Internal radiation

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Hi, I am writing for my mom who has stage 1 breast cancer.  Her lumpectomy was last Tuesday and that went very well.  No lymph nodes removed, so recover was quick.  She has decided to go with internal radiation.  Because of the holidays, I am told that the medical team will not be able to insert the mammosac until January 4, which is 4 weeks post-surgery.  Our neighbor, who had the mammosac inserted but ultimately didn't have internal radiation commented about problems from waiting too long after surgery.  I've talked to the internal radiation doc's office, but they assure me that one week more is not going to cause any adverse heath effects, but I guess I want to hear others' experiences.  Also, my mom is turning 65 on Jan 1, and we are working double-time to get her a Medical supplemental insurance that will cover the 20% that Medicare doesn't cover.  I'm still waiting for the doc's office to tell me that estimate.  Any one out there have ballpark figure on what that is?  English is not my mom's first language and she has limited understanding of the details, so my husband and I are the "breast navigators" for her.  I appreciate any help.  Sue Lin

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  • bpe
    bpe Member Posts: 4
    edited December 2009

    I am 63 and opted for the internal radiation also.  I was told it needed to be done within two weeks of surgery.  I had the catheter inserted along with the saline solution.  However the CAT scan showed the balloon resting on my rib and doing this type of radiation would cause the bone to weaken so much that I could break the rib just by sneezing. So my radiologist decided  to remove the catheter and I had external radiation instead. As for cost, the internal involves an initial CAT scan and then CAT scans twice a day for five days so that alone would add up quickly.  I also learned in USA Today this week that one CAT scan is equivalent to 72 mammograms in the amount of radiation released.  Since my left breast was involved I am actually glad that procedure wasn't done.  My insurance pays our claims without us seeing the charges so I don't know any of the costs.  However Thursday I called and requested my patient profile so I may have cost info soon.  I will post what I find out.

  • suelin16
    suelin16 Member Posts: 6
    edited December 2009

    BPE: Thanks for your reply.  Talked to my mom's surgeon yesterday, and he said that inserting the mammosac at 4 weeks post-surgery (Jan 4) was not a problem.  I am a bit puzzled why this is fine now, given his earlier comment, but he made an effort to assure me that this was not going to precipitate negative health outcomes for my mom.  Also, neither doctors have mentioned the need for CAT scans during that one week of radiation treatment.  My question is how does the total radiation in internal radiation compare to the external treatment.  I think that I will call and ask for numbers.  Basically, in asking questions about the risks and benefits of internal vs. external radiation, we were told by the radiation doc that the risks are about the same and the benefit is the amt of time that treatment finishes (1 vs. 6 weeks).  Thanks for your willingness to share the costs, if you get that information.  SL

  • bpe
    bpe Member Posts: 4
    edited December 2009

    SL

    I have not heard the term mammosac - my procedure was call the ZOFT procedure but it was internal radiation through a catheter. (I'm sure there is a fancier name for it.)  A balloon was at the end of the catheter and they filled it with the amount of saline they felt necessary to expose all the tissue in the cavity left by the removal of the tumor.  I looked at the brochure given to me this morning and it never mentions a CAT scan.  It states that images will be taken before each procedure.  Those images are CAT scans.  I believe the CAT scan exposes your heart, lungs, and other internal organs to large doses of radiation which the external beam avoids.   So when they say the amount of exposure for internal and external are the same, are they factoring in the additional radiation from the CAT scans?   Anyway keep asking questions! 

    When they found they could not do the internal radiation on me, my radiologist offered three weeks of treatment instead of six.  Of course that meant more radiation at each treatment but he and my surgeon assured  me the side effects would be the same and that it was the standard practice in Europe and Canada. They said it was the wave of the future here.  I am now five weeks out of radiation and finally have a boob that feels somewhat normal - I had a tremendous amount of discomfort in the nipple area but experienced minimal  burning of the skin.  My dermatologist told me to get Biofine - even offered to give me a perscription if my radiologist wouldn't.  I used it every day from day one and it took the burning sensation out immediately.  I highly recommend it!  Hope this info is helpful - I wish I had found this website before my treatment.

  • Chevyboy
    Chevyboy Member Posts: 10,786
    edited December 2009

    Hi bpe!  I hope you get this post!  I had the MammoSite device implanted during my surgery on Dec. 4th!  It is "internal radiation through a catheter".......  And the procedure is the same as you described...But I could not find anything close to what you mentioned about the ZOFT procedure!

    I finished the 5 day MammoSite radiation treatment in a whiz!  Just 5 treatment days, twice a day!  Then they removed the device, & I was finished!  And they took 1 cat scan, when they were "filling" and positioning & "planning" the specifics of my treatment.  They also take a "picture," before each treatment, but it is NOT a cat scan!  A completely different machine does this, & it only takes a second....So no, there are not "large doses of radiation."  

    I am so fortunate that I got to take part in the MammoSite Device procedure..& no side-effects either!  I'll try & post the picture of the device, along with the website!  Hope this helps anyone thinking about it!  Jeannette

  • Chevyboy
    Chevyboy Member Posts: 10,786
    edited December 2009
    Dec 11, 2009 06:10 am Jeannettes9565 wrote:

      This is the MammoSite Device that I have!  It was implanted during surgery on the 4th, & I started the "treatments" on the 9th.  It is working very well, so far!  It is inserted into the cavity that was left from the Lumpectomy, & about 1/2 of it sticks out, & is held in place under my arm, with that mesh wrap!  Little "seeds" of Radiation are inserted into the "balloon" and stay for 8 minutes, then are taken out.  A "machine" of some sort, slides them through the "chambers" into the tube. The balloon is filled with saline, & the seeds radiate all around the balloon, to hopefully kill any left-over cancer cells.  

