Radiation Risks

No cancer treatment is risk free. Radiation, chemotherapy, and surgery all have their downsides. Cancer patients who underwent radiation therapy in the past are finding that sometimes the side effects don't manifest until many years after treatment.

Studies show that radiation for breast cancer and Hodgkin's disease, a cancer of the lymph system, increase a patient's long-term risk of dying from cardiovascular disease. The studies evaluated patients who received radiation before the mid-1980s when doses and delivery were less precise than they are today. For breast cancer survivors, the risk is substantially higher in those treated for cancer in the left breast, which is closer to the heart.

Radiation Overview

There are several types of cancer radiation therapy. However, they all use high-energy radiation to kill cancer cells. According to the National Cancer Institute, about half of cancer patients receive some type of radiation during treatment.

When planning a patient's radiation treatment, a radiation oncologist uses imaging that shows the exact location of the tumor and the healthy areas around it. He can then determine the exact area to treat, the total radiation dose, how much he should allow for spillover into nearby tissue, and the safest angles for delivering the radiation.

During treatment, radiation rays also harm nearby healthy cells. For women with breast cancer in the left breast, or those with Hodgkin's disease who may receive radiation to the chest, the heart is often very close to the tumor and therefore receives some of the radiation.

Today's radiation therapy is more precise and damages less of the surrounding healthy tissue. It's difficult to know if newer forms of radiation will still increase patients' risk for dying of heart disease because it takes 10 to 20 years for cardiovascular problems to show up. Furthermore, radiation affects patients in different ways.

The risk for women receiving treatment for breast cancer, for example, depends on what part of the heart receives radiation, how the oncologist delivers the radiation, and the woman's specific anatomy. In cases where the risk is high, some women opt to have a mastectomy rather than radiation.

If your oncologist recommends radiation therapy, discuss all the potential risks and benefits of this treatment. If you believe the benefits outweigh the risks, you can take additional steps to safeguard your heart health following treatment: 

  • Check your blood pressure and cholesterol regularly so you can spot abnormalities early.
  • Don't smoke.
  • Tell your dentist you've received radiation treatment; it may negatively affect some dental procedures.

Labbe, Martine, BSc, Arriagada, Rodrigo, MD, PhD, Jougla, Eric, MD, Chavaudra, Jean, PhD, Diallo, Ibrahima, PhD, Rubino, Carole, MD, PhD, and Vathaire, Florent de, PhD. "Long-Term Cardiovascular Mortality After Radiotherapy for Breast Cancer." Journal of the American College of Cardiology 57(4) (2011): 445-452. Web.

Nainggolan, Lisa. "Left-Sided Radiation for Breast Cancer Ups Heart Disease Risk." Medscape Medical News. Web. 17 August 2006.

Pittman, Genevra. "Chest Irradiation May Increase Long-Term Heart Risks." Medscape Medical News. Web. 21 January 2011.

National Cancer Institute. "Radiation Therapy for Cancer." Web. 30 June 2010.

Friedlander, Arthur H, Sung, Eric C., and Child, John S. "Radiation-induced heart disease after Hodgkin's disease and breast cancer treatment: Dental implications." Journal of the American Dental Association 134(12) (2003): 1615-1620. Web.