Contact Sports After Radiation?

TeresaD

Hello Everyone,

I am having a heck of a time deciding on radiation yes/no. I had a midsized growth removed as well as an in situ growth, they found at the time of surgery. Its all Estrogen positive, so I am scheduled to start Arimidex post rad. I was fine with all this and went in to meet the Radiation Oncologist yesterday.

When she discovered that I practice full contact martial arts, she told me that after radiation therapy it would be best to either find another non-contact sport or make sure all my sparring partners understand that I may not be hit in the chest area. This is due to the increase in fragility of the ribcage after radiation treatment. 

For most people, this is not a big deal, but if you practice martial arts, you know that even with soft contact hitting in the chest area is really hard to avoid. The area above the waist and below the neck are the "allowed" areas for contact. I do wear "cups" - hard plastic bowls - over my breasts, so they are not harmed if I get a blow. But it would be virtually impossible to protect my entire upper chest area (basically anywhere where the ribs could be hit). 

Now, I know it may seem crazy to be considering pretty radical alternatives (mastectomy), to avoid radiation. But although it may be hard to understand, Karate is my own form of meditation. It centers me, its fast enough to break through my "thinking," and the camaraderie is my time of socializing. Asking the black belts around me to not hit me in the center of the target is asking for them to basically be so careful that it would no longer be real sparring. (Obviously I don't want to get hit, and I don't get hit there very often because the point is to block them. But we're talking about 1 hit could possibly shatter that area of the ribcage, according to my Rad Onc.)

Sooooooooooooooooooooooo.....I guess I am sending this out there to all who have had radiation treatment and are really physically active. And especially, if you practice martial arts, what your experience, post radiation has been. Please help me figure this out. 

Everett78

I do TKD 4 days a week.  I had a bmx with expanders and am not allowed to spar (or do push ups etc.)  I hope that I can with the permanent implants.  I'm currently doing radiation and no one has told be about the rib problems ...I'll have to ask.

I did a belt test this weekend and the master wouldn't allow me to spar. (my daughter is 1 step from her black belt and was going to try and "safely" spar me)... I am just concentrating on the other aspects of TKD and Hapkido and not sparring. 

Sorry I couldn't be more help.  Like you, I'm tired of being told what I can't do!

Leah_S

Teresa, you have to decide what you want your life to be, post-treatment, and then do whatever treatment will get you there. If you do rads, will you have to give up martial arts permanently? A second opinion is a good idea for that. If you decide to do mastectomy, how would you feel living the rest of your life without your breast? That's a question only you can answer. As far as that being a "radical" alternative, you have to know yourself to know if it's right. Please realize that lumpectomy is a less aggressive surgery than mastectomy but lumpectomy + rads is a more aggressive treatment.

Best of luck in whatever you decide.

Leah

TeresaD

Thanks for replying Everett. I think as far as implants go, that is not the problem once you're fully healed. After I posted this topic, I found another great thread which discusses pushups and weight lifting. Here is the link: http://community.breastcancer.org/forum/58 

But yea, you should ask your Radiation Oncologist about the fragility of the bones under the location of your surgery. My RO was pretty adamant about the dangers of getting hit there after radiation. But I would be interested in hearing what she says. Maybe my doc is just being overly protective.

I know what you mean about being told what to do. I feel stuck on a merry-go-round trying to figure out the best option here...

TeresaD

Hi Leah, I like the way you explained these two alternatives. I hadn't thought about them quite that way. And it is a permanent lifestyle choice isn't it? That's what it boils down to. In principle I don't have any problem with a mastectomy (and while there were there, I'd probably just have them do both). These days, the way it was explained to me, they just roll back the breast skin, take out the tissue put in the implants (or expanders - not sure you need these if they keep the skin), and you're done. And I do feel that as long as I have my nipples its not such a big deal (strange, huh?). Still, I would hate to get all that done only to discover that for one reason or another I still couldn't spar. She told me I could, with that option, but I am getting leary of the "single answer."

I think you're quite right, I need to have a second opinion. I'll call my surgeon today and see what she says.

Thanks for this response, I really appreciate it. 

3monstmama

I agree about the second opinion.   I was not told that I would definitely have ribs that might be more "breakable"  I thought that was a possible, but rare, side effect but not a definite.  You should also be aware that even with a mastectomy, you might still have to have rads

I ended up with a lumpectomy and rads but I recall when I spoke to the PS about reconstruction after mastectomy that implants can break.  Not often, not normal but they can.  So you may also have to consider that if you go the mastectomy route, what will you do about reconstruction in general.  I was also told that with the other forms of reconstruction, certain activities, like kayaking might have "issues" because of the muscles that would be removed for the reconstruction.  Now mind you it was not supposed to be a big issue but it did give me pause because it was a limitation and my goal was to have my stupidbreastcancer OVER. 

In the end I had to focus on my ultimate goal---a long life and time to annoy my family --and I went with a lumpectomy with the idea that if I had to do a mastectomy for bad margins, I would go with no reconstruction and learn to love my new body.  I did do rads, i have not really had any issues.

Good luck!

Everett78

Well, I met with my radiation oncologist this morning and asked him about the ribs being brittle or weaker after rads and he said ABSOLUTLEY NOT...He said that as far as he's concerned I can do any contact sports I want...The tissue expanders are what limit my activity, not rads.

He said rads from 20 yrs ago used to harm ribs, but not the rads of today. 

Get a second opinion! Deb

TeresaD

Thanks for asking about that Everett. His/her answer does seem to contradict what I had learned about RT even before I spoke to my RO. Every online source I've checked out says something about brittle bones at the  point of radiation. Articles that are much newer than 10 years old. Sigh. I want his answer to be so. I really do. But look at this statement:

"... More often, loss of bone mass is due to cancer treatments themselves. Radiation therapy can break down bone-building cells, making bones susceptible to insufficiency fractures-a major concern in patients with gynecologic cancers who receive radiation to the pelvis. "

Here is the link to that article: http://www2.mdanderson.org/depts/oncolog/articles/10/3-mar/3-10-2.html  - its dated March, 2010.

Another interesting development in RT that I seems to be making the headlines right now http://news.ucsf.edu/releases/one-dose-radiation-found-effective-for-early-breast-cancer/

This may not be something we can use for a while yet. But it could be a solution. I did have someone who works for the local cancer organization, ask a RO she works closely with, about the possibility of bone fracture. He said that its rare, but it happens.

My sense all along has been that for most women this is a rare longterm side effect - but its real.

This is a tough one. I appreciate that you are thinking about it. Just knowing that makes me feel so much less alone. Thanks.

Teresa