Skin Cream during radiation

Thank you - I really thought the system/process through. I didn't want to worry about details once the treatment started.

The xeroform kept my breast cooler. Before I started using them I would slather on a lot of lotion (b/f acquafor I was using Remedy Medline (doctor recommend for day use b/c it's not sticky like acquafor) but it created a paste effect and my t-shirt would stick to my breast- basically suffocating my skin and drying up the lotion. The xeroforms, on the other hand, are paper thin (they are meant to be a "second skin"), saturated in burn jelly (I just add acquafor in for extra hydration) and are specifically designed for burns (it's the dressing that hospitals use for skin grafts and burn wound care - see the link at the bottom of the page).  When I first told my radiologist that I was going to start using them (my friend is a dermatologist and he suggested it), she said it was probably overkill. Maybe she was right, but I don't think I would have had the same excellent result without them.  I used two 5 x 9 - I would put them (and the cortizone and acquafor) on immediately after my treatment, take it off for a couple of hours when I get home from work, put it back on b/f bed and remove it in the morning (I received radiation b/f going to the office in the morning). I used two new bandages each day and put one on the top of my breast, the other on the bottom (covering the crease under my breast, which tends to be a sore spot for most women). Each bandage cost around $2.00 from a pharmacy in my neighborhood, but they are available for much less on the web (see link at bottom of the page). As an aside, my three side effects were skin breakdown (dry/itching/peeling skin/sandpaper texture), "warm" breast and swollen breast.  My doctor said she would only temporarily stop treatments for skin breakdown (peeling, blistering), so I was really focused on keeping my skin intact.  My breast was warm, and still is (just a little bit), but that only bothered me after the third or fourth week and now it doesn't bother me at all. For warm breast I used an ice pack (half ice, half water, always on my shirt (never on my skin)) on and off throughout the day or when I got home at night. Between the xeroform/acquafor lubrication and the cooling ice pack, I felt fine.  I picked up a great ice pack from Duane Reade - large and cotton - covered my whole breast (kept one in my apartment and at my office). The most annoying side effect was the swelling. I am a small B cup and I swelled to a large "C". It wasn't painful, it just felt heavy, like I was carrying a water balloon in my chest.  It would subside slightly over the weekend, and then resume on Mondays. I started limiting my sodium intake two weeks into treatment and would take a couple of alleves (or any anti-inflammatory will work) when it was worse than usual. I'm two weeks out and the swelling is just about gone and my skin is only slightly tinted and it's really soft again. Also, I think the constant lubrication helped fade my lumpectomy and sentinel node scar. My lumpectomy scar went from an angry red line to a very thin white line and the sentinel node is white with a very slight tint of red outline outlining the white. Overall, it looks significantly better than I thought it would at this point. My best advice is to plan everything out, which you are doing, so you are already ahead.

• - Don't use under-wire bras - opt for t-shirts or very soft cotton/no underwire(e.g. fruit of the loom) bras in a bigger size (larger size for the swelling)
• - use a really mild unscented soap on the area being radiated (e.g. dove), gently apply the soap (never rub) and pat dry
• - no sun exposure at all to the area. If you are going to be outside during the day, triple layer the area. On an overcast day I spent a couple of hours outside with just the xeroform and a cotton t-shirt and I definitely felt a burn after wards.
• - try to get some extra sleep. Overall, Ididn't feel fatigued, but I was slightly more tired at the end of the day and getting to bed an hour earlier really helped with that. I also felt very achy (neck, upper back, arms) - like I had the flu - for the first week of treatment. I wasn't expecting it, so I was a bit panicked at first. I asked my doctor about it and she said it was probably stress, but I didn't feel stressed and I asked other women in the waiting room and they had the same experience for the first couple of days, so I'm not sure. I took some alleve and it eventually subsided after the first week.
• - Constant lubrication

On a scale of 1 to 10, (1 being completely painless, 10 being the most pain possible), I would rate radiation at a 3.  I never had any pain, just some discomfort. You will be okay and the six weeks will go by very fast.  Best, j.

Article re: use of xeroform for skin grafts

http://www.ncbi.nlm.nih.gov/pubmed/8537426 

 Links to buy the 5x9 xeroforms.

http://www.google.com/products?q=kendall+xeroform&scoring=p

j414 -  Thanks for info and the google link. I think it's great that these are used for burn wound care. It may be swatting at a fly with a sledge hammer but hell, there's no doubt that fly will be one dead sucker. I'd rather err on the side of caution. Since I've got plenty of time, I'll likely order the Xeroforms from one of the medical supply companies on the internet. Might as well save money where I can. Am I correct that you reapply the same two after your "airing out" break ? Also, tell me please, how do they attach ? I'm guessing I also need to buy medical tape ?

