prone vs supine position in radiation therapy to protect organs

gracestella1948

The prone position vs the supine position in protecting the heart and lungs in radiation treatment

gracestella1948

I was told being in the prone position for breast radiation is better for the heart and lungs because the breast hangs down away from the organs and is away from the field. they said you do not hold breath for that. Has anyone found that to be true?

ParakeetsRule

Who said that? Radiation for breast cancer includes more than the part of the breast that dangles. They need to zap all of the breast tissue including what's touching the chest wall, plus tissue going up to the armpit and lymph nodes in the armpit. It's supposed to catch any cancer that could have started to move away from the breast tissue too.

gracestella1948

Sorry maybe I explained it wrong, I am new to this.They said the whole breast is radiated but only the breast and not the organs are in the field.3 week treatment with integrated booster 15 days at New York Presbyterian.

ParakeetsRule

So your doctors at NYP said that about the position? If so maybe they are opting to only do a smaller area based on your diagnosis. Everybody's treatment is different!

But "whole breast" normally includes all breast tissue, which is also present outside the area that "dangles". Not sure how they would get that when you're laying on your stomach.

RatherBeSailing

Prone is sometimes used with women with larger breasts. The thought is that lying in supine position, the weight of the breast compresses if closer to the chest all, and therefore might give more exposure to the heart and lungs.

I believe it is not used in women who need nodal radiation, which may be what Parakeet is referring to. Here's an article from this site explaining it:

https://www.breastcancer.org/research-news/2012091...

Quietgirl

So many things factor into treatment decisions what is best/right for one person is not always best for another left vs right, larger vs smaller, nodes involved vs no nodes involved, back problems vs no back problems. The list goes on. So yes prone might be the better choice for you and that is why doctors are suggesting it to you but for some it is not even an option. You might want to look through the radiation treatment forum. I’m not sure if anyone in February or march groups were prone or not.

Veeder14

I was prone back in 2018, my doctor took detailed films that showed the direction of the radiation field and how close it was to my heart and lungs, not touching thankfully. Still said some scattered radiation could reach organs. No problems with lung and heart afterwards. Prone was hard for me due to back and neck problems but recovered ok

gracestella1948

Thank you for the reply. I am new to the site and was told the prone position would be better for me concerning the organs. i am so happy you tolerated the position and you are well. Again I appreciate your response it helps to reassure me.

gracestella1948

thank you for your reply that is just what they said. lying on your back especially for large breasted women exposes the organs more. I see we get so many different opinions from different Drs it is so difficult to make decisions. Thank You

AlwaysMeC

I agree with @quietgirl. Treatment really depends on a lot of factors. There are different types of radiation, such as IMRT, proton, etc. They also factor in your anatomy. For example, the breath holding technique will not work for someone whose lungs and heart go outward when holding their breath because it would put those organs in the field of radiation. I was also told that sometimes larger breasted women may need more intense dosing to get to certain parts because there is thicker tissue. Your RO should be able to provide you with the treatment plan after mapping is done you may also ask too see the actual mapping pictures. It will show exactly where they expect the beams to go, and how much radiation those areas will be getting.

BtwnStars

As others said it all depends. At first my RO tried the prone position for me, did all the mapping. Ended up that my heart had a way of falling more forward (just everyone's anatomy is different) so she was not comfortable with that. We switched to the supine with breath hold and it was much better. You can always ask to see the mapping plan and find out their reasons. The breath hold was not as hard as I thought it would be. Hope you have a good outcome. Def use the cream before you think you will need it and consider liklihood of fatigue. I thought after going thru chemo, radiation would be fine, but I actually felt more fatigue with radiation.