In the event that you realized my July newsletter wasn’t sent, it didn’t happen.

In the past I’ve written about the sarcoma my husband developed in 2014. He never had limitations or pain. It remained stable in his upper right arm until this year (2023). He had immunotherapy last year and this sarcoma was declared as cleared. Nothing was seen on his December CT scan. His specialists are mystified at the events that developed this year.

This past January (2023) Chet developed pain in his left upper arm. We suspected a sprain or a tear. He had an x-ray, that showed possible metastasis. A full body PET/CT scan followed. This showed growths in many areas around his body. The worst was in his upper left arm and scapula. Half of the scapula was consumed and fractured by this new growth. The radiology doctor who read the PET/CT scan said the scapula fracture could be seen on the December scan. I called to ask the doctor who read the December scan, as to why he didn’t comment on it. I was told (through his assistant) that he was trained only to look for what was requested for on the scan order. In other words, don’t look beyond! Yet another radiology doctor picked it up.

Radiation was ordered for April. He had extensive treatments. By the end of April his upper spine was treated. Shortly after that treatment  he developed breathing problems. And his head and shoulder are now tilting forward. And the side effects were nasty! Chemo has been easy considering what he experienced with radiation.

We have been in contact with Dr. Block, an integrative oncologist in Illinois. We regret not going out there in March (weather issues delayed this trip). But Dr. Block said that no tumor deteriorates a bone that fast. This was too big to be missed. Or overlooked as the first radiology doctor did.

By June 26th Chet’s breathing was very bad. I drove us over to our local hospital ER. They put him on oxygen and said his heart was going into AFIB rhythms. He was transported by ambulance to the larger hospital in Santa Barbara, California.  His lung had collapsed! Fluid was getting caught between the lung and his chest wall. A tube was installed allowing for drainage.

In a few days they took the tube out and his lung collapsed again! The tube was put back in. He was seen by three doctors in the lung and heart field while in the hospital. The three doctors who saw him in the hospital all agreed this was from radiation. He remained there for 11 days. He recovered well, but will take time to rebuild his lung capacity. He was released on July 6 with supplemental oxygen. Which he didn’t need once we were home.

Last week we saw his lung specialist who cleared him to exercise as much as he can tolerate. He is doing well.

Even though we talked to the radiation doctor, he denies that this can happen with radiation. He is wrong. I have found many articles that says it does.

Fortunately, his local oncologist had a new scan done for his chest, abdomen and pelvis. His sarcoma is now considered to be stable. We will work on finding specialists who can help undo the damage radiation did to his spine.

A collapsed lung involving the heart is known as Pneumothorax. While not considered to be common, it does happen.

Spontaneous pneumothorax is a very rare but recognized complication of thoracic radiation therapy. Currently radiation therapy is an integral part of the treatment of various intrathoracic and chest wall malignancies, chiefly breast carcinomas, bronchogenic carcinomas and lymphomas.

Lung is one of the most sensitive tissues to the ionizing radiation used in different modalities of radiation therapy. Common pulmonary complications to the radiation therapy range from radiation pneumonitis to pulmonary fibrosis but pneumothorax has rarely been reported. Almost all the cases of spontaneous pneumothorax following radiation therapy have been reported in the lymphoma patients following what is known as mantel irradiation, which involves relatively larger amount of pleural surface area compared to other thoracic radiation modalities.

Radiation produces its deleterious biological effects by both direct (DNA strand breaks) and indirect processes (formation of free oxygen radicals).

The effects of irradiation on the skeleton and the bone marrow have been extensively studied for many years.

Specific bone complications of radiation include osteopenia, growth arrest, fracture and malignancy. Some of these complications, such as osteopenia, are reversible. Insufficiency fractures are a common complication after radiation therapy.

Other chest wall injuries due to radiation therapy are osteochondroma and rib or clavicle fractures. Knowledge of the imaging features of injuries caused by radiation therapy can prevent misinterpretation as recurrent tumor and may facilitate further treatment.