About to start radiation: Did anyone have heart or lung complications?

Hey there! I had 35 sessions of radiation from the end of June into August of 2025 and, interestingly enough, I did not have to hold my breath - ever! I was on my back with my left arm up and my head turned and pulled as far to the right as possible. They made a mold and really targeted the left breast area. As far as I know, I don’t have any side effects from it. My radiation oncologist prescribed a prescription lotion that was amazing!! (Silvadene) My doctors explained that radiation has come a long way and is much less harmful that ever before. Best of luck and I’ll be praying for you! You got this!!!

I'm a Radiation Oncologist and just wanted to speak a little bit to discussion regarding breast cancer treatment and impact to the heart and lung. Modern radiation therapy planning and delivery techniques do a great job protecting your underlying organs from radiation exposure. Heart sparing is something we take great care in doing and utilize several techniques for it. You may be treated prone (on your belly with treated breast handing down), or asked to use deep inspiration breath hold technique (DIBH) or we sometimes utilize proton beam therapy. Prone positioning is good when you are only needing to treat breast tissue (no nodes) and the breast tissue readily pulls away from the chestwall when you're facedown. DIBH is a way of cheating your anatomy to protect your organs - when you take in a deep breath the lungs double in size which pushes the heart back from the chestwall as well as making the total amount of lung that gets some of the low dose behing the breast much less. But for some cases, particularly those in which we need to treat lymph node areas, even DIBH doesn't protect the lungs as much as we'd like to keep your risk of pneumonitis low. In those cases, proton beam therapy (charge particle therapy) can be a benefit. Because of the charge on the particles, the exit dose is eliminated and you almost completely spare tissue outside of the breast and lymph node areas. However, proton beam therapy has limited availability and insurance coverage is highly variable.

Best wishes with your radiation therapy! It will be done before you know it!

Happy to say my mammogram and ultrasound today went well. Lump is hardened fluid around incision and my body should absorb it over time. No cancer.

@rosback Also, I washed my breast and arm pits with Neutrogena Transparent Bar. No residue.

@saraheja
I am pleased to see a professional's information. One thing I see little of is the side effects of radiation. I had radiation 5 days a week for 3 week for IDC after a lumpectomy Feb 2025. Then I started 10mg Tamoxifen. I had a very uncomfortable hot on the inside, very cold skin, simultaneously. And of course no sweating involved. Sometimes even goosepimples. At first it was constant: 24/7 for 3 months and I blamed Tamoxifen. However after stopping the Tamoxifen after 10 weeks, which I started immediately after the radiation, I still had the same side effect constant, took pill to sleep. This started dwindling very gradually. Now, a year later I have the same discomfort for a few hours but it's only a day or two a week. I simply have nothing else to tie it to other than the radiation. My doctor has said he has never heard of "that one"; meaning side effect which we assumed at that time was the tamoxifen. This leaves blaming the radiation in my mind. Have you any comment for me?

@luckbme It isn't something we typically hear from patients as being likely related to the radiation treatment. However, radiation causes inflammation in the breast that does cause some generalized symptoms (like fatigue) so it's possible that a more systemic/whole body inflammatory response was trigged by your therapy.

@saraheja Thanks for your reply!

@saraheja Hi Sara, it is my understanding that the heart and lungs complications do not appear for months, even years after radiation.

@saraheja What do you do to protect a pacemaker from radiation in the same left breast ?

@judydarlene To protect a pacemaker from radiation in the same left breast, the following measures are typically taken:
Surgical relocation: In some cases, especially for breast cancer patients, the pacemaker may need to be surgically relocated to the opposite side of the body before radiation therapy. This is to avoid direct or scatter radiation that could cause malfunction of the device.
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Monitoring: A nurse or trained radiographer may monitor the pacemaker during treatment to ensure it functions properly. This is usually done before, during, and after treatment if the pacemaker is directly in the radiotherapy field.
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Treatment planning: The radiation and cardiology teams will work closely together to create a treatment plan that is safe and will treat the cancer while managing its effects on the device. This includes planning the best way to deliver the treatment and considering factors like the type of device, dependence on the device, type of radiation therapy, maximum radiation dose, and location of treatment.
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Interrogation: Before, during, and after treatment, the implanted device may be interrogated to check its battery life, how the leads are working, and if there are any changes in the heart rate or rhythm. This is a painless test that takes about 10 to 15 minutes.
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It is essential to follow the treatment plan and consult with healthcare professionals to ensure the safety and functionality of the pacemaker during radiation therapy.