The New England Journal of Medicine just published a new study on the effects of radiation therapy on women who are being treated for breast cancer and the news is disturbing. Women who receive radiotherapy for breast cancer have a higher risk of ischemic heart disease.
The authors studied 2168 women who had radiotherapy for breast cancer between 1958 and 2001 in Sweden and Denmark. Within 5 years of receiving the radiation the women began having heart problems and this finding continued for over 20 years after the radiation.
Not surprisingly, the greater the radiation dosage, the higher the risk of heart disease. The risk was greatest for women with preexisting cardiac risk factors. The good news is that since this study was done, the dosages of radiation women are exposed to have been lowered.
To me, this is a double whammy for women because most breast cancer occurs after menopause and estrogen is typically discouraged in women who have breast cancer. Estrogen seems to lower the risk of heart disease if started shortly after menopause. The removal of estrogen as a treatment option denies women the cardioprotective benefits of estrogen.
Until we find out the impact on heart disease of lower dosages of radiation in use today, this study provides women another important topic to discuss with her physician when considering treatment.
Because heart disease is often a silent disease in women, view the video interview I did with Dr. Puja Mehta of Ceders Sinai Medical Center about how you can know if you have heart disease – you may be surprised.
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