Recent posts (June 22, 23, 25 and July 4) have dealt with the risk of carotid artery disease following irradiation of the neck for cancer. I made suggestions without explaining the back story that led to my conclusions. Let's look at how I came to my conclusions.
What researchers and clinicians know about the long-term effects of radiation includes:
- Irradiation causes damage to blood vessels in the field of radiation.
- Changes in vessels due to irradiation can progress over time, long after the treatment is done.
- As a group, survivors of cancer treated with head and neck irradiation have an increased risk of premature stroke (stroke occurring in younger age groups than is seen in the general population).
What is not yet known -- but is under study -- includes:
- Exactly how much the risk is elevated and under what circumstances.
- How much the overall risk of stroke can be decreased by interventions.
- Which patients should be screened for silent carotid disease, and how.
- The risks and benefits of surgical intervention, if carotid disease is discovered through screening.
Tomorrow I'll describe the next step in thinking about such a risk.