Anyone taking radiation after chemo?

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softballangel
softballangel Member Posts: 15
edited June 2014 in Managing Side Effects of Breast Cancer and Its Treatment
Anyone taking radiation after chemo?
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  • softballangel
    softballangel Member Posts: 15
    edited September 2008

    I just came back from having an oncology consult and was told that it would be a good idea for me to have the radiation following the chemo treatments. I am in what they call the gray area, I had 3 positive lumph nodes and 13 negative. The initial tumor was less than the 2cm but there were multi focal areas and I also had lobular and ductal as well. Hubby thinks that since the chemo is to travel through your bloodstream then it should kill all of the cancer cells. The surrounding area of the breast does not have any cancer cells. The breast that was taken was also on the left which makes it doubly "sensitive" when it comes to the heart.

    Since I am just starting the chemo, I have some time to research this-- but in the mean time would like some insite from others that have gone, or are planning to have the radiation following the chemo. I am also in the gray area of the stage II, stage III category. Thanks.

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  • Skyrat
    Skyrat Member Posts: 310
    edited September 2008

    Angel - my feeling is to do everything possible to make sure the cells are gone.  If you don't do radiation and the cancer shows up elsewhere, will you regret your decision then?  I had a bilateral mastectomy - my cancer was on the left.  The radiology oncologist explained to me how they make a template to use during my rad treatments to protect the heart.  There is a possibility of heart damage, but it is slim.  There is a possiblity of losing a small sliver of lung - but I have not noticed any problems from that.  A mastectomy does not remove 100% of the breast tissue - so there is always the possibility of cancer cells remaining.  The biopsy on my left breast, AFTER chemo, showed active cancer cells still in the tissue.  The ideal is that chemo will kill all the cancer cells that may have travelled through the lymph nodes.  The radiation did take care of any remaining cancer cells in the remaining breast tissue - according to my last PET Scan.  Hang in there and you will be in my prayers.

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  • softballangel
    softballangel Member Posts: 15
    edited September 2008

    Thanks.. The area surrounding the breast that they took out noted no cancer. The radiation oncologist I talked to noted that I would be getting radiation via tomo and would radiate the whole lung area, not just a small section where a couple of lumph nodes under teh chest wall are still lurking. I also read that IF you do the radiation after the chemo and the cancer comes back, that you can not get the radiation treatments again... maybe it depends upon the next location. Right now I have very little chest wall muscle over the heart area. I did not used to be able to feel my heart beating that much. But now it is so very evident. I am just afraid that getting the radiation might just be too much since this guy wants to do the whole left side. Guess one step at a time and get finished with the radiation first. Thanks again.

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  • MinAZ
    MinAZ Member Posts: 368
    edited September 2008

    Yesterday I went with my friend for her initial radiation consult. She has had two sets of chemo plus mast and SNB. No nodes, fortunately, but she was stage IIIb and that's why she needs the rads even with her breast gone. The radiologist explained the importance of catching anything that might be still in the remaining skin plus the chest wall even though it appears that all is clear. We know a gal who had it come back in the remaining skin. The doctor thoroughly explained the possible side effects but certainly convinced my friend (and me, also) that the benefits far outweigh any potentional risks.

    Maybe you should get a second opinion as far as needing to radiate the whole lung area?

    Minz

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  • lisamed123
    lisamed123 Member Posts: 186
    edited September 2008

    I had a bi-lateral mastectomy and chemo from April 10 to July 17.  I just finished number 19 of rads today out of 33.  Since I had positive nodes, that is why I am doing radiation.  Also, I do not have hormone receptors, so there are no drugs for me to take afer, I only have the chemo and radiation.  I guess I really did not question, I would do whatever they tell me to reduce my risk of reoccurence.

    Skyrat - what were your symptoms of spine mets.  I have been having some pain and it is freaking me out somewhat.  The pain is not bad enough to take a pain reliever, but it is still worrying me.  Thanks.

    Lisa

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  • softballangel
    softballangel Member Posts: 15
    edited September 2008

    Thanks for your insight. I do plan to get a couple more opinions and do some research before committing one way or another. Thanks.

