The Telegraph
Since 1st March, 1999
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Radiation risk to heart disease

The dreaded Cs — cancer and cardiac ailment — have become partners in peril and doctors are blaming it on ill-planned, improper radiation.

With a number of cancer patients suffering congestive cardiac failure, the death toll is creeping up. Most susceptible are cancer patients receiving prolonged radiation to the breast and lungs, as this often affects the heart.

According to statistics available with the state health department, at least eight cancer patients have died from congestive heart failure in the past three years, although the cancer had been “adequately arrested” in these cases.

Confirming this fear is Asia’s oldest radiotherapy department, at Calcutta Medical College and Hospital, which has carried out a survey on the effects of long-term radiation on cancer patients. Since 1995, the radiotherapy department has closely monitored seven cancer patients who had received IMC (internal mammary chain) radiation after surgery and chemotherapy.

These patients developed acute cardiac problems within a year after receiving radiation at prominent cancer hospitals in the city. One of them died, not from cancer, but from congestive heart failure.

“The cardiac toxicity effect started to show three months after radiation. This has led us to believe that prolonged radiation, specially in the left breast area of cancer patients, is causing heart diseases like pericarditis, left ventricular dysfunction and congestive cardiac failure,” said Subrata Saha, radiotherapist-cum-cardiologist at the hospital, who led the survey.

Doctors also found that in all seven cases, apart from the chest wall, the heart had also received high dosage of radiation, causing problems. The report has been sent to the state health department and was also presented at the recent breast cancer seminar in Milan, Italy.

Around 8,000 new breast cancer patients are reported from hospitals in Calcutta alone. Almost 90 per cent of them have received radiation at centres where dated methods are used.

“I do receive 10-15 heart patients who have received radiation and the numbers are growing every year,” said cardiac surgeon Kunal Sarkar. Another cardiac specialist, Ajay Kaul, felt that the dated machines could have something to do with wrong dosage of radiation.

Kalyan Bhattacharya, head of department (radiotherapy) Nilratan Sirkar Medical College and Hospital, called into question the “improper planning” or “wrong field arrangement”. These can cause acute cardiac toxicity and so, the newly-introduced 3-D planning system is a must in every hospital, he added.

“Unless one gets the coordinates wrong, one should be able to ensure that the patient will receive radiation only on the chest wall and not the heart,” said oncologist Chanchal Goswami.

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