to interrupt treatment for a certain period to restore the irradiated tissue.

        Late complications of radiation therapy appear after a certain time has passed after completion of the course of treatment. This may happen in a few months or even years. Basically, late complications arise due to the maximum dose of radiation received by the body tissues. Moreover, their development is in no way connected with the presence of early complications. It is believed that the duration of the recovery period depends on the volume of irradiated tissue, the degree of destruction of the endothelium (cells of the inner surface of blood and lymph vessels) and the number of stem cells preserved during this period. In the absence of stem cells, when it is impossible to replace them with surrounding tissues, radiation damage persists for a long period.

        It is noted that even after many years, the following negative phenomena are observed at the site of exposure to radiation: swelling or fibrosis of the skin surface, radiation dermatitis, ulcers. Such consequences of radiation therapy require constant care, requiring serious attention and regular hygiene procedures. Typically, drying agents are applied to the affected areas.

        Of course, when carrying out radiation therapy, you should follow all the recommendations of the attending radiologist. Responsible implementation of all his instructions will lead to rapid restoration of the skin, prevent complications, and ensure a speedy recovery. Take care of yourself!

        Categories : Diagnostics

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