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Cancer patients at greater risk for heart disease

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It's a double-edged sword: radiation and chemotherapy are helping more people survive cancer. But they may also open the door for severe health problems, like heart disease, down the road.

At 47, Kris Johnson of Canton, GA, has never taken her health for granted. Not with what happened, 25 years ago, during her senior year at the University of West Georgia. She says, "I was feeling very tired at that time. And noticed some swelling in the lymph node in my neck. I just assumed I was a tired, stressed senior in college."

That swollen lymph node turned out to be Hodgkin lymphoma, a lymphatic cancer that usually surfaces in the chest, and neck and arms. Kris needed aggressive chemotherapy and radiation.

But she made it through, graduated on time, and by December of 1989, was cancer-free.

She got married, had a family, and built a life beyond cancer.

But, Kris Johnson says, "It's just later in life that I realize what the impact of that treatment did." Back in August of 2013, she started feeling short of breath, especially when she'd exercise. It almost felt like a heart attack, she says. "I had burning in my neck, and in my jaw and down my arms."

At Piedmont Hospital, doctors ordered heart tests. Johnson was stunned by the findings. She was only 46, and in good shape, but says, "I found that I had two blocked arteries, one 95% blocked, one 100% blocked. They said, "This is significant heart disease. And yes, your lifestyle, you're busy. But you're not really the image of heart disease. You really surprised us with this!"

Piedmont's cardiologist Dr. Jyoti Sharma believes Kris has "Radiation-Induced Heart Disease (RIHD)." She says the exposure Johnson received 25 years ago may have sped up the development up blockages in Johnson's coronary arteries.

Dr. Sharma says they see this sometimes in patients who've undergone chest radiation for breast, lung, or esophageal cancers.

Sharma explains, "When a person is faced with cancer, we need to do whatever we need to do, I think, at that point, to get them through there therapy. Unfortunately, with cancer therapy, like every other medical treatment, nothing we give is side effect-free. And I think patients need to realize that."

So how common is this problem? A 2007 review by the American Society of Clinical Oncology estimated 10 to 30% of cancer patients receiving chest radiation develop radiation-induced heart disease within 5 to 10 years of treatment.

Yet, radiation treatments today are more focused –use less energy – and are less damaging than the treatments Kris Johnson received in 1989.

Doctors also do a better job of shielding organs like the heart from exposure.

But, Dr. Sharma says this is something cancer survivors - and their doctors - need to know about.

Sharma says, "That's the other message that I want to get across, is that as cardiologists, now, we're much more vigilant about cancer patients because they're surviving their cancers, and now we're seeing them much further out, long-term."

Kris Johnson doesn't second-guess her choices back in '89, saying, "Knowing now, what I know, would I have done anything differently? I wouldn't." But she wants to share her story, for other cancer survivors. "This can happen to you. If it happened to me, it can happen to you."

If you are undergoing cancer radiation, or have had it in the past, Dr. Sharma recommends talking to your oncologist and oncologist about your treatment, and your risk factors for heart disease. Lifestyle changes like quitting smoking and avoiding a fatty-food diet can help lower your risk of heart disease.

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