BC Dx and Hodgkin's Disease Radiation Treatment

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7timewinner
7timewinner Member Posts: 183
edited June 2014 in Young With Breast Cancer

Hello!

I am looking to connect with anyone who has been diagnosed with BC, and who also received radiation treatment to the chest for a childhood diagnosis of Hodgkin's Disease. It is now understood by the medical community that radiation treatment to the chest for HD "back in the day" is resulting in several long-term side effects in women, including secondary cancers like breast cancer.

I am one of those women! I had HD when I was 14. I am now 39. Since then, I have had 3 cases of skin cancer, a thyroid issue (also likely from the radiation), and now BC.

Since my HD diagnosis 25 years ago (I have been considered in full remission for 20 years) I have been a participant in a research study to examine the long-term side effects of radiation treatment to the chest. Because of this wonderful study, Hodgkin's Disease treatments have been changed to prevent these types of secondary effects.

If anyone else here is in this category, feel free to share your story here, and talk to others who understand your situation. I'm also happy to share what information I have on the risks of secondary cancers and other long-term effects for this group, and other issues specific to our health histories.

I placed this in the "Young Women" category because most of us are probably under 40, or not too far over 40.

Warmest regards,

Nadine

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Comments

  • reeney77
    reeney77 Member Posts: 53
    edited May 2009

    I am here!! My initial diagnosis of Hodgkin's Disease was in 1991 when i was 15. I was diagnosed with BC at the age of 31. I was also told the mantle radiation is the culprit. I have not had any other issues except thyroid nodules which i had biopsied years ago. I will be having them looked at again when i finish chemo in less than a month.

    i am having a much better time with chemo this round than when i was younger. i expected it to be worse for some reason. I had the ABVD combo at 15; now i'm having TC.

  • 7timewinner
    7timewinner Member Posts: 183
    edited May 2009

    Reeney! Hello again :)

    I was 14 when I had HD (waaaaaaaay back in 1983, lol). Radiation, but no chemo. I'm 39 now, and was Dxd with BC in January, 25 years nearly to the date of my HD Dx. I'm getting 6 rounds of TC, just 3 more to go!

    I'm guessing your onc has you on TC and not Adriamycin because of possible heart issues? The radiation to the chest can cause cardiac issues (I now have moderate mitral regurg.), even though they used a "heart block" back in the 80s.

    My thyroid is currently enlarged on one side, and I'll be having it scanned soon as well. It has been up and down for 3 years, since I started having babies :) I'm wondering if it's nodules like yours.

    Well, as much as I hate having all these fun health issues in common, I'm glad we found each other for support! Hopefully others will find us as well :)

    Nadine

  • reeney77
    reeney77 Member Posts: 53
    edited May 2009

    i'm really surprised you didn't have chemo. i kinda felt like chemo was the more important part of treatment. funny that the radiation is what is causing these secondary cancers. you are right about the adriamycin - said you should probably only have it once in a lifetime. is it bad that i question only having 4 chemos instead of 6? is it bad that i would do the 6 if they offered it?

    hope you figure out your thyroid issues figured out. my nodules don't cause any effects.

    i'm glad there are others like us too. wish they would find us.

  • 7timewinner
    7timewinner Member Posts: 183
    edited May 2009

    My mom refused the chemo because of the possibility of sterility. I was only 14, so I guess she thought I should have a chance to have kids if I wanted them later in life. Turned out OK in the end...25 years of no more HD :)

    Not surprised you are only getting 4 Txs...your tumor was not invasive, and only 1 node involved. Sounds pretty standard. I am getting 6 Txs for one simple reason...15 involved nodes! I'm sure your onc knows what needs to be done. But funny thing...my onc told me the first time I saw him..."you know, chemo is really, really hard. But I bet you any money that at the last treatment, you'll be asking me for more. That's what everyone does." So I think your concerns are all pretty typical :)

    I know we're not the only ones here! Only a matter of time...

    Cheers,

    Nadine

  • reeney77
    reeney77 Member Posts: 53
    edited May 2009

    hope i didn't sound judgemental in my last post - didn't mean to! you're right - 25 years of no Hodgkin's so it definitely worked! i knew that infertility was a possibility with me, but i just didn't really think about it. got pregnant on the first try!! he's my miracle!

