Prone Position & Shorter Course of Treatments

NotAgain2015

Has anyone chosen to use the prone position and / or has gone with the shorter number of weeks for treatment?  I met with my radiologist/oncologist today and he agrees I'm a good candidate for the prone position and he is also suggesting 4 weeks of treatment instead of the normal 6.  Same total cumulative dose of radiation, just delivered at a stronger dose over less time.

It is my left breast, so I like the idea of the prone position which has less impact on my ribs, heart and lungs.  He also mentioned it is slightly easier on the skin.  I like the idea of a shorter course, but is the outcome the same?  Are there statistics for it?  Just wondered if others have researched this issue and wondered what you decided to do. 

c2will

I had the shorter treatment in the prone position.    I also had cancer in the left breast, so I was also concerned about  possible impact to my heart and lungs.  There is a study - search on 'Canadian fractionation' - which shows that it is statistically the same.  I completed treatment at the end of March.  My skin is almost back to normal - just a little tanned.  I didn't experience any major skin issues such as blisters, just swelling and some irritation.

Good luck!

suzieq60

If you have large breasts - go for it. My onc couldn't be bothered setting me up in the prone position (left breast also) and I ended up with considerable breakdown of the skin in the crease under the breast. She tried to explain it away by saying it was from rubbing skin on skin - but not right in the crease in my opinion. The nurse said it was because the radiation was going through 2 layers of skin and it often happens in men in the fold of skin in the groin area too. Anyway, if you have the option - take it. Not sure about the increased dosage though.

somanywomen

Sounds great!!..I wish I had known/been offered prone position..It just makes sense!!!..I did the IMRT Trilogy system, same amount of time (6 weeks) but suppose to be better for less harm to heart and lungs...When my rads were done, I was surprised with an added charge of $30. office visit charge for each visit ($30 x 30 = $900.), I am fighting this with my insurance...Best of luck, it goes faster than you think....

NotAgain2015

Thanks for your replies.  Just for anyone reading and getting ready to meet with their radiologist/onc, I had to ask for the prone position.  It turns out only one location in my town has it.  Its that new.  But as he thought about it he agreed I was a good candidate for it - so just another confirmation that we have to read and learn and take an active role in our care.  He did say that he thought they would start using that position more and more.  What made me think of it initially, was the stereotactic procedure - same idea.  It just made sense to me.

Did any of you also take tamoxifen?  My next big question is how did that affect you?  I'm 51, and my biggest concern is does it just shrivel you up sexually?  (yes this is my inner fear talking!)  Does your skin change, and you just lose interest?  The fear of ending that part of my life is also scary and maybe it is an unfounded fear...  I may also ask this question in the hormonal therapies section.

Thanks for any insight you can share.  Thanks for being there - and for having bravely gone before!!

CTMOM1234

Count me in as another satisfied prone patient (left breast), definitely safer and an added bonus was that it's more private because you're facing down.  As far as # of rads, I was a candidate for shorter run but after reading a lot about what they do and don't know about rads and DCIS, I just felt that the more number of treatments over a long time period at lower levels was a better strategy.  Completed 30 zaps (25 reg'l and 5 boosts).

Can't comment on tamoxifen other than to say that it's a personal decision and I opted out. To increase chance of no recurrence from 95% to 97.5% doesn't seem worth taking 1800+ pills (every day for 5 years) with increased chances of both menopausal side effects and endometrial/uterine/liver/etc. other potential problems. Of course, if it provides one with comfort to take tamoxifen, which may lower chances in both breasts, or if they have difference percentages than the ones my onco. quoted me, then that is certainly a different story. fyi,  I'm pre-menopausal and in my 40s.

KayNYC

Yes, I am half way through the shorter course and I am having my treatments in the prone position. I looked over the research and the outcome was about the same for longer vs shorter course of treatment.Shorter course is more commonly used in Europe and Canada. Prone position radiates less of lungs and heart. The prone position however is usually best suited for women who have a C Cup bra or larger.Hope this helps.

Hugs, K

NotAgain2015

Thanks K and CTMom.. 

How did your treatment go CT - did you feel ok, have any side effects?  Did it slow you down at all?  Any tips?  Could you keep exercising or did you feel too tired, etc.? 

K - how are you feeling half way through?   

I have a couple of weeks to stew about this   I go get setup and start the week of 6/15

CTMOM1234

I can honestly say that the rads weren't as awful as I'd read about from other's posts -- the absolutely hardest part for me was just turning my brain off and taking the zaps. It's freaky when you begin the process, but you have to just get through it one day at a time, then oddly it actually starts to feel like a regular routine. I never felt exhaustingly fatigued, but did feel what I'd term a "wave of wooziness' late in the day starting about 1/2 way through; it would pass after a few minutes.  I opted to go bra-less whenever possible, so that posed some challenges for working and exercising. I also wore stickers instead of getting tattooed, so was very careful about not getting my markings or stickers wet (one of the first things I did when I was done with all treatments was enjoy a nice long bath). 

Skin held up well until that last week, then I did get lobster red, but just kept going. Radiation is a cumulative thing and my skin got ugly dirty color for a good two weeks after being done and than bounced back quickly. Definitely drink lots of water and apply whatever lotion/moisturizer your place recommends 2-3 times a day but never with less than 4 hours before a zap session (think of baby oil magnifying sun exposure).  I'm now about a month out and only a teeny tan line still exists, for the most part, entire area looks the same as before I began rads. Lumpectomy and rads. was definitely a better choice for me than mastectomy, and I am so thankful to have had the option.

Good luck and you'll be just fine.

NotAgain2015

Thank you so much for that post!  Its good to hear about positive experiences and that life goes on. 

Question:  I ride a horse.  It's summertime and I wear a tight-fitting sports bra.  Envision, alot of bouncing and sweating through the bra - literally soaked.  The radiologist/oncologist said it shouldn't be a problem.  But I find that hard to believe somehow...  Do you think I can continue doing that? 

KayNYC

I have nine radiation treatments left. Loving the long holiday weekend break. My skin is probably doing the same. I am pink and the nipple area is sensitive, otherwise they tell me that my skin condition is good. I have had some swelling of the affected arm and breast; I asked for a physical therapy referral . I will be scheduled next week for an evaluation with the lymphedema specialist.. The amount of swelling in the breast is pretty obvious with the arm swelling, less so but irritating late in the day when my rings get tight and I can't stand anything on my left arm. Otherwise, I am feeling good, doing my yoga and stretch DVD's that seem to make the discomfort less under the arm.My energy level is good. My husband says he thinks it actually increased since the surgery.

I have been either wearing a camisole or sports bra. On some days, the nipple area is too sensitve for the compression of  the sports bra. It feels like the soreness of my nipples when I first breast fed my first child (ouch). Can't wait to finish rads and get back to a more normal schedule (I have to get up two hours earlier than normal to get to my radiation appts before I go off to work) and my underwire bra. Just don't feel as put -together in office clothes without a good supporting bra for my D-cup girls.

Best of luck with your rads. Have a great holiday weekend.

K