April 6, 2012

Radiation [and] Hodgkin’s Disease

Recognizing that Hodgkin’s Disease [HD] is commonly diagnosed in the Adolescent and Young Adult [AYA] cancer community [and] given that this week is AYA Awareness Week, it seemed especially appropriate to comment on HD and the potential late effects of successful treatment.

I received a card from my mom in the mail today which included a newspaper clipping entitled, Keep Watch after Radiation by Leo L. Walker, MD [and] published in The State [Columbia, SC] on 03/06/2012 in response to Beware of Radiation Link to Heart Disease a personal account by Mary Staton and her experience with radiation therapy for HD and the discovery of coronary disease half a lifetime later published on 02/23/2012.

To follow is an excerpt from Dr. Walker:

“This phenomenon [radiation-induced coronary disease] has been noted for decades and often fails to get mentioned at the time of radiation, or that used to be the case. It also bears mentioning that these same patients, particularly women, are highly prone to primary thyroid failure soon after the treatments, and in the oder machines used decades ago , there is some risk of breast cancer and other cancers. Fortunately the breast cancers can be detected usually by simple means, and mammography should be used as often as need be. The detection of coronary disease requires more sophisticated tests, but all former radiation patients should keep their doctors apprised of their [treatment] history in order to discover the long term sequelae early.”

Men, but particularly women, with a history of Hodgkin’s Disease carry a lifelong risk of primary thyroid failure, a secondary thyroid cancer, breast cancer, pulmonary and coronary disease, including carotid artery disease, subclavian artery disease, and congestive heart failure to name a few depending on the specifics of the treatment they received.

Personal risk is based on each person’s treatment history.

Today, I would find it difficult to believe that patients are not informed of the potential immediate and late effects of therapy; however, I do believe that there is a tendency to emphasize the immediate and minimize the potential late effects across time, thus import of screening for such potentials falls through the cracks, so to speak.

It is incumbent upon ALL former radiation patients to educate themselves [AND] their doctors about their personal risk as a matter health and wellbeing. It is also incumbent upon parents to educate their AYA children about their diagnosis and treatment history.

Please do NOT lose the war on the battlefield of late effects.

You can find the recommended surveillance guidelines aimed towards early detection and intervention @ http://www.survivorshipguidelines.org/pdf/LTFUGuidelines.pdf

Print them, read them, make a list of questions, then schedule an appointment with your primary care provider to develop a comprehensive plan for health promotion that includes screening for late effects of your cancer therapy.

[Treatment] History Matters: Know your Risk. Carry it WELL.



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