  • 7timewinner
    7timewinner Member Posts: 183
    edited May 2009

    No, no...of course you didn't sound judgmental! Not at all.

    My mother took a chance with no chemo for me...I was Stage IIA, not Stage I for my HD. But we're lucky it worked out fine. Even without the chemo, the radiation treatment, for me at least, extended down over my ovaries...so there was a chance of sterility from that as well. Now I have a 3 year old and a 1 year old, so guess that worked out as well :)

    So glad you were able to have your son!! Medicine can be right sometimes (hence, we are here, lol!) and sometimes not.

    Laughing Nadine

  • Jen2
    Jen2 Member Posts: 6
    edited May 2009

    Nadine and Reeny I also had Hodgkins Disease and now Breast Cancer. I had Hd in 1990 at 19 years old. I had my spleen removed as part of may staging which was stage 1 then mantle radiation. It is now 19 years later I am 38, married and have 3 kids age 7,9,and 11. Two years ago I developed an underactive thyroid and now in April BC. I just had a bilateral mastecomy and will start chemo in a few weeks. I still can't believe this is happening!

  • reeney77
    reeney77 Member Posts: 53
    edited May 2009

    We finally found another one of us! i was lucky to not have my spleen removed. Hope you are recovering well from your mastectomy. What is your chemo plan?

  • TennesseeMichele
    TennesseeMichele Member Posts: 136
    edited May 2009

    I'm here too!  I haven't logged on much this spring because life got too busy but it's slowing down now. 

     I was diagnosed Stage IIB/IIIA HD in 1991 at age 22.  I didn't have radiation, but had ABVD/MOPP chemo.  My spleen was removed (they took my appendix, too, while they were in there.  Did that happen to you Jen?  I was a little put-out with that since it hadn't come up in discussions.)

    We were also concerned about sterility from the chemo; I'm now 41, and my children are 7, 11, and 13 so it wasn't an issue after all.

    Nice to meet all of you!

    Michele

  • Jen2
    Jen2 Member Posts: 6
    edited May 2009

    I had a mastectomy and sentinel node biopsy. The biopsy was clear so they finished the surgery. Two weeks later after further pathology they found something in the node. Not to do any more radiation on me they chose to go back in and take a few more nodes. Depending on what they find will determine my chemo.

  • 7timewinner
    7timewinner Member Posts: 183
    edited May 2009

    Michele and Jen, welcome! I'm sorry for the circumstances that have brought you here, but you're in the right place for support and understanding.

    Michele, I'm just about to turn 40. And yes, I had both my spleen and appendix removed with the staging laparotomy...which, BTW, has now been replaced with an MRI, lol :) Amazing how different things are now! I had HD IIA, radiation but no chemo.

    And now, I have 2 more chemo treatments to go, then onto radiation. It's been a long haul.

    Jen, I know how you feel right now...it's a shock in the beginning. You think, "can I really be going through this AGAIN??" But we are here to support you. And since we have all had HD and mantle radiation, it's more than likley that our BC is from that. So we are a special subset of the overall BC community here :)

    Are either of you a participant in the St. Jude's Hospital long-term side effects study? I have been since my HD diagnosis, and let me tell you...it is a wealth of information for folks like us. I also am having some kind of thyroid issue right now....a VERY large node on the right side, which has yet to be diagnosed as anything in particular yet. I need to wait until after chemo to have an MRI.

    All of the issues I have had since my mantle radiaton 25 years ago....skin cancers, thyroid issue, BC...were all identified as long-term effects in women who were treated for HD as youth. If nayone wants more info. about the study, please just let me know, I am happy to share. 

    Warmly,

    Nadine

  • TennesseeMichele
    TennesseeMichele Member Posts: 136
    edited May 2009

    Nadine, I'm very interested in learning more about the study.  You can PM me if you'd prefer.

     I actually did not have radiation with my HD treatment, so I don't know where I stand now with my BC diagnosis.  Maybe BC is somehow related to HD, and not just from radiation? 

    I can't believe the laparotomy has been replaced by MRI's.  How wonderful!  That was a painful recovery.

    Michele

  • 7timewinner
    7timewinner Member Posts: 183
    edited May 2009

    Sorry, Michele...I didn't catch that from your first post...no radiation, but chemo? Now that is interesting. Back then, the standard protocol was both. My mother refused chemo for me.

