Post-Radiation Symptoms in Nasopharyngeal Cancer Patients: What to Expect

Post-nasopharyngeal radiotherapy

Hello Dr.
Chen, it has been 1.5 months since I completed radiation therapy for nasopharyngeal cancer.
I started experiencing 24-hour pulsatile tinnitus during the mid-treatment, which continues to this day.
Recently, I have also felt a slight swelling sensation below my brain, specifically at the radiation site, and I experience a brief headache at the top of my head when I stand up.
Could these symptoms be caused by damage to the carotid artery due to radiation? Is it possible for these symptoms to appear so soon? The tumor was located on the left side, and since the treatment ended, my left eye appears noticeably more sunken than the right, and my eyelids have changed from double to four eyelids, although my vision has not changed.
Should I undergo any specific examinations? Thank you for your valuable time and advice.

Qing, 30~39 year old female. Ask Date: 2022/05/09

Dr. Chen Sirong reply Oncology

Qing, 39 years old, female.
For some individuals, the inflammatory reactions from radiation therapy may take 2-3 months to resolve.
However, the radiation oncology department is only responsible for the treatment itself; side effects such as tinnitus and vision problems should be evaluated separately by an otolaryngologist and an ophthalmologist.
If the indentations are purely due to connective tissue or muscle atrophy, the physician may request an MRI or CT scan after radiation therapy to assess for other potential causes.
Wishing you peace and health.
Taoyuan Hospital, Dr.
Chen Si-Rong.

Reply Date: 2022/05/09

More Info

Post-radiation symptoms in nasopharyngeal cancer patients can vary significantly, and it's important to understand what to expect after treatment. In your case, experiencing pulsatile tinnitus (24-hour ear ringing) and sensations of pressure or mild swelling in the area where radiation was applied, along with transient headaches, can indeed be concerning. These symptoms may not necessarily indicate damage to the carotid artery, but they could be related to the effects of radiation therapy on surrounding tissues, including inflammation or changes in blood flow.

Radiation therapy can lead to a variety of side effects, some of which may manifest shortly after treatment, while others may take weeks or even months to develop. The acute effects of radiation often include inflammation, which can cause symptoms such as pain, swelling, and changes in sensation. In your case, the pulsatile tinnitus could be a result of changes in the auditory system or surrounding structures due to radiation-induced inflammation. It is not uncommon for these symptoms to appear within a month or two after completing radiation therapy.

The changes you describe in your left eye, such as noticeable sinking and alteration in eyelid appearance, could be attributed to radiation effects on the soft tissues and muscles around the eye. This can lead to conditions such as radiation-induced fibrosis or atrophy of the surrounding tissues. While the absence of vision changes is a positive sign, it is still essential to monitor these changes closely.

Regarding the need for further examinations, it would be prudent to consult with specialists in otolaryngology (ear, nose, and throat) and ophthalmology. An MRI or CT scan may be recommended to assess any structural changes in the area affected by radiation. These imaging studies can help identify any potential complications, such as necrosis or significant changes in the soft tissues, which may require intervention.

In addition to imaging, it may be beneficial to evaluate your symptoms through a comprehensive assessment that includes audiological evaluations for the tinnitus and an eye examination to assess the health of your left eye. This multidisciplinary approach will provide a clearer picture of your condition and help guide further management.

In summary, while your symptoms may be related to the effects of radiation therapy, it is essential to have a thorough evaluation by the appropriate specialists. They can provide targeted assessments and recommend interventions that may alleviate your symptoms and improve your quality of life. Always remember that timely communication with your healthcare team is crucial in managing post-radiation symptoms effectively.

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