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Immune System Recovery After Radiation

How Strong Is Your Immune System After Cancer Treatment

What to Eat and What Should Avoid During Radiation Therapy? | Dr. Kanika Sharma (English)

After chemo and radiation, your immune system can stay suppressed for several months.

A study of people who had chemo for breast cancer found the immune system often took nine months or more to fully recover. Several types of immune-system cells were depleted.

In people who smoked, some immune cells were only at 50% of normal levels after nine months. Thats compared to an 80% rate in nonsmokers.

Researchers say the immune-system damage could leave you vulnerable to some illnesses even if youve been vaccinated. These include tetanus and pneumonia .

Specific chemo drugs have different effects. In the study, people given the drug anthracycline had normal immune function by the end of the study period. Those who took anthracycline plus taxane, a more traditional chemo drug, recovered much more slowly.

While newer research has been illuminating, much remains to be learned about the specific immune-system effects of cancer treatments.

Immune Effects Of High Dose Radiation Treatment: Implications Of Ionizing Radiation On The Development Of Bystander And Abscopal Effects

Ithaisa Sologuren1,2, , Carlos Rodríguez-Gallego1,2, , Pedro Carlos Lara1,3

1 Instituto Canario de Investigación del Cáncer , Department of Immunology, Hospital Universitario de Gran Canaria Dr, Negrín , Las Palmas de Gran Canaria , Radiation Oncology Department, Hospital Universitario de Gran Canaria Dr, Negrín , Las Palmas de Gran Canaria , Spain

Correspondence to:

Keywords: Abscopal effect anti-tumor immunity bystander effect cancer high dose radiation therapy

Submitted Jan 13, 2014. Accepted for publication Feb 19, 2014.

doi: 10.3978/j.issn.2218-676X.2014.02.05

Cancer Treatment Can Cause Mouth And Throat Problems

Complications of chemotherapy

Oral complications caused by radiation therapy to the head and neck include the following:

  • Fibrosis in the mucous membrane in the mouth.
  • Tooth decay and gum disease.
  • Breakdown of tissue in the area that receives radiation.
  • Breakdown of bone in the area that receives radiation.
  • Fibrosis of muscle in the area that receives radiation.

Complications caused by either chemotherapy or radiation therapy

The most common oral complications may be caused by either chemotherapy or radiation therapy. These include the following:

  • Inflamed mucous membranes in the mouth.
  • Infections in the mouth or that travel through the bloodstream. These can reach and affect cells all over the body.
  • Changes in dental growth and development in children.
  • Malnutrition caused by being unable to eat.
  • Dehydration caused by being unable to drink.
  • Tooth decay and gum disease.

Also Check: How Long After Chemo Finishes Do You Feel Better

Dental Treatments May Be Put Off Until The Patient’s Immune System Returns To Normal

Regular dental treatments, including cleaning and polishing, should wait until the transplant patient’s immune system returns to normal. The immune system can take 6 to 12 months to recover after high-dose chemotherapy and stem cell transplant. During this time, the risk of oral complications is high. If dental treatments are needed, antibiotics and supportive care are given.

Supportive care before oral procedures may include giving antibiotics or immunoglobulin G, adjusting steroid doses, and/or platelettransfusion.

Radiation Therapy Side Effects


Radiation not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. Damage to healthy cells can cause side effects.

Many people who get radiation therapy have fatigue. Fatigue is feeling exhausted and worn out. It can happen all at once or come on slowly. People feel fatigue in different ways and you may feel more or less fatigue than someone else who is getting the same amount of radiation therapy to the same part of the body. See Fatigue and Cancer Treatment to learn more.

Other radiation therapy side effects you may have depend on the part of the body that is treated. To see which side effects you might expect, find the part of your body being treated in the following chart. Many of the side effects in the list link to more information in the Side Effects section. Discuss this chart with your doctor or nurse. Ask them about the side effects that you might expect.

Also Check: Best Cream For Breast Radiation Treatment

Oral Devices Need Special Care During High

The following can help in the care and use of dentures, braces, and other oral devices during high-dose chemotherapy or stem cell transplant:

  • Have brackets, wires, and retainers removed before high-dose chemotherapy begins.
  • Wear dentures only when eating during the first 3 to 4 weeks after the transplant.
  • Brush dentures twice a day and rinsing them well.
  • Soak dentures in an antibacterial solution when they are not being worn.
  • Clean denture soaking cups and changing denture soaking solution every day.
  • Remove dentures or other oral devices when cleaning your mouth.
  • Continue your regular oral care 3 or 4 times a day with dentures or other devices out of the mouth.
  • If you have mouth sores, avoid using removable oral devices until the sores have healed.

Oral Complications Of Chemotherapy And Radiation Therapy In Children

Children who received high-dose chemotherapy or radiation therapy to the head and neck may not have normal dental growth and development. New teeth may appear late or not at all, and tooth size may be smaller than normal. The head and face may not develop fully. The changesare usually the same on both sides of the head and are not always noticeable.