    Hmm...I'll have to look into that aspect of HD treatment in the long-term study papers...maybe there's something there about chemo/secondary cancers in HD as well.

    I will gather up some info/websites and re-post here for all.

    Cheers,

    Nadine

  • Jen2
    Jen2 Member Posts: 6
    edited May 2009

    Michele, I did not have my appendix removed and actually did not hear of it before you guys.

    Nadine, I am not part of the St. Jude study but it sounds interesting. I have a small nodule on my thyroid that they were watching, I have not seen my doctor since this all started but I have an appt. coming up. I am going to ask her about it. I find it hard not wondering if it will someday be another thing to worry about.

  • missde3
    missde3 Member Posts: 241
    edited June 2009

    OMG!  I am so happy to find you girls!!!  I, too, had Hodgkin's.  I was 28.  They said I had it for at least 2 years before it was found.  After careful consideration of all the facts, my husband and I decided that radiation only was the 'safest' way to go due to the horrible side effects of the ABVD combo.  Did have the lap w/spleen removal, too.  Had 50 treatments.  Stage IIIa.  We just celebrated my 20 year cancer-free anniversary in Oct.  Was a happy day!  Have had a lot of other illnesses thru the years.  Was dx with BC on Apr 13rh.  Just had bi-lateral mastectomy on May 6th.  Figured it was going to get the right breast, too.  Tough decision.  VERY angry!  Thought I did my 'cancer' time.  Didn't feel it was necessary to get it again.  My thyroid is virtually non-existent.  Can't be found on an ultrasound.  As a side note - my oldest son was diagnosed with Hd 6 years after me.  Only chemo for him...

  • 7timewinner
    7timewinner Member Posts: 183
    edited June 2009

    Hi, missde!

    Congrats on the 20 year remission!!

    And we here all understand the notion of "doing our time" already...it feels incredibly unjust. SO sorry to hear of your son's HD, too...I'm hoping from the sounds of it that he is in remission now as well?

    I am just 5 days away from completing my chemo treatments. It has been a very, very long haul. Then on to radiation.

    But with multiple cancer diagnoses under our belts, we are tireless fighters against cancer!! So Sorry about your recent dx, but know that you can come here (or other boards) for support. It has kept me sane checking in with my March chemo group here.

    Hugs :)

    Nadine

  • missde3
    missde3 Member Posts: 241
    edited June 2009

    Yes - my son is also in extended remission.  15 years this Aug.  Thanx for asking!  The docs were stumped with both him and I getting HD because it doesn't happen that way!  There is no medical documentation of a mother and son getting it.  Anyway - I've been reading a bunch of stuff about rad w/HD and bc.  Seems if you're under 30, the risk of getting bc is 40%.  Great, huh?  I knew that I'd have a higher risk because I was told that with the rad it can cause secondary malignancies but I thought  - well, if something happens in 20 years I'll deal with it then and there will probably be better cures.  Did I jinx myself?  LOL.  It seems that 15-20 years is the magic amount of time for the bc to appear.  Not fair to be cured of one to get another.  Good thing my rad onc was vigilant with my mammos and this year demanded an mri from the ins co.  That's where the cancer was found first.  Nothing on the US and only one spot (I had 2 in one breast) on the mammo.  Scary to have to relive the whole cancer thing again.  But, we apparently are strong!!!

  • missde3
    missde3 Member Posts: 241
    edited June 2009

    Dear 5time - Oh - I'm glad your chemo is almost done!  I'm one of the lucky ones - my IDC was caught so early.  I had 3 little spots - two at .15cm and one at .30 cm.  Tiny but IDC anyway.  There were two spots of the DCIS with the little IDC in one of them.  So for me - no chemo.  When you had your HD, didn't you get rad?  With the BC, they wouldn't let me get any more because of the additional damage.  That's why I had the mastectomies.  They put my case up in the hospital Tumor Board to discuss my options and mastectomy was the only one.  Are you getting the balloon?

    Your user name is 5timewinner.  What does that mean?

  • 7timewinner
    7timewinner Member Posts: 183
    edited June 2009

    missde3-

    My radiation onc. knows that I had HD and radiation before, and said that the targeted radiation to the breast and axillary area will be fine, that radiation today is quite different from what it was 25 years ago.  I had a lumpectomy, chemo, and then rads will start sometime in July, probably. I am more than just a bit concerned that you and I with the same HD history have been given whole different opinions on radiation, though...

