Thursday 7 January 2010

Oncologists Reply

Dear Mrs *****

I apologise for the delay in replying to your letter but I needed to review your notes to obtain the information that you require.

You presented with stage IIA Hodgkin's disease in 1981 and received mantle radiotherapy at a dose of between 35-39 Gy.

There is an increased risk of second cancers in patients with a past history of Hodglkin's disease whether chemotherapy, radiotherapy or combined treatment is required. Cancers related to radiation usually arise within the radiotherapy field and it is therefore likely that your past history of breast cancer is a consequence of mantle radiotherapy.

Your other two cancers are likely related to suppression of your immune system as a consequence of your past history of Hodgkin's disease and neither of these would have been detected by CT scan. Routine surveillance CT scans are not indicated in this situation as the pick up rate is low and each scan involves the administration of a significant dose of additional radiation.

Vigilance is required to monitor for future problems and any unexplained symptoms should be reported to your GP. Avoidance of risk factors for cancer (eg smoking) and active involvement in National Screening Programmes (eg cervical smears) is also to be encouraged.

If you require any further information then please do not hesitate to contact me.

Kind Regards

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