Radiation appt tomorrow help please

Mquara

I am post surgical and just finished round 3/4 of my chemo. I have my first appt with the radiologist tomorrow. I am a highly anxious person that is trying to wean of my meds so I can drive soon but now I am anxious about radiation.

What will happen tomorrow? Typically when will, rads start post chemo? Will I need any post surgical mri/cat scan/ mammogram? All my tests were done presurgery so will they need post surgical images? I hate the mri .

My tumor was large so how will they cover the entire area left behind? (I had a lumpectomy/partial mastectomy and 3 nodes removed)

I'm trying not to worry and trying not to just give up and take a klonopin right now so if anybody can give me a step by step of what they think MIGHT happen with regards to prep, exams, tests that need to map the location I'd really appreciate it.

Thank you!

Connie1230

My radiation started 3 weeks after chemo ended. I did have a CT scan before radiation done right in the radiation dept right before they did the mapping. Honestly, for me at least, this has been a breeze compared to chemo but I had a total of 16 chemo treatments. After 11 of 32 radiation treatments, I have had no side effects (knock on wood).

As far as what happened, after the CT scan I just laid there while they did the mapping. It was not a big deal for me other than not moving. When I know I can't move, something always itches...rofl.

My radiation is done lying on my stomach and my breast just goes into a U shaped hole in the table. The radiation is done twice and since my face is in a spot made for it, I can't see just where that machine is moving. It takes just a few minutes. I know some people have it lying on their back and I know nothing about that

I suspect if you still have one chemo treatment left, this meeting tomorrow may be informational only. Mine was done prior to my last chemo (by one day) but that had been scheduled prior to me missing 2 chemos due to low platelet count. They gave me the option to wait or have it done that day. I elected to get it done because if it wasn't that day, it would have been the day my port was removed and I didn't know how I would feel after that procedure.

Now I may talk a different story when and if the side effects of radiation come, but so far, I can honestly say that radiation has been a piece of cake and is nothing to get terribly nervous or upset about.

GrendelDog

Hi Mquara -

I had my chemo before surgery, so the timing is going to be a bit different for me. My radiologist said I needed to wait 4 weeks post surgery to start treatment, but the planning stuff could happen ahead of time.

I had 2 consultations with the radiologist. The first was prior to surgery to introduce and let me check them out. She went over the basic processes, risks, side effects, etc, but said that until surgery and final pathology, she couldn't say for sure what the treatment plan would be.

After my surgery finished up, I set up the "let's get started" appointment which I had today. We went over the same stuff as above, I got a chance to ask about what they would be radiating (axillary nodes? supraclavicale nodes? internal mammary nodes?). She said she wasn't going to do the internal mammary nodes and she drew a picture to explain why not and how it would cause too much exposure to my heart. I also got a referral to a lymphedema therapist to get some baseline measurements and a sleeve, etc.

Then they did the planning stuff which consisted of getting a set of CT scans while lying on the table in the position I will be in for the treatments. I will be lying face up, hands raised over my head, fingers interlocking. For the planning, I had on a gown, but disrobed both sides (I kept my pants, shoes, socks on). They marked up my skin with markers and put stickers in various places. The asked me to change the position of my head a bit. Then then did the CT scans. After that, they removed the stickers, but put on some other 'long term' stickers that will last until the first treatment at which time I'll get the tattoo markings. I can shower and clean normally with the stickers, but I been told not to 'scrub' them. The also took photographs of the sticker markers in case any of them come off. This planning session took about 20 minutes?? I will be starting treatment in just over a week.

No MRIs were needed

gb2115

I think they have you wait about a month or so after chemo before actually starting the radiation, but they will plan it during that time. The first meeting with the rad onc will probably just be a discussion, maybe a physical exam. I didn't get officially re-imaged before radiation, but they do a CT scan to plan the radiation fields as part of a set-up appointment. At my set-up appointment, I also got two small tattoos so they could line up the machine properly. The CT scan was fast, and did not involve any IV contrast. A week after my planning session, I had x-rays taken on the radiation machine (called a linear accelerator). A few days later I had my first treatment. The treatments are really fast. I found the day to day radiation treatments pretty easy. I had an extremely tough time through it though, because my body has decided to be allergic to everything, which continues to be an ongoing problem. I was dealing with a delayed surgical glue allergy at the beginning of radiation, and once it started clearing up, I had a few days of itch-free existence before the skin in my radiation field decided it was allergic to the radiation lotion. C'est la vie.

So that said, if it hadn't been for all the allergies, I honestly would have found radiation pretty easy.

