Hormonal Imbalances Caused by Radiation Therapy

Introduction

High-energy rays are used in radiation therapy, a frequently used cancer treatment, to kill cancer cells. Radiation therapy can be beneficial in treating cancer but also has adverse effects, such as alterations in hormone levels. Hormone production can be impacted by radiation therapy in several ways. For example, it may harm the cells of the pituitary gland, which is involved in the synthesis of the hormones that control metabolism, growth, and other biological processes. This can result in hypopituitarism, a disorder marked by a lack of one or more pituitary hormones. Hypopituitarism can cause symptoms such as weakness, weight gain, irregular menstruation periods, and weariness. It is important to remember that hormonal abnormalities caused by radiation therapy might start to develop months or even decades after the course of treatment.

What Is Radiation Therapy?

High-energy rays, such as X-rays, are used in radiation therapy, commonly known as radiotherapy, to kill or harm cancer cells. Breast cancer, lung cancer, prostate cancer (when prostate gland cells begin to expand out of control leading to cancer), and head and neck cancer are just a few of the numerous cancers that can be treated with radiation treatment. Radiation treatment attempts to provide a precise and highly focused dosage of radiation to the cancer cells while limiting exposure to healthy surrounding tissue. A device called a linear accelerator delivers the radiation to the tumor. The device produces a high-energy radiation beam aimed at cancer in various directions. A radiation oncologist (a medical professional with specialized training in radiation therapy for cancer) and a medical physicist collaborate to establish the treatment strategy. External beam radiation treatment and internal radiation therapy are the two primary forms of radiation therapy. The most used kind of radiation therapy is external beam radiation therapy. Typically, radiation treatment is administered in tiny doses over a few weeks. The type and stage of cancer treatment, the patient's general health, and treatment objectives will all affect the precise treatment plan and length. Some people might encounter adverse effects.

1. External Beam Radiation Therapy: It uses a device that produces a radiation beam aimed at the tumor (a mass of tissue that develops abnormally when cells do not die when they should or expand and divide) from outside the body.

2. Internal Radiation Therapy: In this form of radiation therapy, a tiny quantity of radioactive material is injected into or close to the tumor. Brachytherapy is another name for this process.

What Are the Hormonal Disorders Caused by Radiation Therapy?

Depending on the site of radiation treatment and the dose received, specific hormonal problems may develop. Radiation therapy may result in a variety of hormonal issues, including:

1. Hypothyroidism: Thyroid gland damage from chest or neck radiation treatment might result in an underactive thyroid such as hypothyroidism (occurs when the thyroid gland produces insufficient thyroid hormone). Weight gain, fatigue, and sensitivity to cold are all signs of hypothyroidism.

2. Adrenal Insufficiency: Adrenal insufficiency, a disorder caused by adrenal gland damage by radiation treatment to the abdomen (stomach), can occur. Low blood pressure, weakness, exhaustion, and weight loss are all signs of adrenal insufficiency.

3. Menopause: Women may experience early menopause (the moment the menstrual period finishes) due to pelvic radiation treatment that damages their ovaries (one of two female glands where eggs are produced and estrogen and progesterone are made). Hot flashes, night sweats, and dry vagina are menopausal symptoms.

4. Hypogonadism: Men who get radiation therapy to the testicles may develop a disorder known as hypogonadism (which occurs when the sex glands in the body do not create enough hormones) as a result of damage to the testes. Reduced libido drive indicates that sex drive, or the urge for sex, differs significantly from one person to another; erectile problems (having trouble gaining and maintaining an erection) and infertility are all signs of hypogonadism.

What Are the Symptoms of Hormone Disorders Caused by Radiation Therapy?

High-energy radiation used to treat cancer can have several adverse side effects. Damage to the endocrine glands, which can result in hormonal abnormalities, is one of the potential negative effects of radiation therapy. Depending on the particular gland that is impacted, radiation therapy-induced hormone abnormalities might present with a variety of symptoms, but some typical ones can include:

1. Thyroid Dysfunction: Radiation treatment to the head and neck can either cause thyroid gland damage either an under or overproduction of thyroid hormones which leads to hyperthyroidism (occurs when the thyroid gland produces an excess of thyroid hormone) or hypothyroidism. While tiredness, weight gain, and cold intolerance are signs of hypothyroidism, shaking, a fast heartbeat and weight loss are signs of hyperthyroidism.

2. Adrenal Dysfunction: Damage to the adrenal glands from radiation therapy to the chest or abdomen might result in low levels of cortisol or aldosterone. Low blood pressure, weakness, sleepiness, and weight loss are some signs of adrenal insufficiency.

3. Pituitary Dysfunction: One or more pituitary hormones may not be present due to radiation therapy to the head and neck damaging the pituitary gland. Depending on which hormone is impacted, this might result in many symptoms. For instance, a lack of growth hormone can result in low height, whereas a lack of prolactin can make men's breasts bulge (gynecomastia) and induce libido loss.

4. Ovarian Dysfunction: Ovarian damage from radiation therapy to the pelvis may result in lower levels of progesterone (a group of drugs known as progestins female hormones) and estrogen (a hormone that functions in the body in several ways for females). This may result in symptoms including osteoporosis, vaginal dryness, and hot flashes.

What Is the Treatment Plan For Radiation-Related Hormone Disorder?

A particular treatment strategy will be chosen depending on the kind of hormone problem that develops and the unique condition. The following are examples of common treatments:

1. Hormone Replacement Therapy: Hormones that the body is no longer producing must be replaced through supplementation. For instance, a person may get growth hormone replacement treatment if radiation therapy destroys the pituitary gland and results in a growth hormone shortage.

2. Medications to Manage Symptoms: Some patients may require a prescription to treat symptoms brought on by hormone problems. For instance, thyroid hormone replacement treatment may be advised if a patient experiences hypothyroidism due to radiation therapy.

3. Surgery: Surgery may occasionally be required to remove a tumor or damaged gland that is the source of a hormone imbalance.

4. Follow-up Care: Regular follow-up treatment is essential to track hormone levels and look for problems. This might involve physical examinations, imaging studies, and blood testing.

Conclusion

It is essential to understand that radiation therapy might temporarily or permanently harm the hormone-producing glands. The resulting symptoms may develop after a specific amount of time and can be managed with hormone replacement therapy. Additionally, it is essential to recognize that not everyone who undergoes radiation therapy will have hormonal abnormalities; the likelihood of acquiring these diseases is affected by various variables, including the radiation dose received and underlying medical issues. The radiation oncologist can obtain more details on the radiation therapy side effects unique to the treatment plan.