Hi:

Just wanted to add my two bits. I had a mastectomy and lymph removal, with a very large area to radiate. I had tatoos (too many to count) only S.E. was tiredness. Glaxol was the only lotion I used recommended by a Nurse! Am fair skinned but didn,t burn or itch, it was super.

Compared to Chemo (Taxotere), Rads was truly a piece of cake.

Have a great day, my dear ladies.

Erika

p.s. had been out of Country for 6 months. Because of computer glitch, lost my Private Messages.....please send again!!

J414-  I'm going to have to test carefully before I risk wiping out the ink. But if I keep the Tegaforms on the ink, this may work.

Of course, since nothing ever seems to be black and white these days I did just find a lttle discussion amongst nurses which raises some questions about using the Xeroforms proactively on healthy skin. As I read, "One side of the discussion is that it can be applied to the entire area of the wound including the good skin surrounding the wound without any problems to the good skin. And the other side of the discussion is that it should not be applied to good skin because it traps moisture on the good skin making it "mushy" and susceptible to further breakdown." http://allnurses.com/wound-ostomy-continence/proper-application-xeroform-213792.html Since I know "breakdown" is an issue, this seems to merit consideration. Of course, your first hand experience says quite a lot. Seems like so many tecnical things to be considered, we have to become our own experts.

MTG,

I have small breasts and still two xeroforms did not cover the entire radiated area, so I don't think I touched any "healthy" skin (rads hits the areas surrounding the breast too).  I am almost three weeks out and my skin looks fantastic - it's just slightly off tint and I'm very, very fair. As an aside, a week after I finished radiaiton (and the oncologist told me to wait a week) I started drinking 2 "green juices" a day (an antioxidant overload) - an ounce of broccoli sprouts a day (Hopkins research shows it stops the growth of breast tumors) and a kale juice (which was not that tasty), which is also very powerful antioxidant (both ground up in my vitamix with lemon juice and distilled water).  I am a big fan of antioxidants and this protocol may have helped the healing/cell regeneration too.

Your skin is going to get red and itch, and your breast will likely swell, it won't be pretty, but please don't despair, it will quickly bounce back. I was really upset by the last two weeks - I always had perfect skin and now I was red and swollen (but no pain, just a little discomfort). My doctor repeatedly said it would significantly improve when treatment ended and I held on to that. And it did. We have the same pathology and we are very lucky. I'm not happy about having BC in my thirties, but I am so damn grateful that it was small with estrogen/prog receptors, her2-. In six weeks it will all be over - hold onto that.  Best, J.

Xeroforms on Sale

J414 and Those who may buy Xeroforms - I did some research and found several sales on Xeroforms 5" x 9" Petroleum/Petrolatum Gauze Dressing

From AllegroMedical.com - Box of 50 for $61.55 -$9.23 [Save 15%, (15sep09, BUT this sales ends Midnight Monday)] = $52.32 + $10.95 ship = $63.27 for 50 or  $1.26 each http://www.allegromedical.com/browse/browseProducts.do?searchPhrase=xeroform+dressing

From IMed.com -  at $67.40 for a box of 50 - $8.08 with 12% Off (code: MEDNET12) = $59.31 +$6 ship =  $65.31 or  $1.31 each. http://www.imed.com/shop/detail.cfm/sku/K1155

From WheelChairMedical.com -  A box of 12  for $16.15  x 4 = $ 64.60 for 48 w/ 5% off (code: FREE5) = $61.37  + $5.95 ship = $67.32 for 48 or  $1.40 each. http://www.wheelchairmedical.com/p-67150-xeroform-petroleum-gauze.aspx

In case anyone sees this after the above sales have expired, simply google "Xeroform Gauze dressing" as J414 suggested and then to save even more $$$, plug in a few of the store names into Retail Me Not (http://www.retailmenot.com/) to see if the stores have any coupon codes which may improve the price..... The really great thing is this site works for non medical, non BC purchases as well so we can save money when we feel like being indulgent and rather than practical.

Did anyone else get an e mail wanting a rating on MY Girls Radiation Cream?  Well I did and I rated it a 1 (lowest rating)  I said it feels good but really did nothing to stop the burns.

