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All TopicsForum: Radiation Therapy - Before, During and After → Topic: Smoking and Radiation Therapy

Topic: Smoking and Radiation Therapy

Forum: Radiation Therapy - Before, During and After — What to expect from treatment and ways to cope with side effects.

Posted on: May 20, 2008 09:52PM

Leia wrote:

I haven't been here, in a while. But found this new story, on breastcancer.org of interest:


The lead sentence says, "Cigarette smoking dramatically increases the risk that a woman who has undergone radiation treatment for breast cancer will develop lung cancer later on, a new study shows."

In August, 2006, I was diagnosed with IDC, 2cm, Stage I, Grade 1, 0/3 nodes, ER+/PR+, HER2-. I had a lumpectomy, with totally clear margins. They wanted me to do the radiation. I initially went to the appts, but in the end, I refused. Walked out. With totally clear margins, from the surgeon, why torture, my body?

And now, this study. 18 months, later.

I'm a long-term, smoker. Which I've totally been honest, with all of my docs, since forever. But now, if I had agreed, to the radiation, NOW I have a much greater chance of getting lung cancer. CAUSED by this "radiation therapy." Which provides such a minimal benefit.

I'm continuing to get the mammos. My next one is in two days. And probably, another MRI. And if it's cancer, again, I'll deal with it, surgically.

I am NEVER getting, radiation.

This radiation, makes no sense, to me. Nor, any of these other "treatments."

But, that's just for me. Smoker, IDC, 2cm, Stage I, Grade 1, 0/3 nodes, ER+/PR+, HER2- Plus, I weigh, 132, but have 36DD breasts.


My point, don't automatically believe, the docs. They're just operating off the latest "study." And this lung cancer one, was a real eye-opener, for me.


Dx 5/5/2006, IDC, 2cm, Stage I, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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May 21, 2008 03:41AM MarieKelly wrote:

I'm right there with you about these concerns. I'm also a smoker. I knew about it when I was going through the diagnosis and treatment back in early 2004 and this was one of the numerous reasons why I refused radiation. This most recent information you're referring to isn't the first that's been available...concerns about post radiation lung cancer have been published since at least the mid 1990's. The article that I remember seeing during the time I was making my treatment decisions was published in 2003. I too, walked out of the rad onc office and said no thanks. The only treatment I've had has been the lumpectomy. I refused everything else and over 4 years later, there's been no recurrence.

Ki-67 5%. Wide margin lumpectomy and biopsy track removal. Refused radiation and hormonal therapy. Dx 2/22/2004, IDC, <1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2-
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May 21, 2008 11:39AM AnnNYC wrote:

I think this is such important information to get out there!

And: the risk of radiation tx causing lung cancer is also extremely high for EX-smokers.  EX-smokers who develop breast cancer should be strongly warned.

I was a smoker when dx'd with BC on March 9 last year, and an "ex-smoker" as of March 24, 2007.  No one ever mentioned risk of lung cancer from rads.  Thank God a different unusual circumstance led me to mastectomy rather than lumpectomy for 1 cm tumor.

Dx 3/9/2007, IDC, <1cm, Stage I, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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May 23, 2008 11:04PM mdb wrote:

Thursday, 5/22, I had my two year post cancer mammo that said, "post Lumpectomy. Benign, no evidence of Malignancy. Followup Recommended in six months."

Totally normal, breast tissue.

With my rejecting, the radiation, after two years, if there were some cancer cells, left, shouldn't they have grown, by now?

Of course, they still may be growing, but SO slowly. I'll definitely "catch them," in time. Why even DO this radiation?

But you said it before, Marie. they force the radiation on 100% of the women for the 10% it really helps.

And I find this, appalling.

I didn't even know, about those earlier, studies.

We women, don't have to accept, this.

And I've made, my decision. No radiation, for me. EVER. And NONE of this Tamoxifen or anything else.

What I find, interesting (or appalling) is that they treat breast cancer like that's the only "bad thing" that can ever happen, to you. And so, you have to "do everything," to stop, it. And if you agree to all of these horrible "treatments," you're fine! Even if the treatments, make your life, a living, hell.

Well, the truth is, you don't have to submit, to them. And no guarantee, your life will be "fine."

For my part, two years before my 2cm IDC diagnosis, I got this external Leiomyosarcoma butt cancer. Which is like the most deadly cancer, of all. 1% or less, of people, get this cancer. And it's totally, deadly. But mine was external, and they cut it out, and I'm fine.

No Doc, even at the Seattle Cancer Care Alliance, offered me any "radiation" for my Leiomyosarcoma Butt Cancer.

No $$$ to be made, there. I do still have CT scans, for that, and all clear.

