Saturday, February 24, 2024

Left Breast Cancer Radiation Effect On Heart And Lungs

Heart Issues After Breast Cancer Radiation: Left Side Has Twice The Risk

Radiation Treatment: Managing Your Side Effects

Coronary artery disease was far more common in young women with breast cancer who had radiation to their left breast than in those who had it to their right.

Young women who receive radiation therapy to their left breast where their heart is located have more than twice the risk of developing coronary artery disease than those who had radiation to their right side.

Coronary heart disease is something that increases in risk as women age, generally in the population. Most previous studies have focused on the average breast cancer survivor population that is a bit older in their 60s and 70s, on average. We were interested in whether this effect among younger, typically healthier women was also present. And we found that it was, said Gordon P. Watt, a postdoctoral research fellow in the department of epidemiology and biostatistics at Memorial Sloan Kettering Cancer Center, in an interview with CURE®. Watt is a co-author of recent research that analyzed the risk of coronary artery disease in women with breast cancer between the ages of 25 and 54.

The study included 972 women who underwent radiation therapy for breast cancer: 466 had it on the right side and 506 on the left. Average age at diagnosis for both groups was 46, and each group was followed up with for 14 years.

Given these findings, women of all ages may want to advocate for continued follow-up and survivorship care after radiation treatment for breast cancer.

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Why Have A Video Visit

It may be appropriate to speak with your physician through video if you live far away from your providers office, or if you feel more comfortable having a visit from your home. You may have a routine check-up before a procedure, or a standard follow-up appointment after it is completed without having to travel to the doctors office.

Protect Your Heart With Surface Guided Radiation Therapy

When fighting left-breast cancer, who is looking out for your heart? We are.

Radiation can be a powerful treatment for breast cancer. But your left breast is very close to your heart. We work to make sure that the radiation treatment you need today does not affect your heart tomorrow.

We use Surface Guided Radiation Therapy, also known as SGRT, a radiation therapy guidance technique that has been shown to reduce radiation exposure to your heart while youre treated for left-breast cancer. This will protect your heart.

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Why Choose To Have Your Breast Radiation Therapy At Memorial Sloan Kettering

  • In order to deliver radiation in the best possible way, it takes a dedicated team of doctors, nurses, therapists, physicists, and treatment planners. Our breast cancer team is one of the largest and most experienced in the country.
  • Our radiation oncologists have access to and experience with every single form of radiation therapy available. There is not just one best type of radiation for all of the women we care for. But with our deep experience, we can select the best technique for each individual woman and tailor our approach as needed.
  • Our team of medical physicists ensures that the radiation dose each woman receives is accurately and safely targeted to cancer tissue and spares nearby normal tissue.
  • We consider the details of each unique woman. Our publications have demonstrated that our personalized care leads to superior outcomes.

Proton Therapy Is Our Focus

Lung Tumor Tracking by Radar for Gated Radiation Therapy

The New York Proton Center has a singular focusto provide adults and children with cancer the most sophisticated and advanced form of radiation therapy. While we do not provide surgery or chemotherapy, some of our patients do receive these important treatments from other healthcare providers in coordination with proton therapy.

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What Is A Video Visit

Through Video Visits, you can avoid traveling to and waiting in the doctors office by video conferencing with a provider instead. It is a quick, convenient way to communicate with medical professionals contributing to your care. Ask our providers today if this convenient service is appropriate for your needs.

Impact Of Radiation Therapy Laterality Should Be Considered In Survivorship Care Of Young Breast Cancer Survivors

Contact: Nicole Napoli, nnapoli@acc.org, 202-375-6523

WASHINGTON –

Radiation therapy is an effective and widely used treatment for breast cancer. While the benefits of radiation therapy for breast cancer are clear, long-term complications related to radiation therapy may occur. According to a new study in JACC: CardioOncology, women with left-sided breast cancer undergoing radiation therapy between 1985 and 2008 had over twice the risk of subsequent coronary artery disease compared to women with right-sided breast cancer with up to 27.5 years of follow up.

Researchers studied participants in the Womens Environmental Cancer and Radiation Epidemiology Study to evaluate the risk of coronary artery disease in breast cancer survivors. After excluding women who did not receive radiation therapy or who had a preexisting cardiovascular disease diagnosis, 972 women were eligible for analysis. All the participants were diagnosed with breast cancer between 1985 and 2008, were under 55 years old and had completed a cardiovascular health questionnaire. Clinical and lifestyle factors were distributed equally among both groups of women. The average follow-up time was 14 years.

When evaluating the presence or absence of two or more cardiovascular risk factors, such as increased body mass index, smoking, high blood pressure or high cholesterol, there was little evidence for differences in the association between left-sided radiation therapy and coronary artery disease.

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Radiation Therapy For Breast Cancer May Have Long

HealthDay Reporter

WEDNESDAY, Sept. 22, 2021 — Younger women who undergo radiation for cancer in the left breast have a heightened risk of heart disease years later, a new study finds.

Among women who received radiation therapy for left-sided breast cancer, 10.5% developed coronary artery disease over the next 27 years, researchers found. That was close to double the rate among women who had radiation for tumors in the right breast.

