Radiation; Long-Time After-Effects

[Bowling Grammy]

11 years ago, I had a Lumpectomy (left breast)followed by radiation and chemotherapy. For the past 5 years or so, I have had shortness of breath, and also have developed an esophogeal problem, having to have the Heimlech method admistered twice in less than a year. Two days ago I had a Motility Test and was asked at that time if the Dr. had mentioned the possibility of radiation after-effects as the cause of both my problems.  He had not, but logically it makes sense to me.  The Dr. is talking about cutting a muscle in my throat to relieve the "lump" symptoms and swallowing difficulties.  I'm also interested in what can be done for the shortness of breath.  I had been told that the chemo exits through the lungs and caused the filia to disappear which filters for the lungs.  There is no replacing that, but perhaps there is some exercise or something that can be done to alleviate the shortness of breath.  Are the two problems connected?  I appreciate any help you can offer.  Thank you.

[rkmsim]

I had that problem with the feeling of a lump in my throat after I finished chemo and radiation.  It turned out that I had a thyroid problems - a goiter - and it was pushing inward against my esophogus and trachea. I also had problems breathing when I would turn my head a certain way. My surgeon said thyroid problems are not unusual after chemo.  I had surgery to remove most of my thyroid (not cancerous) and I no longer have problems choking, breathing and feeling like there is a lump in my throat all of the time.  If you haven't had your thyroid checked, it may be worthwhile to do so.

[Lady Macaroon]

I TOO HAVE HAD LONG TERM EFFECTS BUT FROM CHEMO WHICH I TOOK IN MARCH 1992 FOR BREAST CANCER. THE EFFECTS HAVE BEEN STRONGER THE PAST 6 YEARS THAN AT THE BEGINNING.

[surgeon]

It would be highly unlikely that radiation would have affected your esophagus, unless there had been a need for very unusual targeting. Likewise, it's not common that chemo would leave you permanently short of breath. One possibility is that you have reflux, which can cause both a stricture in the esophagus, and, if severe, lung problems from chronic aspiration. In any case, a clear answer needs to be found, because neither situation is good, whatever the cause. So it ought to be pursued with your internist until both situations are clearly understood.

[CCF-RN,MSN-JS]

Dear Bowling Granny, When radiation therapy is given for breast cancer all attempts are made to shield vital organs such as the lungs and heart.  However, there is a possibility that an area was within the radiation field and could be damaged.  Regarding chemotherapy, the body's mechanism for eliminating waste products particularly drugs is either by way of the liver and/or the kidneys, not the lungs.  The chemotherapy medications that are usually given for breast cancer do not have lung toxicity as a long term side effect.  

Your symptoms would need to be evaluated in context of physical exam, as well as your medical history.  An internist would be a good professional to start with to help to direct the evaluation of your symptoms.