Orthodontic treatment for patients with these dental growth and development side effects is being studied.

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Role Of Vitamin D In Radiosensitivity

More recently, accumulating evidence has confirmed the anticancer role of vitamin D in several cancer models. In addition to the induction of differentiation and proliferation inhibition, the role of vitamin D as a magnifier of radiation response is emerging. Evaluation of combined therapy was performed in preclinical studies, showing synergistic or additive antitumor effectiveness. To date, the molecular mechanisms by which vitamin D potentiates the antitumor effects of RT are only partially known, and need further clarification. The antitumor actions of vitamin D are carried out through several mechanisms, such as induction of apoptosis, inhibition of proliferation, and suppression of angiogenesis. Additionally, vitamin D can also potentiate the antitumor effects of RT through different pathways. A summary of previous literature on the role of vitamin D to enhance radiation sensitization in cancer is presented in Figure 1.

Figure 1. Vitamin D-induced molecular mechanisms involved in enhancing radiosensitivity in several tumors.

How Radiation Modulates Antigen Presentation By Cancer Cells

Bone Marrow and Stem Cell Transplantation for Cancer An Introduction

A bulk of work in pre-clinical tumor models, supported by clinical observations, provided the rationale for the hypothesis that focal tumor RT can convert the tumor into an in situ, individualized vaccine . Irradiated cancer cells undergo a stressful death that is associated with the release of DAMPs, such as the high-mobility-group Box 1 alarmin protein , and the upregulation of signals that promote their phagocytosis by DCs, such as calreticulin . This fate is shared by cancer cells that are treated with chemotherapy agents such as anthracyclines and oxaliplatin . In addition, our recent studies have revealed a key role of radiation-induced viral mimicry in the stimulation of robust tumor-specific CD8 T-cell responses that are capable of mediating systemic tumor regression in concert with ICB therapy .

Overall, preclinical and clinical evidence suggests that RT, in addition to the recruitment of DCs specialized in cross-presentation of tumor antigens to CD8 T cells, can enhance tumor antigenicity by inducing a burst of gene transcription that is likely to provide many new and potentially immunogenic peptides for loading onto MHC-I of both cross-presenting DCs and cancer cells.

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Ionizing Radiation And The Immune System

The effects of ionizing radiation are seen not only in the tumor cells but also in the tumor microenvironment. In general, lymphocytes are among the most radiosensitive cells, followed by monocytes, macrophages and antigen-presenting cells , specifically dendritic cells , which have a higher radioresistance 3133. Ionizing radiation also has an effect on the vascular endothelium, with an increase in the production of molecules involved in cellular adhesion, which facilitates the recruitment of antitumor T cells against the corresponding sites 34.

After irradiation, dead and stressed cells release a variety of substances that gives ionizing radiation either immunosuppressive or immune stimulating properties. There is still a lack of information on the role and functionality of immune cells after irradiation. Nevertheless, a number of experimental studies have clarified some aspects of the immune response after exposure to radiation.

Radiation induces distinct tumor cell death forms and, consequently, the release of pro-inflammatory cytokines, chemokines, tumor antigens, and other danger signals. Through this mechanism, radiation may enhance tumor immunogenicity. Radiation may promote a large amount of tumoral neoantigens that are then presented to the T lymphocytes. Therefore, radiation carries the potential to initiate the adaptive and innate immune responses, resulting in systemic antitumorigenic effects inside and outside of the irradiation field 35.

What B Cells Do

B cells react against invading bacteria or viruses by making proteins called antibodies. Your body makes a different antibody for each different type of germ . The antibody locks onto the surface of the invading bacteria or virus. This marks the invader so that the body knows it is dangerous and needs to be killed. Antibodies can also find and kill damaged cells.

The B cells are part of the memory of the immune system. The next time the same germ tries to invade the B cells that make the right antibody are ready for it. They are able to make their antibody very quickly.

Recommended Reading: Hpv Head And Neck Cancer Symptoms

Oral Complications And Social Problems

The social problems related to oralcomplications can be the hardest problems for cancer patients to cope with. Oral complications affect eating and speaking and may make you unable or unwilling to take part in mealtimes or to dine out. Patients may become frustrated, withdrawn, or depressed, and they may avoid other people. Some drugs that are used to treat depression cannot be used because they can make oral complications worse. See the following PDQ summaries for more information:

Education, supportive care, and the treatment of symptoms are important for patients who have mouth problems that are related to cancer treatment. Patients are watched closely for pain, ability to cope, and response to treatment. Supportive care from health care providers and family can help the patient cope with cancer and its complications.