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  • neicy
    neicy Member Posts: 5
    edited September 2008

    I will be taken radiation after chemo

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  • Skyrat
    Skyrat Member Posts: 310
    edited September 2008

    Lisa - I didn't really have any symptoms other than it is painful to lay on the right side very long, the ribs start hurting.  Of course, can't lay on the left side long either due to radiation.  I also feel like I have a knuckle in my spine now and then.  I also have pain in the backbone if I am up too long.  Not sure if the pain is the cancer or side effects of Aromasin and Zometa.

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  • tomatojuice
    tomatojuice Member Posts: 382
    edited September 2008

    Softballangel I was told I was in the grey zone also. Also had three nodes positive, one of them had extranodal extentions. My oncologist highly recommended that I have radiation. Then the doctors had a conference and were all in agreement with her. I had already decided it though, because of the exrtanodal ext. My masectomy was on the left. But from what I have heard they now have more ways to protect the heart and lung.Radiation has changed in the last ten years. Since I have had 18 nodes removed my chance of developing lymphadema go up 10%. I think I now have a 30% chance. But even so , I have finished chemo, and have had my 2nd of 29 rads and am feeling confident. I agree with your husband.But this decision, like all the others is personal.

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  • lisamed123
    lisamed123 Member Posts: 186
    edited September 2008

    Skyrat,

    Were your mets to the spine discovered by a routine scan?  My dr. does not due scans unles there are symptoms.  I did mention the spine pain and the rad dr. pounded on my spine and asked if I felt pain wrapping around my side, and I did not, I did not even feel the pain.  It is very fleeting.  I do have some rib pain, but it could be from the radiation on that side.

    Thanks.

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  • Tucheta
    Tucheta Member Posts: 51
    edited September 2008

    Angel

    I will also have radiation after chemo, but I haven't spoken to a radiation oncologist yet so I don't know any details and I didn't think too much about it yet. As you said, one step at a time...

    I was wondering if you've read this:  http://www.breastcancer.org/treatment/radiation/when_appropriate.jsp

    It explains when radiation is recommended and why you cannot repeat it to the SAME area but you can to other areas. It even talks about people in the gray area.

    Let us know if you get a second opinion  

    Ralu

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  • Skyrat
    Skyrat Member Posts: 310
    edited September 2008

    Lisa - the mets were discovered by the PET Scan following the rads.  There were 4 of the T vertebrae and two ribs affected then.  Thumping on my spine did not produce any pain to the ribs or the spine.  I am not sure what kind of pain they are looking for.  I had a CT Scan last month that showed the bone mets have spread to two lumbar vertebrae, the femur and the pelvis.  Still no pain to talk about that would indicate bone mets.  The onc is going to be scheduling another PET Scan in a couple of months to see if these mets are still active or if the Zometa and Aromasin are arresting them.  I keep asking my onc what he is looking for when he asks me if I am experiencing pain because I have been telling him all along about what I have been feeling.  They radiated the T-11 vertebrae because of something I said.  I think he is afraid of telling me what they want because of the possibility that I would imagine it.  LOL

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  • softballangel
    softballangel Member Posts: 15
    edited September 2008

    I had already checked out that page and I am in that grey area that is mentioned. My surgeon says I do not need the radiation because of the pathology reports. This radiation oncologist recommended it mainly because I had lobular and ductal involvement as well as multi focal areas. Since there are no guarentees of it returning, I am not sure if I want to risk my options and do the radiation now and not have that option later on it really needed.

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  • Panchoandlefty
    Panchoandlefty Member Posts: 181
    edited September 2008

    I had a bilateral mastectomy, dose dense ACT, and I am in the middle of rads... 

    In the old days, usually people who were getting chemo only had rads if they had 4+ nodes, but in the last few years they've found that radiation improves survival rates for women with 1-3 nodes so many more are getting it.

    In particular, younger women are often given rads after chemo if any nodes are positive. 

    My radiation experience has been uneventful. I've finished 17 of 33 and I am planning to run in a 5K next week. No burns. Just some fogginess/mild fatigue. Do it. You only get one shot.  