Experts said the findings, published recently in the Journal of the American College of Cardiology: CardioOncology, are not unexpected.

Because of the heart’s anatomical position, the organ and its arteries are exposed to more radiation when a woman receives treatment for cancer in the left breast.

And previous studies have found that those women do have a higher long-term rate of coronary artery disease compared to women who receive treatment to the right breast.

But the new study focused on younger women, diagnosed before age 55, said researcher Gordon Watt, a postdoctoral fellow at Memorial Sloan Kettering Cancer Center in New York City.

Those women are likely to live for many years after their breast cancer treatment, so it’s important to understand what kinds of long-term follow-up they will need for their overall health, according to Watt.

He stressed that the point is not to deter women from receiving radiation therapy.

The study included 972 women who received radiation for stage 1 or stage 2 breast cancer between 1985 and 2008.

Technical Advancements For Late Complication Risk Reduction

Breathing can reduce radiation effects

Several radiation techniques for delivering dose to the breast and regional lymphatics while sparing healthy tissue have been developed, including: 3D conformal radiotherapy and intensity modulated radiation therapy , deep-inspiration breath hold , prone positioning, accelerated partial breast radiation , hypofractionation and proton beam radiotherapy . We will discuss each of these techniques briefly below.

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Our Weill Cornell Medicine physicians are recognized leaders in cancer care and research and are experienced managing even the most complex cases. We assemble the team of cancer care professionals you need to achieve the best outcome, drawing from our esteemed roster of cancer surgeons, medical oncologists, radiation oncologists, radiologists, pathologists, oncology nurses and nurse practitioners, social workers, nutritionists, and others with experience and compassion to care for people with cancer. As a major medical center, we can also link you with NewYork-Presbyterian Brooklyn Methodist Hospital physicians who treat other health problems, all right here in your community.

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Breast Cancer Radiation Therapy Side Effects May Increase Heart Disease Risk Years Later: Study

More than one-in-10 women who received left-side breast cancer radiation therapy develop heart disease within the following three decades.

Women who undergo radiation therapy for the treatment of breast cancer in their left breast may face double the risk of heart disease later in life, according to the findings of a new study.

Researchers with the Memorial Sloan Kettering Cancer Center in New York City found that more than one-in-10 women who received left-side breast cancer radiation therapy develop heart disease within the following three decades, which is double that of those who receive treatment on their right breast. Their findings were published earlier this month in the medical journal JACC: CardioOncology.

Doctors have long known that radiation therapy for breast cancer increases the risk of coronary artery disease . However, the researchers in this latest study sought to determine whether treatment over the left breast, closer to the heart, made any statistical difference. According to their findings, it did.

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What Are The Special Needs Of Patients Who Received Radiation To The Chest And Later Require Heart Surgery

Each patient who receives radiation therapy may have different prior histories and extent of therapy. Each patient needs to be individually evaluated to determine the effect of prior radiation therapy on their heart, lungs and blood vessels. The surgery needs to be well planned with respect to the possibility of radiation damage to the underlying tissues and organs. Patients should seek a Center of Excellence with experience in performing surgery on patients with prior radiation exposure. Centers with experience and who provide a variety of surgical techniques and approaches can provide the patient with the least amount of trauma and .the best outcome.

Problems Moving Your Arm And Shoulder

Left Breast Cancer Radiation Effect On Heart And Lungs ...

Radiotherapy might make it harder to move your arm and shoulder. This can affect your activities and work. It usually improves when the treatment finishes. Your nurse or physiotherapist can give you exercises to help.

Its important to continue the arm exercise you were shown after your surgery. This will make it easier for you to lift your arm to the correct position during radiotherapy. It can also help stop your arm and shoulder from becoming stiff.

  • There is help available ask the hospital for support
  • Talk to your friends and family about how you are feeling
  • Ask about local support groups
  • Your GP or hospital can provide counselling
  • You can get help and support online through forums

If you’re experiencing a side effect that hasn’t been covered in this video, you can find more information on the Cancer Research UK website.

On screen text: For more information go to: cruk.org/radiotherapy/side-effects

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With A Career On The Line Gil Made His Choice

Across his seven decades as a professional musician, Gil Chimes had done it all: Sung in bands, performed on Broadway, written commercial jingles, and even played harmonica on Tony Orlandos mega #1 hit, Tie a Yellow Ribbon.

Then in 2019, at the age of 77, Gil received the diagnosis: a three-centimeter tumor on his lung. Because it was too close to his heart for a safe biopsy, his medical oncologist and thoracic surgeon recommended a resection. But losing more than half of his left lung would have meant permanently giving up the mica trade-off Gil simply wasnt willing to make.

And thanks to the New York Proton Center, he didnt have to.