    I am not sure what the radiation plan is just yet, but I will surely report back here about it.

    So glad your son is in remission!! The idea of cancer in my own babies just make me ill...and is a huge worry for me, given my own history with it. "5timewinner" is the name I picked because this BC Dx is my fifth time dealing with and beating cancer...HD, 3 separate skin cancers in the field of radiation, and then BC. It may become "6timewinner" though if my thyroid issue is bigger than just a nodule!

    I think we all had the same approach about the radiation 20+ years ago...if another cancer does happen, I'll deal with it then. Well, then is now ;) My goal is to make this the final one.

    To that end, I highly recommend Diana Dyer's book on how she has kept herself in remission after a childhood cancer (with radiation) and then 2 separate diagnoses of BC. She has been in remission again for over 12 years, I believe...diet, lifestyle changes, meditation, etc. An excellent read!

    Cheers,

    Nadine

  • 7timewinner
    7timewinner Member Posts: 183
    edited June 2009

    Everyone,

    Sorry it has taken me so long to get this out to you...here is a link to the St Jude's Long-Term study, of which I am a particiapnt:

    http://tiny.cc/uKMod

    It's a great starting point for understanding our unique medical situation.

    Nadine

  • missde3
    missde3 Member Posts: 241
    edited June 2009

    I'll keep you in my prayers for the rest of your treatments.  I have had numerous biopsies of skin done and so far - so good.  No cancer.  I see the dermatologist 1x a year for a complete check-up and have her remove anything I don't like.  I see her inbetween if there's something i have a question about.  What kind of skin cancer did you have?

  • 7timewinner
    7timewinner Member Posts: 183
    edited June 2009

    Fortunately, all 3 of my skin cancers have been basal cell. I am very fair and have practically no freckles on my entire body, so it is very easy for me to catch any changes in my skin. Plus...I've been looking for them since the first one, lol! In fact, the last one was removed during my lumpectomy...I never had a biopsy, I just knew it was another basal cell and I asked the surgeon if she wouldn't mind removing it while she was dicing me up anyway.  Sure enough...the path report said I was right! Made my surgeon laugh that I knew before the path report.

    Sounds like you have an excellent plan in place for yourself. That is the absolute key for us HD survivors!

    Nadine

  • missde3
    missde3 Member Posts: 241
    edited July 2009

    I, too, am very fair.  My kids call me Casper!  I have light blue eyes and was a platinum blond as a kid.  (Am still 'blond'!)  How is your thyroid?  Mine died about 3 months after the rads ended.  I've been on Synthroid for 20 years.  I'm getting an ultrasound in a few weeks to check it out again.  We are such high-maintenance girls!  It seems that I'm one of the oldest ones here.  I'm 49 - will be 50 Aug 26th.  Scary!!!  Ironically, after all my HD treatments and surgeries, I turned 30 on the next birthday! And, 21 years to the month with the BC dx.  Weird. 

  • 7timewinner
    7timewinner Member Posts: 183
    edited July 2009

    I have a thyroid MRI scheduled in mid-July...so I figure, I can deal with it then. It gets very enlarged on one side after chemo, then settles down to just larger-than-normal. I'll know soon what is next.

    I just turned 40 today, day of my last chemo.  40, 50, none of it matters...we are alive today! Celebrate! :)

    My own BC diagnosis was 25 years minus 2 months after my HD Dx. Like it knows just when to show up...

  • missde3
    missde3 Member Posts: 241
    edited July 2009

    Happy Birthday! What a great birthday gift to end your chemo!  I hope everything settles down for you. Good luck with MRI.  One step at a time.  My thyroid shrunk so much after the rad.  The doc said better to be small than big because then it's a potential problem.  She also said if my thyroid becomes cancerous - no big deal!  They can remove it or kill it.  Another body part gone!  Are you going to go on Tamoxifen after your treatments?  I have to.  Don't want to because it's messing with my hormones.  Increases the risk of uterine and endometrial cancers.  Gynie says - no problem!  If the uterus develops cancer, they can remove it.  There goes another body part!  I have Polycystic Ovary Disease so I'm at a higher risk for that anyway.  I guess I should just have a super surgery and just remove all unecessary body parts!

  • Ippuni
    Ippuni Member Posts: 24
    edited July 2009

    Hello everyone!