I have anxiety problems too, so I get it. I also made sure to tell the radiation staff and oncologist about the anxiety problems, which helped, so for me they explained things more. I think it helped to tell them. Don't worry about your visit with the rad onc, it'll be ok. :-)

Tappermom383

I just had my radiation mapping yesterday; my lumpectomy was on March 31. You need to heal before starting treatments (and of course we had to wait a week for insurance authorization). The mapping was very easy. The techs explained everything they did; got me positioned the way they wanted on the table - put some wires on me to mark the radiation field. Even put a BB on my nipple because otherwise it doesn't show up in the scan. The RO came in to check the setup before they did the CT scan. Because the machine is open, it's much easier than an MRI (and only occasional whirring noises as opposed to machine gun-like clanging). When the CT scan was done, they tattooed me in three places, then put stickers over the tattoos and marked them with an "X" because they're so tiny.

One of the techs had to help me move my right arm (the surgery side) as it went numb in the overhead position. But the treatments aren't as long as the mapping so I don't expect that to happen again.

The lead tech showed me my scan and pointed out my surgery site (and the edema that's still there), the wires (which they removed after the scan), my nipple. Then she took me into the treatment room as no patient was in there. I got to see the control room (looks like something out of NASA) and the radiation machine.

In about a week, they'll call me in for a simulation to check the plan. I should start treatments (33) the next day.

Other than my arms being a little uncomfortable and the tiny prick of the tattoos, it was painless and easy.

Best of luck to you!

MJ

Mquara

thank you all. It helped. I went today, I am getting 7 weeks of rads. I go back on June 20th for the big appt and to make the mold. Then I start sometime after 4th of July. My last chemo is May 31st. I did not see the machine or anything but the nurse and Dr spent quite a bit of time with me, then they sent in the therapy dog and handler for a few minutes.

I hate that I ge all worked up over something so small but I hate walking into any situation blind, I have to know all I can, so not knowing had my anxiety levels high.

I'm cleared for a max of 30 minutes per day of swimming which was another thing I was frantic about. I enjoy my pool time with my family and with 7 weeks of rads I didn't want to have to sit out. The nurse initially said no not at all but the dr said ok. I don't go in every day so hopefully it will be ok. I have a rash guard shirt and will make sure I keep the chlorine on the lower side.

Thanks again

Kicks

I did my 25 rads 7+ yrs ago. The Rad Dr insisted on a new MRI with Contrast so that was done the day of my last Taxol, just before infusion. I saw Dr the next Mon and had a CT (no contrast), tattoos and simulation. That Wed, I went in for first rad. So for me, it was 1 week after last Taxol. I did not do any boosts.

"Mold"?

For me, what I found the most 'shocking' (for lack of a better word) was how big the Rad Room was and that the entrance was a big open area (probably 8' tall x 12' wide) for a 'door' - there was nothing covering it at all. They had some very nice 'plants' (artificial of course) around the room below the ceiling. I don't know the exact width of the room but it was probably 40'ish in diameter. Yes - diameter - it was round. I was told that the round shape was why a door was not necessary.

The 4 'tats' I got were about the size of a small freckle bbut blue. (Not visible at all while 'dresses'. OR in a swimsuit.)

The Facility I went to had a lot of lockers in the changing room and WD were each assigned a personal locker and given the key for it so your personal effects were secure while you were doing rads. They also supplied very nice/comfy terry cloth robes for you to change into. Had totally enclosed showers, if you chose to use them after rads.

Oh - if you are 'uncomfortable' on the table - ask for 'padding'. Because of my osteoarthritis, when laying flat on my back on 'something' I have to have a towel rolled and put under my neck. As my LE had already developed when I did rads, they insisted on doing more padding. Don't be afraid to tell them to accommodate YOU!

Won't be long now til you get to ring the bell!

Hopeful82014

Kicks, re: the mold: some facilities use a high-tech, molded bean-bag like cushion to maintain consistency of positioning. They are made individually for each patient and then recycled (at least at the facility I used).

And some facilities don't require a tattoo; some don't use them at all (using stickers instead) and others will forego tattoos for stickers if you ask.

Ruby3813

Yes, my facility used the mold. LIke Hopeful said, they have you lay in the position you'll be in every time you get rads, then they mold this bean bag like thing around you. It sets into the shape you've made in it, then they keep everyone's molds hanging on a rack in the rads room. When you come in for your rads (at least in my case), they have your mold on the table with a sheet over it and you lay in "your" mold. Makes holding your arms in position very easy because you can't move around.

Also, my facility used the sharpie and stickers. The stickers are VERY sticky and when I finished treatments, they were kind of hard to get off. I ended up using makeup remover on them, but it took some time to get all of the stickiness off.

I kept using the Mometasone cream for a couple of weeks after I finished my treatments and my skin is doing great. I can't even feel the lumpectomy and sentinel node biopsy scars with the hand anymore.

I finished my rads on April 21st and definitely don't mind not having to drive to the facility everyday. I do kind of miss "my rads team" and the people I met in the waiting room while going there. I brought brownies on my last treatment day for all of the radiation techs who were always so nice. I just set up my 6 week follow up apt with my RO and hope to see some of the techs while I'm there. :-)