    Stephanie 

    Stephanie 

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  • marejo
    marejo Member Posts: 1,356
    edited September 2008

    Hello "angel"

    I, too, was considered in a gray area.  I had my mastectomy and SNB and at the initial "look see" of the 2 sent. nodes they said "no cancer."  But, when the pathology report came back 1 microscopic cell (.085 cm) was found in 1st sent. node but 2nd node was clear.  Because only the 1 microscopic cell was found we (surgeon, myself and onc) believed there would be no more cells found and my fear of lymphadema was greater than worrying over if any more nodes would have been found to be positive so I opted out of letting them go back in and remove anymore nodes.  Before chemo started I met with a radiation onc. to get her opinion on whether she felt radiation would be needed seeing as I would be going through 4 dose dense a/c and 4 dose dense taxol along with herceptin PLUS I had mastectomy with the 2 sent. nodes removed.  She said "most definitely" and without removing anymore nodes we really couldn't be absolutely sure no more nodes were affected. 

    At first I thought I would not do the rads and really believed there was no more cells BUT dh convinced me (along with rad. onc) that it was just one more safeguard to protect myself from a recurrence.   Looking back (and I am not a 3 year survivor) I am SO HAPPY I gave myself that added protection. 

     Go for it.................it can't hurt but it surely could help.

    Mary Jo

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  • softballangel
    softballangel Member Posts: 15
    edited September 2008

    Thanks for the information. I guess what confuses me more than anything is that you can go to one oncologist and he/she says one thing and you go to another and the answer is again different. I went back through the notes that my initial oncologist had noted and he did not mention any radiation, just the chemo. Since I will not be seeing him again due to changes in health care coverage I do not know if he just decided to work with the chemo first, see how things go and then talk about the radiation when I get closer to the completion of the chemo treatments. I also have to check my medical coverage to find out if they would cover the radiation also if it is not 100% required but just recommended or not. My other major problem is transportation since I would have to travel 60+ miles one way 5 days a week and hubby is looking at the time, money, gas and wear and tear on the vehicles for a short visit each day. The oncologist I just saw was looking at doing tomotherapy verses the initial oncologist was associated with a group that does not have that machine. That could also be a reason why the hestitation.

    Also, unless I am reading wrong, the second oncologist wanted to radiate the whole chest wall-- which is on the left-- and if using tomotherapy, that area could not be radiated again IF the cancer returned to any part of that left chest wall. I think that is why the initial oncologist did not mention radiation treatments at this time.

    Thanks everyone for your input-- this is really helping me with my decisions.

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  • Westie
    Westie Member Posts: 89
    edited September 2008

    I'm getting 35 rads after chemo.

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  • KKing
    KKing Member Posts: 425
    edited September 2008

    I am starting 21 rads on Oct 15.   16 are obliquely across the breast and 5 are direct on the area the lump was removed.   My rad doc said it would decrease my chance of recurrence from 25% to 10%.... that was enough for me.   I know there are side effects but I feel like the others.... take whatever will decrease your chances of this thing coming back

    Karen

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  • EGAL
    EGAL Member Posts: 539
    edited September 2008

    After my DX of Stage 3, Grade 3 with 15 positive nodes, my Onco said he was going to use the "full arsenal" to treat me. After 8 rounds of chemo, bilateral mx, 6 weeks of radiation, and 36 Herceptin treatments, I feel I have fought the "war".  Last check was NED, hope it continues!

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  • Deedee79
    Deedee79 Member Posts: 52
    edited September 2008

    Hi! I'll be taking radiation after chemo. I'm having tch and will continue the herceptin for a year. The best to you. Dee

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  • HensonChi
    HensonChi Member Posts: 357
    edited September 2008

    Same for me...I will finish TCH Oct 28...and then 30 days later my radiation starts.

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  • softballangel
    softballangel Member Posts: 15
    edited September 2008

    If I go with the rad it woul be 25 rounds and they want to do it with tomotherapy. All this guy is wanting to hit is the lumph nodes under teh chest wall and around the incision site.

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  • softballangel
    softballangel Member Posts: 15
    edited September 2008
    Thanks for writing back. How did you do with the 5K? I just started the chemo last week. I am doing the dose dense AC with either a placebo or Bevacizumab (AvastinTM) . I do this for 3 more cycles and then change to taxol weekly with either a placebo or Avastin for 12 weeks. I have read that alot of us are getting the radiation but the radiation oncologist I saw wants to tomo the whole chest wall to with 50Gy and then increase the areas of the scar and where the lumph nodes are located under teh chest wall. From what I was gathering, since he is looking at tomo verses "regular" radiation, if I do this and the chest wall is all part of it, I can not have it again if the cancer returns to any area of that side of teh chest. Those are some of my concerns.
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