Radiation and Expanders

grneyd5600

Hi, I saw my Rad Onc for a consult.  I had a BMX 4/19/10.  PS inserted the Mentor Expanders at that time.  I have been having saline fills over the past 6 months.   I was told by the BS and PS at the beginning I would probably need radiation I wasn't referred to the Rad Onc until now.  Rad Onc tells me that the expanders are going to interfere with the radiation he needs to do.  He has recommended that I have the saline withdrawn. 

My question is - has anyone else with expanders had radiation?  If so, did you hve the saline taken out?  If not, did you make out ok with the radiation? 

Any insight would be helpfuf.

Thanks!

ps123

I had radiation with expanders in and had no issues.  I had to be fully expanded before starting as you can't do fills while you're doing radiation.

Pat

grneyd5600

Thansk Pat.  I was actually fully expanded.  Rad Onc and PS have determined it's all coming out.  Yikes! 

Leah_S

Sounds like "second opinion time" for the rad onc. I've also never heard of this, but the PS will follow the instructions of the rad onc.

Leah

gale1525

I had rads w/expanders and none of my doctors thought it would be a problem. They only said get them expanded bigger than you want because your skin won't stretch any more after rads.

Nana60

I am also having radiation with expanders and both my rad onc & PS said I had to be fully expanded. (I had zap #2 today & am praying I don't have any problems with my expanders!)

grneyd5600

Thanks for all the responses.  I think I am going to circle back around with Rad Onc and have another discussion around why he insisting on this.  Maybe there is something else going on and he hasn't told me or I didn't understand why he made this recommednation.  I will keep you all posted! 

FCB

Good luck with the rads onc.  I had radiation with expanders and at my initial meeting with the rads onc he said I'd need to have the expanders completely drained.  Then he left the room for a minute and called my PS, and changed to only partially drained.  They had to tape down my left (non-cancerous) breast for each zap to get it out of the way and it worked great.  To my understanding, it depends on where your tumor was located, if you need your nodes zapped, and your own personal body shape. 

I was overexpanded quite a bit before rads, got partially drained, then refilled (but not nearly as much) after a bit of recovery from rads.  I just finished my reconstruction (including nipples) and everything turned out so amazingly, I could never have imagined it would look this good (indeed, I look better than before).  I wish you the same kind of luck!!!  Best to you!!!

Texas357

I had my radiation after I was fully expanded with no issues.

GrandmaBubba

FCB I'm so glad to hear you say you had a good turn out. I will have BMX next month with TE's  inserted. Then radiation. I hope I can be as satisfied as you are.

squidwitch42

I too had Rads over my expanders, and like most was fully expanded prior.

grneyd5600

FCB - thanks for the info!  that helps so much.  My Rad Onc has connected my PS and sounds like they are going to do something similar for me that they did with you.  I will keep you posted.

Thank you all for the information and feedback. 

kittycat

I hope they decided to not remove your expanders.  What a pain that would be. 

CT124

am doing radiation with expanders in place. I had to push radiation back one week so PS could overexpand. Once tissue is radiated, it cannot be expanded further. I have ab 900cc on each side. The only thing techs need to do is to tape non radiated side during RT so that it doesn't fall into tx plan and be exposed. Have you talked with PS to understand why they are thinking this way? I would keep asking until I had answers that I understood. Each of us has such different treatments that it is important to understand or individualized plan.  I hope all works out for you.

grneyd5600

Kittycat - they are just going to remove the saline and empty the expanders.  PS says that my skin is stretched good so I should be fine when we go to the exchange process. 

jejw

Can anyone who received neoadjuvent chemo comment on the length of time one waits between surg(BMX) and the start of radiation therapy?

grneyd5600

Jejw - I had my surgery (BMX) first and then did chemo.  I had to wait two weeks after my drains were out to start the chemo.  I am not sure how long they would wait for the radiation after the BMX. 

Tg5471530

jejw- Are you getting Expanders put in at the time of the surgery?  This makes the timing different depending on how long it takes for your insisions heal, and how long it takes for them to fill your Expanders.  I had my surgery on Oct. 5th with expanders.  I only need to fill them to a size b, so this wk is my last fill.  Then I think I wait 1 wk and can start radiation.  Good luck!

Ca1Ripken

jejw - They say they can start at about 4 weeks after surgery.... I had TE placement, so am being over-explanded first, but looks like I'll be on track to start rads about 4 weeks from my 10/20 surgery (after neoadjuvant chemo). 
HTH!!  HUGS!!

grneyd5600

Leanna9 -  have you seen the Rad Onc yet?  If not, I would suggest you do that sooner than later.  I didn't see the Rad Onc until the end of radiation and he contacted my PS.  They determined I needed to have my expanders drained prior to start of radiation.  According to the Rad Onc the inflated expanders were going to interefere with the ability of the radiation to hit where they needed it.  Now, that may just be my personal case because of where they are trying to go to but I would still suggest meeting with rad onc soon.

jejw

tammyg:  How much saline did you get in your expanders.  I have some swelling outside of the expanders so it is limiting how much saline the PS can put into them.  I also only wanted to be expanded to a size b which would take about 300 mls of saline in each but my PS says he has to overfill by 200 mls.  Does your PS overfill?  I feel my skin is so stretched (plus pressure on the mastectomy incision line) that I just can't hold more fluid now without causing incision rupture.  My PS puts in 50 cc per week but I don't know if I can hold that much?