     I just discovered this topic and am very excited to find others out there.  I was first dx'd with HD at 16yrs of age (stage IIIb).  Had 6 mos of MOPP and 3 mos of "full mantle" radiation.  4 years later at 20 yrs of age I had an HD recurrance.  6 mos of ABVD and 3 more months of radiation (focused on the recurrance site).  Fast forward 20 years to 2004 when I noticed a lump in the middle of my throat.  Turned out to be thyroid carcinoma (3 different varieties!).  Had my thyroiod removed and radioactive iodine therapy.  Now in March of this year, I've got BC.

     I just started 4 cycles of TC every 3 weeks on 6/25.  I am having a rough time of it.  It is worse by far than the ABVD treatments.  So far, scarily similar to the MOPP treatments I had at 16.  I keep telling myself that it is only 4 tx's - nothing compared to the 12 I'm used to - but still, I'm wondering how I'm going to make it through.  Anybody out there in a similar situation?  I read on the TC thread about how well everyone is doing with the treatments while I'm flat out.  Is it the history of previous chemo or am I just one of the lucky ones who's body is up in arms against TC?

    5timewinner - I'm happy to discuss my doc's radiation tx rationale with you

    missde3 - I'm with you - I feel like getting my uterus and ovaries out now - why wait ?  I don't need 'em anymore!

  • missde3
    missde3 Member Posts: 241
    edited July 2009

    Ipunni - Can you tell me what TC is?  I'm a stage 1 also but I don't need chemo.  Doc said it would cause more harm than good for me.  I've been lucky in that sense but I also chose bilateral masectomies 'cause I figured if it showed up in one, the chances are great for it to show up in the other.  All my docs, PA's and nurses all agree it was caused by the radiation 20 years ago.  Apparently. there aren't that many of us out there due to HD being so rare (less than 1% of all cancers).  What a group we belong to!

    Happy 4th!!!

  • 7timewinner
    7timewinner Member Posts: 183
    edited July 2009

    lppuni

    I just finished 6 rounds of TC (Taxotere/Cytoxan) and I did NOT have an easy time of it at first...pneumonia, anemia requiring blood transfusion, then a bad reaction that made it difficult for me to breathe during the infusion.

    Here's the thing to remember to make the TC easier... WE ARE NOT JUST ANY PERSON WALKING IN OFF THE STREET WITH A BC DIAGNOSIS! We have a history of HD, radiation, and for many of us, we have had a spleenectomy as well. Add chemo to a person without a spleen, and your white blood cells will probably tank like mine did. That's how I got the pneumonia.

    I called my onc, told him I had a fever, reminded him that I have no spleen, and he still said, "It'll be fine..." and gave me some antibiotics. I asked about the Neulasta shot, and he said, "not necessary."

    Then I got pneumonia, and now he understands!! INSIST on getting the Neulasta shot after your chemo treatments.

    Once my Neulasta shots were in place, and then Aranesp (for red blood cells, if that is an issue for you), and BENADRYL during infusion to prevent bad reactions...my last 3 treatments went much smoother.

    You have to be a strong self-advocate during chemo because most oncs don't have the experience of working with HD survivors. We have special needs.

    Stay in touch, write me directly if you need support during TC. I am here!

    Nadine

  • klsanders1
    klsanders1 Member Posts: 1
    edited July 2009

    Hi

    I just found this group and have a lot in common with you all - except for my age.  However, I still think of myself as young so I'm going to crash the party.  I had HD Stage 1A in 1986 treated with full mantle and abdominal radiation as well as a staging lap - and had my gall bladder removed as well!  I was 36 at the time and the mother of 2 young adopted children.  Then I had my treatment side effect - who is now 20 years old and in college!  My personal opinion was that it was the prednisone I was taking for problems with my lungs from the radiation

    Fast forward to today - quite literally as I found out within the last hour that I have ductal carcinoma in the right breast.  My next steps will be planned out over the next few days but my most immediate concern is telling my children and my mother about this.

    Thanks for listening.

    Karen

  • 7timewinner
    7timewinner Member Posts: 183
    edited July 2009

    Karen,

    I'm so sorry you have any reason to be here, but know that this is a wonderful place for support, and that you will get through this, too.

    Write any time with questions, concerns, etc.!!

    Love and blesings,

    Nadine

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