Treatment for Radiation Induced Fibrosis?
I am almost finished with rads, but I am concerned about possible long-term complications, one of which is radiation induced fibrosis. I was reading a bit today and found this one article talking about a possible treatment for it, which surprised me, because I had always read that treatment is limited (aside from fat grafting showing marked improvement in radiated tissue). I doubt this treatment has been well-established yet since I hadn't heard about it before, but who knows - maybe it has promise? I see that a few follow-up studies have been done so I will post those as well. I'm sharing it for anyone who currently has fibrotic damage or for those in the future whom it may help.
The Irreversibility of Radiation-Induced Fibrosis: Fact or Folklore?
Although oncologists should be encouraged by the mounting evidence that radiation-induced fibrosis may be reversible, many questions remain unanswered. First, because this was not a randomized trial, the results need to be confirmed. Second, fibrosis occurs in many different organs and tissues after radiation. Is it equally reversible in all of them? Third, the results of this study suggest that patients may need to be on antifibrotic therapy indefinitely. Is this, in fact, the case, or could treatment be discontinued after some finite interval? Finally, as the authors point out, the safety of long-term high-dose vitamin E remains in doubt. How does this drug combination impact on that issue?
Delanian et al29 are to be congratulated on their pioneering work. The future continues to look brighter for cancer survivors who may be troubled by the long-term complications of treatment for their malignancy.
Role of Pentoxifylline and Vitamin E in Attenuation of Radiation-Induced Fibrosis
Comments
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What are the symptoms of this problem?
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I had no skin layer evidence. It was occurring but only gradually so it was not apparent for quite a while. It essentially is the fat in the breast tissue being rendered to oil, leaving behind gradually hardening burned structural tissue. The area where the spreading continues for me throughout the 10 years since treatment is hard, and painful to any pressure or touch. There is no sign of its presence in looking at the skin. In that area there is no way to monitor for recurrence through simple physical exam, as it is abnormal. Providers routinely do not read the chart and try to palpate it anyway.
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Here's a description of fibrosis in the breast:
Definition: Fibrosis is the formation of scar tissue. Fibrosis can occur as a result of radiation treatments. While radiation is being given, it affects cancer cells and healthy tissue that is nearby. In healthy tissue, small blood vessels in the area may be damaged or sealed off. When this happens, the affected tissue no longer gets enough nourishment. Radiated healthy tissue may then "fibrose" or scar. That scar tissue will feel firm or may feel like a mass or even like a recurrence of cancer. Fibrosis may also occur naturally in breast tissue that has fibrocystic changes.
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AA, when I found this article I thought of you...thought you might want to look into it.
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Thank you, dancetrancer. I wasn't able to participate in the studies for pentoxyfylline/vitamin E, but have been watching them too. I hope to see physicians at a cancer center on a trip to the Lower 48 later this year and discuss it once more, and see what they are willing to offer me. Your research is very thorough as you are wending your way through all of the different parts of treatment, and a wonderful example for others.
A.A.
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Awwh, thanks AA! I am hoping my tenacity (obsessive compulsiveness? LOL) in researching things helps others. Very cool that you knew about this already. I'm thinking if this research pans out, it would be great if they could give the treatment to patients preventatively, so that fewer women have to deal with fibrotic changes from radiation.
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I finished radiation treatment 10/26/12; at my two week follow-up visit, I asked what I can do to prevent scar tissue. My RO gave me an perscription for 400 mg of Pentoxifyllene (3x daily) to be taken with 1000 mg of Vita E. The 400 mg 3x daily was way to much for my little body, so the doc reduced it to 1x daily with Vita E. I don't have any sense of scar tissue in my breast except the scar area is firm, but I guess it's too early. When does the scar tissue start to show?
Also, immediately following radiation treatment completion, I've been seeing an acupuncturist. It was amazing, the swelling in my breast went down within 24 hours of the first visit and the very burned skin healed within three weeks. The acupuncture doctor said it usually takes more visits to see the success I had. I wonder if I keep seeing him if that will help prevent the scar tissue, too.
Update: I had problems with the Pentoxifyllene; First we reducted the RX from 400Mg x 3 daily to just one 400mg 1x daily. Still the side effects were too much for my little body (and they don't make in smaller doses...but I will ask again). Side effects, extreme anxiousness (I could hardly talk), vomiting, felt completely amped up (like my body was going to explode); lowered blood pressure. Usual BP for me is around 110/80, mine dropped to 82/64
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