Now I am worried that I can't be fully expanded before I start radiation. What now?

grneyd5600

jejw - best advice I have is discuss with your Rad Onc.  Mine actually called my PS and they worked it out between. My PS does overfill.  He told me he needs working room.  The good news is I was told since my skin is already stretched pre-radiation I probably won't need to stretch again afterwards.  That once the skin heals we can move forward on the exchange surgery.  Either way - reach out to your Rad Onc. 

jejw

Leanna:  I'm wondering how you can be expanded so quickly.  How much saline will you have in the TEs? 

beacher4209

has anyone had problems after radiation with expanders when it came time to put the implants in? my ps has told me there can be problems cause the rads do so much damage to the skin. The implant may not be able to hold the implant, may get holes in the skin, may have to take them out and have no breast or go for the surgery where they take tissue from another site in my body... but that was not an option before because im thin! soooo im worried any good news?

Smile_On

My plastic surgeon is also concerned with the effects of radiation on my skin.  I know I cannot have any reconstruction until my skin heals, and how it heals determines the type of reconstruction.  My skin might take a while to heal since chemo has seemed to put my body into very slow healing mode--my surgical incisions were not healed for about 4 1/2 months.  I am hoping for a "basic" (although I know no surgery is basic) implant surgery where my expanders are traded for implants.  My surgeon thinks I more likely will need a lattimus dorsi flap reconstruction.  I am also thin and the stomach one (can't remember the exact name) would not work for me.  She said this surgery works better for thinner women b/c you can't see the implant as well and it looks more natural.  It takes a longer recovery time though and after so much time being pretty sedentary I am yearning to get back to my active lifestyle.  I think you should definitely ask your plastic surgeon your questions about damaged skin and see what their advice is--every body has different needs.  Good luck!

beacher4209

Thanks Smile_on, i know what you mean by sedentary! Been that way since Nov.17th,so bored.i use to work out 3-4 x a week. i did not have chemotherapy but my expander really bothers me and i still cannot ly on my back and get my elbow to the floor so i may not be able to start rads,i called physical therapy and they cannot get me in till next week!! i thought i could push my arm myself but its not working now the pt asked me on the phone if i had lymphema, i said my ps said i did not but they still want me to see a lympheama specialist... its like one thing after another ! i was told i would just have a masectomy and get reconstruction and be done,NOT ! i want this done im sure u know the feeling. i know there is alot of us out there but i feel very alone  good luck to u too

grneyd5600

Ladies, I have 7 more rad tx left to go.  The skin is doing ok and I am not having trouble with the expanders yet.  I am scheduled to see the PS end of next week to see how the skin looks after the radiation.  Based on that assesment we will figure out what to do for the reconstruction time table.  I will keep you posted. 

Beacher - I have to admit my expanders have been much more painful than I dreamed.  I have had more pain from them than anything else.  Hang in there!  As I was able to get back to excercising it did ease up and I have gotten more comfortable.   

beacher4209

Hi Jackie< Good to hear! I hope it continues to go well for you. I bet u are counting the minutes to get the expanders out. My worst part is the outside where my arm and armpit are cannot explain it,just very sore. It seems like my breast gets harder at night and expanders are like bricks on me,does that sound like your experience? Keep us posted on your progress

bher

beacher4209 - I am almost finished with my rads with an expander in place.  Rads with the expander has been a constant worry for me.  I was over-expanded before rads started.  The tightness right now is almost unbearable.  My RO and PS both have said my progress is normal and the PS is very confident that I will have a good result with the permanent implant.  I wish you well and good luck with rads.

grneyd5600 - I am curious if you have felt the increased expander tightness with radiation? It bothers me more than the skin issues. I have 3 more rad tx left.  

grneyd5600

Beacher - I definitely found the expanders felt like bricks especially once they were inflated to where I thought I wanted to be.  The pain you are describing is a lot like I had as well.  I always just figured it was the edge of the expander rubbing along the inside of the skin but who knows.  Hang in there.

bher - actually my Rad Onc insisted that I be "deflated" to start rads.  So , I had to go in and have 500 cc's of saline drained out prior to the start of rads.  It upset me when it happened but knowing you are having such tightness it may have been a good suggestion after all.  I am scheduled to see PS end of next week so he can see what the skin looks like as I finish up rads.   

bher

grneyd5600 - Will you have to go through the fill process again with your TE?  I was overexpanded before radiation but because I was so tight towards the end, my PS took out a small amount of  saline out to relieve my pain.  He wants to put the saline back in after radiation is complete.  Not sure how that is going to work since I am very tight again.