Mediastinal (thorax) Irradiation

[Jack54]

I am so sorry about posting possible bad news for anyone who has went through all of the agony associated with cancer. I have Barrett's Esophagus and COPD, not to mention heart disease. I have received massive doses of radiation to my chest from 10 cardiac catheterizations, and a "64 slice  Coronary Artery CT Scan", over a 4 year period. I also have six coronary artery stents, due to CAD (coronary artery disease).

I have just started researching the affects of this radiation. My background is in Nuclear Power Plant Generation, so I am more or less qualified to understand the affects of ionizing radiation on our bodies. Take maximum doses of anti-oxidants to remove the free radicals circulating within your body, that result from any amout of radiation. Free radicals cause cancer over a long (relative term...) period of time.

I post this as a warning to anyone who has received radiation to the chest as part of a treatment, or through testing which involved high amounts of exposure to ionizing radiation. Ct Scans always involve some amount of radiation, as do cardiac catheterizations.  The "64 slice Coronary Artery CT Scan" is approximately equivalent to 300 to 600 chest x-rays, I have read.

The very serious cardiac problems listed below, can be treated with great sucess, but you have to be aware of your risk, after having received radiation to the chest. If you have any symptoms of heart disease, please see your doctor ASAP.

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Late cardiac effects of mediastinal radiotherapy in patients with Hodgkin's disease

Sinikka Pohjola-Sintonen, MD *, Karl-Johan Tötterman, MD, Matti Salmo, MD, Pentti Siltanen, MD
First Department of Medicine and Department of Radiotherapy and Oncology, Helsinki University Central Hospital, Helsinki, Finland


*Correspondence to Sinikka Pohjola-Sintonen, Harvard Medical School, 164 Longwood Avenue, Boston, MA 02115


Abstract

Twenty-eight patients younger than age 40 years, treated for Hodgkin's disease with mediastinal irradiation, were examined no less than 5 years after the irradiation in order to evaluate the frequency of cardiac abnormalities. Twelve patients (43%) had had some pericardial event after radiation: a diagnosed pericarditis, remarkably increased heart volume, or a conspicuous change of cardiac silhouette, suggesting pericardial fluid. On evaluation, 50% of the patients complained of symptoms, and 13 patients had to stop the exercise test on a low level because of chest pain, dyspnea, or general fatigue. In 13 patients some of the following abnormalities in the electrocardiogram (ECG) was found: right bundle branch block (four), first-degree atrioventricular block (four), abnormal P terminal force (five), or a low voltage (two). In ten patients (38%) an increase of the pericardial fluid was seen in the echocardiogram, and in nine patients the right ventricle wall thickness had increased. In two patients a severe coronary artery disease was found.

One died suddenly after an acute myocardial infarction (AMI), and the other had a large anterior AMI. Two patients with chronic pericardial fluid underwent partial pericardectomy. Two cases of mild pulmonary valve stenosis, one pulmonary subvalvular stenosis and two aortic valve deformities were discovered. Eight patients went through cardiac catheterization, and in all but one case the pressures were slightly elevated suggesting diminished diastolic compliance. In summary, 19 of 28 patients had some abnormal cardiac findings, but only three of them were serious ones.

http://www3.interscience.wiley.com/journal/112686599/abstract?CRETRY=1&SRETRY=0