Latent Radiotherapy Effects

A lot of Grays

In 2011 I received 65 grays of radiation to help prevent the recurrence of my cancer following surgery. I have described my experience of radiotherapy already. I have also described my onset of lower cranial palsies in 2015. I am writing this at the beginning of 2025 as an update is due. I remain cancer free or at least there is no evidence of cancer in my annual scans. These are not the quite the same thing but I must treat them as so. I must remain positive and banish any thoughts of cancer spreading invisibly and unseen by the radiographers. And for the most part I do, I believe that I do not have any active cancer cells. But it is not 100%. It is hard to vanquish every nagging doubt. Especially, when things are slowly changing and evolving.

The palsies I described before remain largely unchanged. I can still lift my right arm, my tongue still bends to the right but it hasn't got any worse. Over time these palsies have been joined by others. My sternocleidomastoid muscle which is innervated by the Spinal Accessory Nerve has wasted away on my right side which, with my drooped shoulder, is perhaps the most visually obvious of the changes. Not that anyone really notices these things unless you point it out. Inside my mouth some of my soft palate has wasted away leaving a very asymetrical opening to my throat.

In 2024 I was officially diagnosed with palsy of the larynx. This had gradually become a problem over two or three years with hoarseness of my voice and difficulty raising my voice. In everyday conversation it is not too much of an issue. I speak comfortably and am understood. Very often there is no reason to suspect that there is anything wrong with my voice. But soon as I am speaking under stress it becomes apparent. Talking on the phone is a real challenge and people get incredibly frustrated very quickly with me. I can't shout without going all falsetto. Talking in noisy environments which can be challenge for anyone can become impossible. I am also prone to post nasal drip and phlegm that sticks in the throat and this can add a gravelly sound to the voice.

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Also in 2024 I noticed a tinglng numbing feeling in the right hand side bottom lip and the area immediately below. This became another permanently numb part of the face. This, unbeknown to me, had affected the inside part of the mouth and also the bottom right hand side gum which my consultant noticed under examination. Movement and expression are unaffected by this palsy. So apart from once biting my lip this has so far not resulted in any real impact on my day to day life.

One other impact of radiotherapy is on the skin itself. This was very clear during radiotherapy when my skin was red and raw from the radiation burns. But there are also latent effects. The skin ages more quickly and losing its elasticity and thinning. I have been to date very lucky with this, but I do have some scars where I have scratched the itchy skin obsessively. Daily moisturising is essential, and as I have been extra sensitive to sunlight since treatment, I always apply a factor 50 sunscreen every day of the year before going out. This has possibly helped my skin stay in better condition than it otherwise might of been.

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