Coping with Radiation Side Effects with Soft Tissue Sarcoma

If you’ve been diagnosed with soft tissue sarcoma, a type of cancer that forms from soft tissues which connect and support other tissues in the body (such as the muscles, tendons, nerves, and blood vessels), you’re wading through a lot of questions and concerns. What are the treatment options for soft tissue sarcoma? How is will treatment affect my day-to-day life? Is soft tissue sarcoma curable?

First off, know that you can fight soft tissue sarcoma. “This is a curable cancer,” says Richard Bakst, MD, a radiation oncologist at Mount Sinai Hospital.

When you’re diagnosed with soft tissue sarcoma, your medical team will want to find out if the cancer has spread (and if so, how much) using a process called staging. Soft tissue sarcoma staging helps doctors better understand how serious the soft tissue sarcoma diagnosis is and how to best treat it.

Surgery is the most common soft tissue sarcoma treatment. “Surgery is meant to remove the mass that the surgeon can see, both with their eyes, and on imaging,” says Bakst. The goal of surgery is to remove the entire tumor along with at least 1 to 2 cm (less than an inch) of the normal tissue surrounding the tumor. This is to make sure that no cancer cells are left behind. In some cases, surgery may be the only treatment for soft tissue sarcoma needed. “Sometimes proceeding surgery, radiation is administered, or following surgery, radiation can also be administered as well,” says Dr. Bakst.

Treating Soft Tissue Sarcoma with Radiation

Radiation therapy is a daily treatment given over the course of five to six weeks that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. “Radiation is intended to eradicate microscopic disease that may be left behind, that the surgeon can’t see with his or her eye or that can’t be picked up on the scan,” says Dr. Bakst.

The side effects of radiation therapy depend on the area being treated and the dose given to the patient. “Typically radiation patients see their oncologist once a week during treatment,” says Dr. Bakst. “The doctor should always explain all the toxicities that they’re developing. One of the benefits of seeing patients on a daily basis, is that we can really manage those toxicities as they develop so that they don’t become too severe,” says Dr. Bakst.

Some common side effects of radiation therapy are:

• Skin changes to the area in contact with radiation, which can range from redness to blistering and peeling
• Swelling, pain, and weakness in limbs and joints being treated
• Fatigue
• Bone weakness, which can lead to fracture years later
• Nausea and vomiting (more common with radiation to the abdomen)
• Diarrhea (most common with radiation to the pelvis and abdomen)
• Pain with swallowing or difficulty tasting (from radiation to the head, neck, or chest)
• Lung damage leading to problems breathing (from radiation to the chest)
• If radiation is given before surgery, it may cause problems with wound healing
• Hair loss, headaches, and problems thinking (more common for radiation to the brain to treat metastatic sarcoma)

Many of these radiation side effects will improve or go away after radiation therapy is completed. Some side effects from radiation, however, like bone weakness and lung damage, may be permanent.

Tips to Cope with Radiation Side Effects

Feel good about going back to work. Many people with cancer are eager to go back to work. It’s not only a source of income, but a great way to keep busy and give you a sense of routine. “In general patients can work, at least during the initial portion of those treatments, however depending on how their toxicity progresses, they may not be able to work on a daily basis towards the end of treatment,” says Dr. Bakst.

Practice self-care to help boost your self-image. Cancer can alter how you look and feel about yourself, especially if  you start to experience physical changes, like scarring, hair loss, and skin and weight changes. It’s OK to feel angry or frustrated, you have a right to grieve. That said, trying to stay positive is key. Here are a few ways to boost your self-image:

• Focus on how coping with cancer has made you stronger or wiser.
• If your skin has changed, ask you doctor how you can care for it.
• Look for new ways to enhance your appearance. A new haircut, hair color, makeup, or clothing may give you a lift. If you’re wearing a wig, you can take it to a hairdresser to shape and style.
• Keep active with activities like swimming, doing yoga, or taking an exercise class. Moving more can help make you stronger, but it can also lift your mood, reduce stress, and help you relax. Here are more astounding benefits of exercise. 

Talk with your family and friends. Your loved ones are a great source of support. During treatment, it’s important to keep communication as open and honest as possible, and to ask for help when you need it. Most importantly, enjoy your time together. Your life may change in many ways, but you’re still you and they’re still them. Focus on the relationship you have and spending as much time with them as possible.

“I think the best thing people can do undergoing treatment is to just focus on the task at hand. Come in for radiation every day. Follow [up] with their physicians as prescribed and undergo all the imaging that’s ordered for them. And of course be vigilant about their bodies. Focus on their pain control, focus on their function, focus on their food, focus on their calories, focus on their fluid, and overtime they will naturally return to their normal life, but it’s most important to get the treatment that you are prescribed,” says Dr. Bakst.