Risk Of Cardiovascular Disease In Left Breast Cancer

In the entire patient group, the cumulative hazard of cardiovascular disease was numerically greater in patients treated with left-sided RT than those treated with right-sided RT, but the difference was not significant . The cumulative incidence of cardiovascular disease was 0.6% at 5 years and 1.9% at 10 years in patients treated with right breast RT and 1.0% at 5 years and 2.3% at 10 years in patients treated with left breast RT . Figure 2B shows the hazard plots for cardiovascular disease according to tumor laterality and hyperlipidemia. Regardless of hyperlipidemia, patients treated with left breast RT showed slightly higher incidence of cardiovascular disease than those treated with right breast RT, but the difference was not significant. Figure 2C shows the hazard plots for incidence of cardiovascular disease according to tumor laterality and smoking. Although smokers have a higher risk of cardiovascular disease, no difference was observed between left and right breast cancer in either group, the smokers or the nonsmokers. Table 4 indicates incidence rates and unadjusted HRs for cardiovascular disease in patients with left breast cancer relative to right breast cancer in various subgroups. None of the subgroups were identified to have a higher risk of cardiovascular disease in left breast cancer compared to right breast cancer.

Lt=left Rt=right HyL=hyperlipidemia.

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Not All Proton Therapy Is Created Equal

Most proton centers use volumetric beams that deliver a fixed quantity of energy to the entire tumor. But the pencil beam scanning technology at the New York Proton Center delivers intensity-modulated proton therapy, or IMPT.

Widely considered the most advanced form of proton therapy, IMPT can target different parts of the tumor with different radiation dose levels based on the prescription and the tumors exact location, while better protecting the surrounding normal tissues from irradiation. Thats particularly valuable when treating the most complicated tumors, those residing in the lungs, mediastinum , pleura , or thoracic lymph nodes.

Does Cancer Cause Heart Palpitations

Heart Sparing Radiotherapy for Left-Sided Breast Cancer

Heart palpitations are a relatively rare symptom of leukaemia. According to our 2018 patient survey, palpitations or heart irregularities occur as a symptom of leukaemia in 6% of all patients before they are diagnosed, making it one of the least reported symptoms in our survey.

How can you protect your heart from radiation?

This is called Deep Inspiration Breath Hold, or DIBH. DIBH will protect your heart during treatment. Then, during treatment, youll take and hold a deep breath in the same way as before. When your breast surface is at the right position, the display lights turn green and the SGRT system turns the radiation beam on.

Can radiation cause enlarged heart?

Radiation therapy aimed at the chest region for breast cancer or lung cancer, for example, can prompt a thickening of the blood vessels and heart valves, inflammation, and artery blockages. Heart problems due to radiation often impact younger people, too.

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Effects On The Lung Or Heart

Sometimes after treatment to the breast or chest wall area, part of the lung behind the treatment area can become inflamed, causing a dry cough or shortness of breath. This usually heals by itself over time.

More rarely, fibrosis of the upper lung can occur, causing similar side effects.

Although particular care is taken to avoid unnecessary radiotherapy to the tissues of the heart, if radiotherapy is given on the left side you may be at risk of heart problems in future.

Breath hold technique is thought to reduce the risk of any possible damage to the heart and lungs.

A Lung/thoracic Cancer Treatment Unlike Any Other

Proton therapy is an advanced and extremely precise form of radiation treatment that targets and destroys tumor cells while reducing the risks of harmful side effects. It may be right for you if you have lung cancer, or another thoracic tumor, and your physician has recommended radiation therapy as part of your treatment plan.

Conditions treated include:

  • Thoracic sarcoma

A lung or thoracic tumor that has recurred in the chest may be most safely retreated with proton therapy. This includes a tumor that previously received radiation treatment, allowing some patients a new chance for a cure.

Lung/thoracic cancers that have spread outside of the chest, or a cancer that originated in another part of the body and spread to the chest, are generally not best treated with proton therapy.

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Changes In The Shape Size And Feel Of The Breast

In time radiotherapy can cause the breast tissue to change shape or shrink in size a little. This can happen to your natural breast tissue or a reconstructed breast.

After radiotherapy, the breast might feel hard and less stretchy. This is due to a side effect called radiation fibrosis. This side effect is usually mild.

Sometimes the breast can shrink a little over time. This is because radiotherapy can make the breast tissue contract so that the breast gradually gets smaller.

An implant in a reconstructed breast can become hard and may need replacing.

Let your surgeon know of any changes, they may be able to do some minor surgical adjustments to improve the look.

D Techniques And Imrt

Proton Therapy FAQs for Breast Cancer

One of the first major advancements in radiotherapy that resulted in reduced doses to normal tissues is the use of 3D imaging for the design of the radiation plan. Radiotherapy based on computed tomography-simulation with treatment planning software and image verification of patient setup allows for more accurate estimation of target and organ dosimetry. 3D planning allows for adjustment of the radiation beam angle and the addition of in field blocks to reduce underlying lung and heart dose. In addition to a static cardiac block, field-in-field techniques have shown the greatest reduction in cardiac dose, but both forward-planning and IMRT have both been employed . These techniques result in lower volumes of heart receiving high and low doses as well as a reduced complication rates. These techniques also minimize dose inhomogeneity that results in areas that receive higher than the prescribed dose within the breast tissue and at the surface of the breast leading to decreased acute skin toxicity.

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