Wow ! I thought hydrocortisone/ cortisone creams were ok !!!! I've just completed my pre-radiation shopping and picked up a tube thinking that's what every uses to deal with itching. Now I'll be sure to check it with my doctor. Of course, I'm feeling a bit foolsh now since I already know that everything should be okayed by the doctor, I just thought this was like aloe and ok without asking. A dumb move but you ladies have my back (even without knowing it).

Not trying to make anyone feel bad, MTG, just trying to help.  But, there's a reason the docs tell you not to use any creams or lotions, period, for the duration of your rads therapy.

For one thing, you can't prevent burns (or skin break-down, as the professionals call it), but you can definitely make it a lot worse by disregarding your doc's advice and using moisturizers, etc.   A lot of women just can't or won't accept that fact - it's not like you're going out in the sun or anything.  The radiation works by killing cells  - all cells - but gradually.  It kills both healthy and cancerous cells, and the healthy cells regenerate relatively fast.  So, any itching is caused by that and goes way beyond the surface of the skin - the entire breast is radiated through and through which means the itching is also coming from the dermis.  Also, moisturizers and creams tend to hold in the heat from the radiation.  Lastly, the skin becomes so insulted from the treatments that even gently rubbing it can cause painful breaks and blisters, which is why they tell you not to wash the breast.  You want to avoid even the gentlest rubbing on the skin, and they give you Lidocaine in gel form instead of cream form so you can just gently spread it without really affecting the skin. 

Hydrocortisone shouldn't be used on the skin on a regular basis even if one is not going through radiation therapy.  It can clear up short-term issues like rashes and itching, but using it regularly is bad even for healthy skin. 

MTG...My radiologist told me today to use hydrocortisone cream if I start having bumps and /or itchiness. He said any brand will work. If it gets worse, he will give me a prescription for Silverdine. I have been using calendula lotion (homeopathic) and told him about it. He looked it up and said it was ok to use. My skin is doing really good so far and I have had 14 treatments and get zapped in 5 different places.

I finished 30 radiation treatments Dec.30.  Sometimes, I would apply simple olive oil to my breast, especially after a bath at night.  Very soothing.  My instructions said not to use talc, but corn starch was okay.  I never had more than a bad sunburn.

What I found most useful was the lycra camisol.  I always wear underwire bras, and was uncomfortable braless.  The ones I found were shaped, with a "cup" formed into them.  Sometimes, I would put on a bra over the cami!  Another trick that helped, try wearing your bra inside out.  The seams are smoother, and the fabric often is, too.  I did that for a few months after treatment.

Hope this helps someone!

Okay, I stand corrected on the hydrocortisone 1% - I guess it's such a weak concentration that it won't affect the skin the way stronger concentrations are used.  My whole thing is just make sure your doctor approves - I've seen women talking about using creams and lotions in spite of what their doctors tell them before and it really bothers me because there is a reason they tell you to stay away from creams and lotions.

For what it's worth, I did really well during my rads too until maybe the last week when it got to be very painful.  I wouldn't let them put tape on my breast (they wanted to leave it there throughout the treatment) and the last couple of treatments someone stuck a small piece of tape on my breast.  The skin seemed to holding up pretty well, so a couple days after treatment I removed it and all the skin came up with it.  Just a caution for you ladies.

I would also like to strongly advise using cornstarch VERY liberally and often on the underside of your breast, especially once you have a burn.  I ended up with a nasty keloid under there that is making me crazy - it bothers me so badly and it just keeps on growing, not to mention that it's just gross.

Best of luck to all of you - this may seem like the longest 6-7 weeks of your life but you WILL be finished and when that happens you can breathe a sigh of relief. 

CCBaby  where do you get Calendula lotion?  I am totally naive about anything related to the rads and will be starting in early Oct; however, my radiologist told me I could use aloe, or any "good" cream that I wanted.  I don't know what to get or where.  Thanks,

Linda

Thanks, CC, I will go this weekend.  Appreciate your help.

Linda

Is anyone else having an issue with the creams semi drying on the skin and either flaking or just feeling gritty rather than simply absorbing ?  I'm using calendula or sometimes aloe instead  (also sometimes just Miaderm which doesn't seem to have the same problem) and thinking I'm appplying it too thicky. Or is it something else ?  This isn't a problem now but may be if/when my breast starts getting sore and I wont want to wipe it down before rads. Thanks.