Treatment Areas And Possible Side Effects

How to Restore Energy After Radiation Treatments
Part of the body being treated Possible side effects

Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is over. But sometimes people may have side effects that do not improve. Other side effects may show up months or years after radiation therapy is over. These are called late effects. Whether you might have late effects, and what they might be, depends on the part of your body that was treated, other cancer treatments you’ve had, genetics, and other factors, such as smoking.Ask your doctor or nurse which late effects you should watch for. See the section on Late Effects to learn more.

  • Reviewed:January 11, 2022

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Researchers Disable Cloaking Mechanism That Hides Tumors From The Immune System After Radiation Therapy

Irradiated breast cancer cells release DNA from mitochondria , setting off an alarm for the immune system. The blue color marks nuclei. Image courtesy of the Galluzzi lab.

Localized radiation therapy against a tumor can trigger a beneficial immune response throughout the body by releasing DNA from mitochondria into the cytoplasm of tumor cells, according to new preclinical research by Weill Cornell Medicine and NewYork-Presbyterian investigators. The findings suggest a new strategy for boosting this response, which may significantly increase the effectiveness of radiation against certain cancers.

Radiation therapy is a cornerstone of modern cancer treatment, and it can be highly effective against certain tumor types. In addition to destroying tumors that are exposed directly to the radiation, the treatment can trigger an abscopal response, in which the damaged tumors prime the patient’s immune system to recognize and destroy similar tumors elsewhere in the body. That boosts the effectiveness of the treatment dramatically, sometimes even leading to complete remission. Unfortunately, very few patients develop an abscopal response after radiation therapy, and researchers have struggled to figure out why. The new work helps explain why the response is rare, and points toward ways to address it.

Dr. Lorenzo Galluzzi

Dr. Silvia Formenti

Certain Drugs Used To Treat Cancer And Other Bone Problems Are Linked To Bone Loss In The Mouth

Some drugs break down bone tissue in the mouth. This is called osteonecrosis of the jaw . ONJ can also cause infection. Symptoms include pain and inflamedlesions in the mouth, where areas of damaged bone may show.

Drugs that may cause ONJ include the following:

It’s important for the health care team to know if a patient has been treated with these drugs. Cancer that has spread to the jawbone can look like ONJ. A biopsy may be needed to find out the cause of the ONJ.

The following may also increase the risk of ONJ:

  • Having teeth removed.

Patients with bone metastases may decrease their risk of ONJ by getting screened and treated for dental problems before bisphosphonate or denosumab therapy is started.

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The Bottom Line: Expert Wound Care For Radiation Wounds

As a patient of radiation therapy, you need ongoing and personalized wound care to help you overcome radiation injuries and side effects. You deserve to get that help in the comfortable, refreshing, and attractive environment offered by R3 Wound Care and Hyperbarics.

With eight convenient locations throughout Texas, R3 Wound Care provides advanced therapies like HBOT previously only available at large medical institutions. Every HBOT treatment at R3 occurs in a clear acrylic chamber where you relax, recline, and enjoy a good book or movie for a few hours.

Visit the R3 location closest to you today to learn more about this natural alternative healing treatment and its potential to finally liberate you from your painful radiation side effects.

Oral Complications May Be Caused By The Treatment Itself Or By Side Effects Of The Treatment

Cancer Treatment: Chemotherapy

Radiation therapy can directly damage oral tissue, salivary glands, and bone. Areas treated may scar or waste away.Total-body radiation can cause permanent damage to the salivary glands. This can change the way foods taste and cause dry mouth.

Slow healing and infection are indirect complications of cancer treatment. Both chemotherapy and radiation therapy can stop cells from dividing and slow the healing process in the mouth. Chemotherapy may decrease the number of white blood cells and weaken the immune system . This makes it easier to get an infection.

Also Check: Most Common Cancer Drugs List

Targeting Cancer Cells With Advanced Radiation Therapy

Advances in stereotactic radiation therapy and technology are helping the Radiation Oncology team at UT Southwestern’s Harold C. Simmons Cancer Center deliver more effective and less invasive treatments to patients. Nina Sanford, M.D., provides a behind-the-scenes look at the life-changing options.

In general, dietary supplements are not regulated by the U.S. Food and Drug Administration. They are not tested for effectiveness or safety in the same way as medications or prescribed treatments. So, we can’t fully predict how supplements and vitamins will interact with or reduce the effectiveness of prescribed treatments, including radiation therapy.

A recently published study showed that women with breast cancer who took supplements in addition to treatment had higher risk of their cancer coming back. I also published a study in 2019 showing that nearly a third of patients with cancer who were using complementary and alternative therapies such as dietary supplements did not discuss it with their doctors.

No matter how beneficial a supplement might seem, its important to let your provider know about it, so we can best advise you on weighing potential risks and benefits.

4. Will radiation change the way I look?

Most patients dont need to worry about long-term dermatological issues after radiation treatment, but we generally advise them to use good sun protection and to keep their skin moisturized to minimize risk.

5. Can I continue to work and exercise during treatment?

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