Thorax (any - chest, mantle, mediastinum, whole lung, spine, TBI, whole abdomen or left hemi-abdomen)
Late Effect (1st of 4)
Breast cancer
Your risk is greater if:
- You have a family history of breast cancer.
- You received a radiation dose higher than 30 Gy.
- You are female.
Recommended Evaluation (for females only)
- Do a monthly breast self-exam beginning at puberty.
- Have a yearly clinical breast exam beginning at puberty.
- Have regular mammograms starting 8 years after treatment or at age 25 (whichever comes last).
Management
- You may need a surgical consultation for a diagnostic procedure if a lump is detected.
Late Effect (2nd of 4)
Underdeveloped breasts
Your risk is greater if:
- You had radiation treatment to the breast.
Recommended Evaluation
Management
- You may want a surgical consultation for breast reconstruction after you have stopped growing.
Late Effect (3rd of 4)
Heart problems (congestive heart failure, weak heart muscle, disease in the valves, heart attack, etc.)
Your risk is greater if:
- You were at a younger age during treatment.
- You received a higher radiation dose, especially greater than 40-50 Gy.
- You also received anthracycline chemotherapy.
- You have high blood pressure (hypertension).
- You have a family history of high cholesterol.
- You have a family history of early heart attacks.
- You are very overweight.
- You smoke.
Recommended Evaluation
- EKG at the end of treatment
- Special ultrasound (echocardiogram) or heart scan (MUGA) at the end of treatment, then every one to two years based on your age at treatment, the dose, and the cumulative anthracycline dose
Management
- You should have a cardiology consult if any abnormalities are detected by exam or history.
Late Effect (4th of 4)
Pulmonary fibrosis (loss of elasticity in the lungs resulting in shortness of breath)
Your risk is greater if:
- You were at a younger age during treatment.
- You were also treated with actinomycin, bleomycin, busulfan, carmustine, lomustine, cyclophosphamide, doxorubicin, or methotrexate.
- You smoke.
- You have asthma.
- You had radiation greater than 20 Gy to the whole lung.
Recommended Evaluation
- Physical exam yearly
- Pulmonary function tests at the end of treatment, then every two to three years as clinically indicated
Management
- You may need to have a consultation with a lung specialist (pulmonologist):if you have abnormal studies or if you are having symptoms.