     I have a new "prototype" that is pretty new, & it should make it possible for more women to be candidates for this type of Radiation.  Your cancer has to be small enough, & not near the skin or bone structure, & not the aggressive type, & from what I understand, your breast has to be fuller...

    But I am amazed at how far we have come with treatments!  There are web-sites that explain this further, but thought some of you would be interested!   So basically this type of treatment takes 5 days, twice a day, & that's it! 

    So  far, all treatments & tests have come back very positive, with the same results as the longer Rads treatments...If you have any questions, just post them....Have a fun day Gals!

    Don't walk ahead of me, I might not follow. Don't walk behind me, I may not want to lead. Just walk beside me & be my friend.
    Diagnosis: 10/26/2009, ILC, 1cm, Stage I, Grade 1, 0/2 nodes, ER+/PR+, HER2- [Edit] [Delete]</td></tr><tr><td>Jeannettes9...
    Att000164
    Denver, Co
    Joined: Nov 2009
    Posts: 53 </td><td> Dec 11, 2009 06:14 am Jeannettes9565 wrote:

    http://www.mammosite.com/breast-lumpectomy/view-a-demonstration.cfm

    This is the web-site that shows the MammoSite procedure~  Hope this can help!

  • suelin16
    suelin16 Member Posts: 6
    edited December 2009

    Thanks for the responses to my posting.  I talked to the radiation manager and the radiation oncologists office again, and they explained that the pictures taken before each treatment are min-CT scans and are not the same amt of radiation as a regular CAT scan.  The total amount of radiation from the internal treatment is less than the external treatment, including all scans, but I am told that it's like comparing apples and oranges because of the way the radiation is administered.  Bottom-line, I am comfortable recommending to my mother that she go with the internal treatment since the outcomes are as good as the external treatment, and it's shorter than than the latter.  Thanks for the mammosite demostration link.  I'll show that to her before Monday, Jan 4 when she starts her treatment.  Best of all luck to to you both.  SL

  • Chevyboy
    Chevyboy Member Posts: 10,786
    edited December 2009

    Hi suelin!  I was afraid I lost you!  Like I said, I had the Device implanted during surgery, but I don't think it matters when they do it...I am so glad your Mom is going to do it!  I am 72, & we have Secure Horizons, plus the Medicare Insurance, here in Denver.  I have been getting some of the bills for the tests, & surgery, & our insurance covered most of it!  I asked about the radiation, & it was really ESPENSIVE, but she thought the insurance would cover it!  God, I only hope so!  But I'm SURE the Radiology department checks with your insurance before they do anything! 

    And I knew they weren't "cat scans" that they use, before each treatment, but I don't know what they are called....just "pictures."....I'll ask tomorrow when I go for my check-up! 

    Yes, the end result is the same as with the longer treatment!  How is your Mom doing?  My incisions are healing up very well....but still healing from where the Device was removed!  I'm going to ask about "massaging" cream or something around the incisions also.

    I'm going to an Oncologist on the 4th, to talk about taking Tamoxifen....Have they mentioned this to you yet?  Okay, talk to you later...keep me posted...Jeannette

  • suelin16
    suelin16 Member Posts: 6
    edited December 2009

    Hi, Jeannettes: We received some good news from the hospital's financial counselor last week as well.  In short, she told me that because my Mom was diagnosed through GA's breast and cervical program and immediately placed on emergency Medicaid, and now is newly on Medicare, she is entirely covered.  This is a huge relief because we were researching possible Medicare supplement plans and were racing to get her application in before January 1.  I think that my mom is mentally ready for Monday, when her internal treatment starts.  Yes, her surgeon has mentioned Raloxifene, which is similar to Taxoxifen, but apparently given to older women.  Mom will have to be on that for 5 years, but I am not sure when that will start.  We are awaiting results from genetic testing to determine if she should go through chemotherapy.  We're all hoping not but will likely go with that oncologist's recommendation.  Would you please let me know what your doctor recommends in terms of cream for the area around the incision?  My mother already feels a lot of itching and says that that was the worse part after her lumpectomy.  Take care and happy New Year!  Sue Lin

  • Robinsn
    Robinsn Member Posts: 2
    edited June 2010

    Hi Suelin16, Sorry to hear about your mom, But thanks to God you got the help though Medicare and Medicaid.

    Medicare Supplement Insurance

  • suelin16
    suelin16 Member Posts: 6
    edited June 2010

    Hi, thanks for your messsage.  Yes, the combination of the two has made getting good treatment possible.  My father who had a series of strokes before age 65 was not so fortunate. My mother made it through the treatment in January with flying colors and seemed barely slowed down.  She's on hormone treatment and is about ready to begin twice a year intravanous injections of the bone density drug that her doctor has recommended.  He thinks that this treatment might yield better outcomes than the once a day medication (what her insurance covers). 

    Take care, Sue Lin

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