Post radiation side effects

[jeanie1]

Are there any studies or info available about possible post radiation effects-appearing 2 years after radiation for DCIS-post lumpectomy in regards to upper and lower digestive track-pains?

[PaulMD]

Hi there.

The radiation dose and intensity that is usually given for post surgical DCIS patients are calculated and delivered such that only the superficial structures of the breast and chest wall receive the major fraction of the radiation, relatively sparing deeper structures such as the lungs and esophagus.  Esophageal complications usually arise if the primary aim of the radiation is to cure something in the lungs, and less likely from breast or chest wall radiation.  Abdominal pain, coming from organs like the stomach and intestines are very unlikely to be due to radiation in the chest area.  However, I suggest that you still have this seen by your doctor so that this can be evaluated.  

Regards and God bless.

[Thomas32]

Hi Jeanie, the radiation you refer to, ductal carcinoma in situ -DCIS, can you please let me know the site and if left or right breast? Although Annie's was ductal invasive, node neg, the site of surgery for br sparing surgery was on the outer rim of rh breast right next to the sternum. However tattoo marks extend over the sternum to the opposite left healthy breast. During the course of radiation Annie told Oncology that 'you are making the heartburn worse, you are burning too deep!'. Also she had CMF and radiation and experienced post ca treatment refractory heartburn plus abdominal discomfort (pain) 24/7.  This was like a 'tight belt' just under the breasts under the sternum. The site of this pain/discomfort was eventually found by nissen fundoplication surgery to be on the outside of the distal oesophagus (serosal) as severe perioesophageal inflammation. This surgery provided relief for an adverse symptom that peristed for 5.5 years post ca treatment.

From this I can understand why br ca patients progress with reflux oesophigitis to eventually have Barretts oesphagus up to 10 or more years later and for which you find literature. A foremost researher is Prof Januss Jankovski Oxford.

As an aside, during the 5.5 year long period of fruitless GI investigations-concentrating on mucosal oesphagus- and consulting various gastroenterologists , Annie was referred to pschycologists and pschyciatrists and I clearly remember my brave wife*, tearfully telling all that would listen 'I am not imagining that I have heartburn and pain upper abdomen...' Sorry I am too emotional to describe more.

*Pre ca treatment Annie was 'Business Woman of the Year' -employed 300 people.

[Thomas32]

I forgot to mention why I am interested lh or rh breast. The upper part -fundus- of the stomach where the distal oesophagus enters -angle of HIS- lies over to the rh and my layman engineering common sence tells me that some xrays have the potential to get near to this part of the oesophagus when treating the rh breast. For a lh breast the xbeam would be directed away from the distal oesophagus towards the lh arm.

Please if Paul MD could comment on this aspect I would appreciate it. Thank you Tom and Annie.