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Chest pain after the treatment of lymphoma?
Question : Chest pain after the treatment of lymphoma?
I was diagnosed with lymphoma Non Hodgkin’s (aggressive – fast growing type with a large anterior mediastinal mass of 10 x 14 cm) in Dec 2006. Completed my treatment of CHOP Chemotherapy and Rituximab Immunotherapy and ending up with radiation. After all the treatment, the tumor shrink-ed to 4 x 8 cm.
My last major checkup was a PET scan in Jan 2008 and the results indicate that the mass is inactive. Then around August 2008, i started to feel a little chest pain, but i did 2 LDH blood tests, which came out fine.
I´m wondering about how serious does this chest pain indicate? Do I automatically assume that Í am having a relapsed or is it possible that its an irritation ? I do realize that the best solution is to meet my doctor but it will be another month till I return to my home country and meet up with him. During this month, I would love to know what I can expect.
Any comments or suggestions would be greatly appreciated from either medical personnels, ex patient or relatives of such.
The pain is at the tumor site but sometimes I feel the same kind and degree of pain in other spots too. Its not a big pain, rather an annoying one. The pain on the spot of the tumor seems to be spontaneous where the other spots are random.
I found out about my lymphoma when I started to cough a lot, which rapidly wosen until the 3rd week, i decided to do an X ray and found out the tumor. However, I do recall that prior to the coughing, I did have sporadic chest pains about two months before. I thought it was because of the gym.
This time, I haven´t really been doing a lot of physical work apart from jogging.
I´ve read that the mass usually becomes some kind of a scar after the treatments. Could it be possible that this scar is causing an irritation just by being there on itself or do you think if this scar is going to cause an irritating pain, it must be because its relapsing into a tumor again? Does good level of LDH ruleout the possiblity of the tumor replapsing?
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Best answer:
Answer by happydawg
You should call your MD tommorrow to arrange a CT scan to look at the chest and see whats going on. I would not wait on this. Its been 12 mo since you had a look see and this chest pain could be anything.
God Bless you and keep you in his care.
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#2 written by iRun 1 year ago
Fellow lymphoma survivor, but I had Hodgkin’s Disease. I also had a very large mediastinal mass and I have a lot of scar tissue left in my chest. Until my mass started to press on a nerve in my shoulder, it didn’t cause any pain.
I think you should go see your oncologist. The two major things that need to be ruled out here are your heart as the source of the pain and a possible relapse.
As to the heart, as you’re probably aware, the Adriamycin used to treat both Hodgkin’s and Non-Hodgkin’s can sometimes be toxic to the heart muscle. Mild chest pain could indicate a possible early heart problem. Thus, I would want to make sure that your doctor rules out the heart as the source of the pain.
As to lymphoma, you say you did feel some sporadic chest pains from your mass before diagnosis. I think it would be a good idea to get a CT or chest x-ray to rule out the possibility of a relapse. That your LDH level is normal is a good sign, but actual imaging would show better whether this is a possible relapse.
Now all that said, I get aching pains from time to time in my chest, often when I’m running. I’ve been having them since the middle of chemo. I know some of these pains are from lung damage I suffered from a drug specific to Hodgkin’s Disease. But other pains are in the wrong spot to be the lung and are mysterious. I’ve had a full workup — CT, PET, heart tests, lung tests — and my oncologist couldn’t find anything wrong. In doing some research on lymphoma, my guess is the pain is basically what you said — it is caused by the scar tissue rubbing up against other things in the chest, or by the scar tissue continuing to shrink a little bit. I know from reading lymphoma message boards that it isn’t rare for people with large mediastinal masses to report pain sometimes in their chest during and following therapy. I haven’t really heard of anyone having chest pain as their first symptom of relapse.
I think the chances are very good your pains are due to the scar tissue, and do not indicate a relapse or a heart problem. However, obviously, your oncologist should make that call, and not someone over the internet. See your doc, let him run his tests, and if everything comes back fine, you can look for an alternative explanation like scar tissue.
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#3 written by Nursy 1 year ago
What made you get diagnosed with lymphoma in the first place?? Did you have pain then?? Is the pain in the area where the mass is?? I wouldn’t automatically assume that you’re having a relapse. Are you having any other symptoms?? Did you do anything that might have caused a muscle to stretch in your chest?? I’m sorry, but there are a lot of reasons contributing to your pain. Maybe I shouldn’t have said anything at all but could you see a dr where you are??
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Wow here i was thinking i was an idiot for constantly complaining about chest pain to my oncologist – but now i see i’m not alone at all!!! I had Hodgkins Lymphoma, it was a massive tumour in my chest which initially caused chest pain, a heart murmur, fainting spells and much much more. When i had it biopsied they had to basically move a rib out of the way so i’m left with a 6cm scar and a dent in my chest just above my left breast. Since the surgey i have had what i would call a reasonable amount of pain. I am never sure whether it’s from the surgery or the scar tissue, so i keep a diary log and show it to my oncologist every two months when i see him.
The pains i get a similar to that of irun. I’m over a year post surgery, and 9 months post chemo, and i seem to get a lot of nerve pain around that whole area. Sometimes when i move certain ways it feels like a lightening bolt is going through my body!! Ouch!!! I also get plenty of pin-prick-like pains which seem to be easing over time.
Another kind of pain i get which worries me is a heavy kind of ache in my chest. I get it when i exercise, when i’m stressed and at other random times. One of the chemo drugs i had (bleomycin) has left me with Raynaud’s Disease as well as asthma so just to be sure i requested a heart scan, and some further blood tests which all came back normal. I make sure i am getting regualar CT’s to rule out a relapse, in conjunction with blood tests (i’m always worried about my LDH level but it’s been normal since chemo. If i have a clear scan and a good LDH level i always feel much much better!)
I must add though, i did have a CT last week and upon reading the scan my oncologist seemed to think that the residual mass was looking rather fine, but the radiologist who did my scan has requested i go for a PET which has completely put the wind up me!!! I know in my heart (or in my chest for that matter) that i haven’t relapsed but the fact that the radiologist is worried makes me worried (meanwhile my oncologist is sitting back saying he’s pretty certain it’s inactive residual mass but wants to be sure.)
I guess all in all i’m saying the pains you are getting sound like they are fairly common among us Lymphoma Patients who have had mediastinal disease. If i were you i wouldn’t be stressing over a relapse, but the only way you’re ever going to know is by requesting scans and blood tests. Hell i do!!! It’s your body and the only way you’re going to feel as ease wit hthe situation is if you take charge. I love all my doctors but sometimes i have to let them know that i’m in charge!!
A good LDH level and no lymphoma symptoms is a great indicator that no relapse is in site though!!! Good luck!!!