Unlike this incredible market in useless, whole breast radiation. This is a Big Business!

I just find it, sad, how people have their breasts, cut off, and take drugs that make them sick,and accept radiation that gives them lung cancer, for nothing.

Nobody gets out of here, alive.

For my part, I love my breasts. And so does, my lover. And I'm going to enjoy them as long as I can.

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Jun 26, 2008 08:25AM Copenhaver wrote:

Thanks for posting that link. I've been looking for information on just that subject. I'm a week from completing my chemo treatments and need to decide on radiation. I have the same knee jerk reaction to undergoing radiation. I've been a smoker forever and really don't want to trade breast cancer for lung cancer. So far I feel I have been agressive in my treatment.

I was diagnosed at age 45 with Stage II 5cm Invasive Lobular Carcinoma with 3 lymph glands out of 6 involved. I was ER/PR+ HER2-. I had a bi-lateral mastectomy, even though the cancer was only one one side, just to make sure the sneaky stuff wouldn't come back. I opted for the chemo, even though I had clear margins after the surgery. My tumor markers during treatment have been consistently down around 17/18.

I've read other studies that say radiation to the chest wall in smokers (or ex-smokers) can raise the risk of developing lung cancer http://jco.ascopubs.org/cgi/reprint/18/6/1220.pdf. What I can't seem to find is how much does having radiation reduce the risk of recurrance. Does anyone have any information on that? I mean does having the radiation treatment reduce recurrance by 10%, 30%, 90%?? It's hard to completely weigh the risk without having both sides of the story.

I did meet with the Radiation Oncologist right after surgery and was upfront with her about my smoking and she strongly recommended radiation. ??? Not sure why she thinks it's a good idea given my history, but I didn't ask that question during the appt. I talked to my Chemo doc about my concerns and he agreed that it is a valid concern but said that I should meet with the radiation oncologist one more time to make my final decision on treatment. I need to make that appt soon but want to go to the appt with all the info in hand.

Any additional information any one has would be greatly appreciated.

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Jun 26, 2008 06:55PM Nitsana wrote:

Hi i dont know about the rate of recurrence unfortunately - but your doctor should be able to tell you. There is an online tool called Ajuvant - dont remember the link or i would tell you - but i am pretty certain that your oncologist can tell you - and it gives scores for your particular situation - for recurrene with and without different treatments.

 thanks for all this information by the way - it really is helpful. i am an ex-smoker with concerns about radiation (with or without being an ex smoker!). What i did notice about the article (pointed out in the comments by the Breast Cancer org on the side) that the study was done many years ago and the type of radiation was different than was done now. However, BreastCancer org's comment says that current practices mean that they dont radiate to the lungs - but I've done my

simulation for radiation - and they necessarily will radiate 2 cm of my lung - which they consider small - and from what they say that is quite common to radiate a small part of the lung when radiating right breast. So, it seems that perhaps modern treatments reduce the effects to lungs - but do not exclude it completely. Thats what it seems to me... but i am still doing more research on this. There is also another treatment - which seems to be still experimental - called Partial Breast Irradiation - where they only deliver radiation to the area of the tumor as that is the location of most recurrences. Seems to have positive of leaving lung out and negative that not much is known about it  - no long term knowledge. And also - less is known on giving higher doses of radiation at one time - which this treatment necessitates.

if anyone has knowledge about that - would l;ove to hear! 

Dx 11/19/2007, IDC, 1cm, Stage IIB, Grade 3, ER+, HER2-
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Jun 27, 2008 07:01PM - edited Jun 27, 2008 07:03PM by Shirlann

I hear you mdb, but I have to say, my HMO would do anything rather than treat.  We pay a fixed amount yearly and the less they do, the more they make.  In fact, these docs get a bonus at the end of the year if they don't spend as much as the others in the group.

In Europe, the situation is not exactly the same, but most docs are on a salary and don't make money from treatments.

I am not disagreeing with you about the money mongers, we have had them, and we still do, but it just was not my case.

I think what we have is a "set protocol" for each parameter.  So, no matter what, they do what the protocol says.  Even if it is silly, makes no sense, or is actually harmful.  This way they protect their rear ends and don't get sued as often.  I had a very small tumor, no nodes, and I wish that I had said no to rads, but we are so intimidated.

I have no heart or lung issues 9 years later, but I have bone pain from either osteonecrosis (dead bone) or bone softening.

So what I TRIED to do, and what I would now INSIST be done, is, get a lead apron and put it under your breast and over your abdomen.  I asked, but they said, "Oh, nothing gets anywhere except the breast".  Just not true.  So anyone who is contemplating this, MAKE them give you an apron, it sure is no skin off their nose.

Hugs, Shirlann 

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