Radiation scatter?

linn56 · October 2009

Anyone know anything about this? I was reading an article on Web MD last night about radiation scatter. That some radiation can expect to scatter to the other breast and the rest of the body, no matter how well it's "focused".

I had thought of this when I first learned I would need radiation, but assumed "they" had solved the problem of scattering by now. But then I thought of my dentist and how they always use a lead blanket over your torso when doing X-rays to the head.

The article mentioned a doctor who is forming a small shield out of lead to place over the other breast, since breast tissue is known to be especially sensitive to radiation. He said in the video that the dose received by the non-treated breast is (if I remember correctly) equal to 40 mammograms EACH DAY of treatment. I found that shocking, if true. Though he said he was more concerned about this effect for younger women, 20 and 30 years olds. I assume that is because the mutagenic changes made by the radiation take a certain number of years to show up. Maybe we 50 year olds are supposed to die of other causes by then. (I should tell my doctor about all the 98 year olds in my family...)

Anyone know more about this issue?

Krissy37 · October 2009

Bump

I am interested in any information anyone can share on this topic??

CapeBretongirl · October 2009

bump

Colette37 · October 2009

Linn...I have been having nausea problems directly after having radiation. The rad onc relunctantly admitted to me that I "could" be having scattering which hits my stomach. All I know is that I have been getting nausea, dizziness and I have been having bad heart burn from this. The rad techs seem to think that people are totally stupid that go in there and don't have a clue as to what is going on.

I look at it this way...I am going to try to get all my treatments in, but if it gets to the point that I start having major weaping sores I am going to say ENOUGH! If it is doing that to my outside, what is it doing to my inside? If the cancer can survive from that, then my number was up a long time ago.

MarieKelly · October 2009

Linn -

I've done a huge amount of reading on the subject of radiotherapy through the last 5 years. I flat out refused it after my lumpectomy. They have definately NOT solved the scatter problem - there's been some reduction, but it hasn't been completely eliminated and I doubt it ever will be. Scatter is probably not the biggest problem anyway - direct hits to organs and tissue adjacent to the target area is more concerning in my opinion. They've been coming up with ways in which to reduce that too but again, it hasn't been completely eliminated either.

You're right - the younger the patient is, the more concern there is regarding long term radiation induced toxicity for the reason you stated regarding secondary cancers, but also the concerns about cardiac, thyroid and lung damage. In women with aggressive cancers and especially metastatic cancers, the concern is not as great regardless of the age because if you're not likely to live long enough for a secondary cancer to be induced by the radiatiion, then it's a moot point.

Cardiac toxicity isn't usually apparent for at least 10 years after radiation and is more frequent in left sided breast irradiation. My cancer was in the left breast and already having a mitral valve problem, the risk was high for me.

Smokers who receive chest area radiation run a significant higher risk of eventually developing lung cancer. Of course, smokers run a higher risk anyway just by virtue of the fact that they smoke, but radiation increases that risk numerous times over. I smoked and still do ..another reason why I wouldn't allow myself to be radiated.

I really don't know how many mammograms would equal one day of radiotherapy, but I wouldn't be surprised to learn that what you stated was true or very close to it. The radiation delivered is not a minor amount by any means. Even the prospect of continuing to get yearly mammograms is beginning to worry me and after having them yearly for the past 5 years since my diagnosis, I'm considering asking to have a breast MRI instead of a mammogram at least every other year. There are even some hospitals who are starting to keep track of how many CT scans patients have becasue of concerns about the delivery of too much cumulative radiation.

http://www.redjournal.org/article/S0360-3016(08)00128-4/abstract

nanabolini · October 2009

I wouldn't be surprised if everything you say is correct. I've had a swallowing problem since the 4th week of rads. My rad doc showed me graphs of where the rads were going, saying it was not possible that the esophogus was getting any radiation. I don't believe it. Now 2 months after rads are done I still have the swallowing problem. It's a worry. Before rads I thought a lot about not doing at all mainly due to the problem of scattering. Of course everyone treated me like I was a nut case and said I read too much. hmmm.

ravdeb · October 2009

goodness! am not well read on this at all and I guess I need to be. I had rads in spring of 2006 to my left breast. My tumor area, where the boosters were directed, is very close to the heart and I must have asked my onc a million times about this. She said that there was a possibility it could touch the heart but only a small part of it and this was a big IF.

Now I'm wondering...

pj12 · October 2009

Attempts to control the radiation field include IMRT (Intensity Modulated RT), IGRT(Image Guided RT), and Gating (coordinating RT with breathing pattern). These are SUPPOSED to target the radiation more precisely. I don't know how prevalent these systems are... it is what I had.

About the lead shield for the other breast: Does the radiation beam scatter as it goes through the air before it enters your body? Or is it like a laser beam... focused to a point inside your breast, then ricocheting around from the inside? If it is the latter, a shield would not help

As we say, "the gift that keeps on giving."

Pam

dalycity · October 2009

Actually, I asked my primary care doctor at that time of my radiation; she said that, "you don't know about radiation--it radiates and bounces everywhere." Those were her words. Of course, my radiologist said otherwise.

jklls · November 2009

Hello, I thought I would just add in my 2 cents. They may not be worth much but here they are. I am a Radiation Therapist. The reason they don't put a lead apron on you before treatment is because if they did, it would slow down the energy of the beam and that would cause more scatter and your body would absorb more of a dose. Radiation dose not scatter through air. Rad techs do not think you are "stupid." but may not know what areas are being treated on you internally. There may be scatter to your stomach if they need to treat lower on your chest to cover all the breast tissue but that may be specific to your case and not other persons. As for your throat being burnt, that can happen if there is treatment to the super clavicle area. Depending on how your head is turned, your throat can get some radiation. Your doctor can show you pictures of how it your treatment was planned off of your CT (or cat scan) but if your therapists didn't check your chin position, it be turned into the treatment field. As for me, Yes, I would have radiation. It is much better choice than having mets. No one should have to ever go that. In the end, it is a personal choice and one that only you can make, Good Luck and bless you during this time.

Radiation scatter?

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