Patients' Perspectives:
Telangiectasias

This particular sequence of treatment causes many capillaries in the area of a radiated field, usually a field that has received a boost, to dilate and stay dilated. As patients who developed these as a result of chemotherapy, we found that the telangiectasias do not hurt; they simply look rather odd.  Except for failing to perspire, a common occurance when skin has been exposed to radiation, these areas seem not to be different in texture or function than nearby unradiated skin.  Sometimes, these areas are said to have "radiation recall" or "radiation rebound" effect because the capillaries "recall" that they received radiation.

In discussing this with a radiation oncologist, we found that they most commonly occur when adriamycin is given shortly after radiation. 

From the Patient's View

In my case,  I asked whether I could receive my radiation therapy for breast cancer while waiting for the insurance company to render a decision on my request for high-dose chemotherapy with stem cell rescue (HDC/SCR).  Because my cancer was on the right side, there was no concern on the part of the oncologists or radiation oncologists that my heart muscle might be damaged by the radiation therapy.  So, everybody agreed that it could be done, with one of the radiation oncologists saying that it MUST  be done so that my skin didn't have the opportunity to become reinvolved with cancer.  I had had peau d'orange before my surgery and thus already had significant involvement of tumor cells in the dermal lymphatics (these are lymph nodes in the skin).  Had I waited to have my radiation until after the chemotherapy, it's likely that I wouldn't have this reminder of my breast cancer.  But, if I'd waited, my view is that I would probably have had a recurrence by this time (this note is written seven years after HDC/SCR).

The use of chemotherapy during or after radiation now is usually limited to 5-FU and Cytoxan, with some use of methotrexate, depending on the physician's preferences.  My high-dose chemotherapy could have substituted Cisplatin for Adriamycin, but we knew that my tumor was sensitive to Adriamycin, so that changing the chemo for the HDC was not an alternative, from my perspective.

The picture above on the right shows the telangiectasias on the right side of my chest.  The area towards the bottom of the hockey stick field was more raw and weepy towards the end of my radiation than the remainder of the hockey stick field.  So, the telangiectasias seem to be a little more intense (dense) than the  remainder of the hockey stick field.

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