Radiation therapy 6weeks vs. 16 rounds.

Shorter cycles of rads have been being studied for several years - preliminary results are that the treatment is about the same as the 6-week version.

I had one-week, high-dose rads, which left my skin in really good condition. This treatment is also quite good. My rad onc at last checkup said that these shorter treatment cycles are especially indicated in older women with low-grade cancers (like your mothers and mine).

The main reason I hear for the slower adoption is that hospitals are used to scheduling for 6 weeks, and reluctant to give up the income, where this radiation is appropriate.

Susan Love's book points out that Rads are still important for grade 1s, and that skipping, especially for larger tumors, is not a good idea.

The Canadian trial was quite large and the results looked very good for 3 weeks vs 6 weeks. It has been a while since I read the report but IIRC they found that 3 week higher dose and the 6 week are about the same both regarding effectiveness (preventing recurrence) and cosmetic result.

The Canadian trial did have some limitations. They limited eligibility - women with large breasts were not eligible for the trial.  They said they were concerned about cosmetic results of the higher dose per session on women with larger breasts. I'm not sure what their exact size limit was. I think there are a European trial and some US trials underway that don't have that limitation.

Sue, I'm not convinced that that is the main reason. My treatment is through my HMO which owns its own treatment facilities and has its own medical staff on salary. The radiation treatments including the once a week doctor visit during rads treatment have no copay. They would get $20 to 30 from me regardless of whether I did 3 week or 6 week treatment (A $10 copay for each of the initial consultation visit with the rad onc, the post rads follow-up visit and I can't remember if there was suppose to be one for the visit with the rad onc before simulation). They have no economic incentive to prefer 6-week. Like the Canadian health system, the economic incentive is to do the cheapest treatment that gets effective results.

I really wanted to do the shorter course of treatment and pressed my rad onc about it. His concern was that he hasn't seen data broken out for using the shorter course of treatment on women who are getting Herceptin for HER2+ cancers. Since radiation can have some heart complications and Herceptin can decrease heart function, he didn't want to take the risk of the more intense shorter duration radiation treatment until there is data on that specific situation. Since Renia's mom is HER2-, this concern wouldn't apply to her.

My laywomen's opinion is that he was being over conservative -  I had a lumpectomy and was stage 1 so they were just doing the breast (for more advanced cancers they radiate more of the chest to get the lymph nodes there and the radiation gets closer to the heart). And the Canadian test didn't exclude women who were getting Herceptin - with about 25% of cancers being HER2+ it seems like there would have been enough HER2+ women in that trial that they would have noticed more heart problems on the shorter course if that was an issue. He didn't seem at all concerned about the large breast issue (I'm a DD). I decided to accept his decision, partly because the extra 3 weeks didn't bother me that much and partly because I haven't seen results from clinical trials that included larger breasts.

bluedasher - actually, the person who told me that was my rad onc - but not for the copay, etc. They just charged my insurance more for the views. What he was saying was that there are formulae for the machine, scheduling staff, etc that shorter course rads disrupts.

I'm in Canada as well.  With I first met with my rad. onc. he automatically assumed that I was having recon and told me that I will be getting 25 rad treatments.  Once I told him that I will not be getting recon, he reduced it down to 16.  I will be getting the same care, just less rads but will have the same effect.