Heart damage from radiation?

jmb5

I had radiation on my left breast 11 years ago when I was 41 and am concerned about potential heart damage. At the time, I asked my radiation oncologist because the cancer was so close to my heart, and he blew me off and said the way they do it now doesn't cause damage. This was February/March 2010. I do not have any symptoms, but as I get older, it's always in the back of my mind that there could be damage I'm unaware of. I've decided to meet with a specialist in a cardiac/oncology center. I am having an EKG, echocardiogram, and a consult with the doctor. I'm curious if anyone else has had these concerns, what your doctors have told you, and if anyone actually has heart damage. Any feedback would be appreciated.

ParakeetsRule

I've actually had interesting heart symptoms and had all those tests and even wore a monitor and they found nothing wrong. If you're not having symptoms I don't really see the point of going through a bunch of tests. If they find something, is there even a treatment for it? And would they even know for sure if it was from radiation or something else? Heart problems are extremely common even in people who haven't had chest radiation.

Spookiesmom

That’s what my RO told me 9 years ago. He could stop it, the beam, before it got to my heart. I had cardiac issues before rads, nothing has gotten worse.

RatherBeSailing

JMB, one widely used stat used by radiologists (source is Darby) that every Gy of radiation to the heart increases relative risk of cardiac issues by 7%. So if you had a 10% chance of having problems, 2 Gys would increase those odds to only 11.4%.

Most plans, even on left side, can keep radiation dose - even on left side - to well under 5 Gys, often below 3 Gys. Dose to some of the arteries, including the LAD, can be higher. If you really wanted the info, the hospital should be able to supply the dose volume histogram that would tell your cardio-oncologist exactly what your dose was.

But I doubt it is necessary. You're probably fine, especially since you didn't have chemo. Still, I think you're smart, at over 50, to at least get some baseline tests with a cardiologist who knows cancer treatments. Damage can take many years to manifest. My cardiologist just ordered a CT calcium scan to check arteries.

Hope this helps. And hope getting checked out gives you reassurance that everything is fine!

RatherBeSailing

JMB, one widely used stat used by radiologists (source is Darby) that every Gy of radiation to the heart increases relative risk of cardiac issues by 7%. So if you had a 10% chance of having problems, 2 Gys would increase those odds to only 11.4%.

Most plans, even on left side, can keep radiation dose - even on left side - to well under 5 Gys, often below 3 Gys. Dose to some of the arteries, including the LAD, can be higher. If you really wanted the info, the hospital should be able to supply the dose volume histogram that would tell your cardio-oncologist exactly what your dose was.

But I doubt it is necessary. You're probably fine, especially since you didn't have chemo. Still, I think you're smart, at over 50, to at least get some baseline tests with a cardiologist who knows cancer treatments. Damage can take many years to manifest. My cardiologist just ordered a CT calcium scan to check arteries.

Hope this helps. And hope getting checked out gives you reassurance that everything is fine!

jmb5

That's what I was thinking about getting baseline tests. I'd also like to hear what a specialist in this area has to say about it, and if he thinks it's worth keeping an eye on. I'm going to the Cleveland Clinic, which is where my radiation and mastectomy were at, so they have all my records, but just to be sure, I was planning on requesting my records. I have no clue what the details of the radiation are.

RatherBeSailing, why did your doctor decide to check arteries?

MinusTwo

jmb5 - So you're 52 now?. if you've never had an Echocardiogram, you might want to get one of those in addition to a stress test just for a baseline. But I agree with others - you're probably fine.

AliceBastable

Well, I've been to a cardiologist - a cardio-thoracic surgeon, to be exact, in 2019. One of the things my pre-op chest CT in 2018 found was an aneurysm in the descending artery. So, several months after my lumpectomy, re-excision, nephrectomy for kidney cancer, and radiation, I decided I'd better see what was going on. He was talking about some time in the future, if/when it got to the dangerous point, I'd need surgery. I mentioned that I'd had left breast radiation, and the RO had assured me there wouldn't be any damage to my heart or lungs. The cardio doc shook his head and said, "There's ALWAYS damage." And about the same time, after I got one of my follow-up CT scans for the kidney issue, the radiologist described a smudge on my lung that appeared to be scarring from radiation. I've had a couple more chest CTs since then, and the last one said it's starting to get smaller.

Just my personal experience, and my anecdote, but draw your own conclusion.

MinusTwo

agree Alice - I don't think anyone escapes from cancer treatments w/o some damage - whether its rads, chemo or surgery.

ClaireCawthorn

I've just been diagnosed with DCIS on the left side. I'm currently debating whether to get lumpectomy with radiation (3 weeks), or a mastectomy with reconstruction. I also am concerned about damage to heart and lungs, and I'm also being told that the risks are very low these days, however small sections will still be radiated, but will heal. Perhaps I should make an appointment with a cardiologist and get their input on it.

I would also like to hear your experiences with radiation from a cosmetic point of view. Did it end up visually distorting the breast? Were there any noticeable long lasting effects?

mfk

Hi ClaireCawthorn - today is the last day of three weeks of partial breast irradiation to my left side, after a lumpectomy for DCIS. The planning document for my radiation shows minimal doses to my lung and heart. The breath hold that's required during the treatments is not difficult. So far, cosmetically, the breast might be a little bit swollen but nothing significant. I can't speak to the long-lasting effects, but so far, so good. Happy to answer any other questions you have about the entire process. It's actually been pretty easy, all things considered.

RatherBeSailing

JMB, my heart looks fine, but my cholesterol is borderline. She just wants to check before deciding what my risk is, and it's the arteries on the front of the heart that likely took more of a hit from the radiation.

Glad you're at a good hospital, and with someone trained in both disciplines.

RatherBeSailing

JMB, my heart looks fine, but my cholesterol is borderline. Cardiologist just wants to check before deciding what my risk is, and it's the arteries on the front of the heart that likely took more of a hit from the radiation.

Glad you're at a good hospital, and with someone trained in both disciplines.