Oncology (General Cancer)/radiation injury

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Hello Doctor, In 2003 I was treated for breast cancer with chemotherapy and radiation. I developed a severe radiation pneumonitis and was on prednisone for 6 months after therapy was finished. I ended up with some scarring on my upper left lung due to the pneumonitis.(fibrosis) Periodically, I will experience shortness of breath and pain in the chest, end up in emergency and of course am always tested for heart attack and pulmonary embolism, always negative. I am healthy and active 60 year old female. I recently has pulmonary function test which stated "Borderline isolated reduction in diffusing capacity of carbon monoxide, consider cryptic pulmonary vascular or parenchymal lung disease". My questions are, can pulmonary fibrosis symptoms come and go as they seem to do with me, can pulmonary fibrosis worsen over the years and is there anything I can do about it? Once the doctors see I am not having a heart attack or PE and that there is only a small bit of scarring on my lung, they really have no answers. What do you think? And have you ever heard of other women who had radiation treatment for breast cancer have these problems? The radiation oncologist is dismissive. Thank you.

Answer
From your description it is evident that your radiation injury to your lung is rather small in itself. So your symptoms can not be explained just by your injury alone. Other temporary factors like infections, stress etc must play a role too. Yes a radiation injury can get worse over time but it can hardly move back and forth between better and worse hence my conclusion above. In your case with this limited injury your risk of getting worse over time is most probably minimal.
I have seen a number of women with some lung fibrosis after radiation therapy. But this is usually not a big problem in any way and usually with a minimum of symptoms - if any at all. I would even state that in most cases there are no symptoms at all even in cases with more fibrosis than seems to be the case here. That is why I think that here there must be some additional factor or factors. I think you probably should discuss this with a lung specialist. I need to add that in most cases it is impossible to give radiation therapy to cases like yours without some effect on the lungs. Good luck!




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Oncology (General Cancer)

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Claes-Gustaf Nordquist, M.D.

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Questions concerning Cancer, Oncology, radiation Therapy, Tumours, Chemotherapy, Cytotoxic Drugs, Hormonal Therapy, Radiation Protection.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions in the number of questions there. I also answer questions in these other categories: General History, Military History, Brain Tumors, Breast Cancer, Colon Cancer

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I'm a medical doctor and specialist in medical oncology and radiation therapy

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