Can you/did you ever miss a day?

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Raili
Raili Member Posts: 435

I'm scheduled to have 6 weeks of radiation, M-F.  I know this is standard.  What happens if you skip a day??  How horrible is that?  Does the rad onc freak out on you? 

I still don't understand why EVERYONE seems to get 5 to 7 weeks of M-F rads, no matter how different a person's case is in terms of age, size of cancer, stage & grade, type of cancer, size of margins, general health, ETC.  Why doesn't any of that stuff matter/affect how much rads is prescribed?  And really, in the grand scheme of things, would missing a day REALLY be such a huge deal??  Yes, I am thinking of attending a work meeting that can't be rescheduled. :P

Comments

  • Faith316
    Faith316 Member Posts: 2,431
    edited March 2010

    When I was taking radiation from 12/08 - 2/09, I had to miss a day due to snow and slick roads.  It was no big deal.  They just tacked an extra day on to the end of my treatment.  Some women actually end up taking a break mid-radiation if they are having lots of skin reactions.  Good luck with your treatments!

  • elimar86861
    elimar86861 Member Posts: 7,416
    edited March 2010

    Yeah, no big deal.  I had a three day weekend over Labor Day because they were closed.  Then, in the fifth week, I was so fatigued and getting sore, I asked for another three-day weekend just to have an extra recovery day and they said sure, no problem. 

  • NatureGrrl
    NatureGrrl Member Posts: 1,367
    edited March 2010

    Absolutely not a problem to miss a day.  My treatments started before the holidays, so I missed Christmas and New Year's days automatically, and then missed a couple of other days at other times due to bad roads.  For me, they just tacked on the missed days to the ends of my treatments.  I had 38 treatments total.

    You might ask your radiation oncologist about the questions you have about people getting similar treatments.  I think the every day thing is standard partly because it's easier on people to get less strong treatments more often than stronger treatments farther apart.  Within that, I'm guessing dosage, etc., may vary quite a bit.  I had most of my treatments on the entire breast but the last 5 treatments were targeted to where my lump had been.  There's room for a lot of variation within the every day program.

    Meanwhile, plan on going to your work meeting!  And good luck!

  • MarieKelly
    MarieKelly Member Posts: 591
    edited March 2010

    I skipped EVERY day - refuse it all 6 year ago. So far,  not doing radiation has worked out just fine for me.

    In answer to your other question about why individual differences don't seem to matter when it comes to treatment like radiation,  it's because it's being prescribed under a standard of care.  Individual differences aren't taken into consideration under standards of care. Under standards, treatment is prescribed according to what's been determined to be most beneficial for a large group of people as a whole rather than what's best for each individual in that group. So they deliver treatment to everyone who meets the standards criteria to recieve it - whether they personally really need it or not, they get it.  It eliminates a lot of the decision making process for the physician who would otherwise have to make treatment decisions individually and in a more indepth manner. As long a a physician prescribes treatment under a standard of care, they're more or less protected from being successfully sued if they prescribe treatment that doesn't turn out well for the patient. 

  • AsiaYM
    AsiaYM Member Posts: 2,216
    edited March 2010

    It is ok to skip a day, I asked. No big deal.

  • ruthbru
    ruthbru Member Posts: 57,235
    edited March 2010

    Yes, you can miss a day; they'll just tack it on at the end. I was GLAD to get as much radiation as they wanted to give me, because I NEVER want to play this game again!!!!!!!!!!

  • 3monstmama
    3monstmama Member Posts: 1,447
    edited March 2010

    Like everyone said, you can miss a day.  I knew I had a couple of long planned three day weekends and told my radiation oncologist about them up front.  She scheduled me to start a week later to fit one in and ok'd my missing a day for the other one.

    I am more inclined to think that everyone gets relatively the same treatment for the same reason we can buy tylenol or whatever for a headache as opposed to having some drug compounded---its a treatment that works a particular way and it doesn't need a particular degree of specialization.  Healthy normal cells can get X amount of radiation and either not be bothered or rebuild themselves in Z time but nasty awful cancer cells get X amount of radiation and need Z X 5 time to recover.  So the unhealthy cells get repeated exposure to the radiation and don't have time or ability to reinvent themselves and eventually they die off while the healthy cells regroup and go on mostly because there is still some degree of damage for some people.

    At least thats how I understand it.

  • SoCalSue
    SoCalSue Member Posts: 16
    edited March 2010

    My treatment also included Labor Day so I had the 3 day weekend off.  I became so sore, especially my nipple, that I refused my 25th treatment.  The Rad Onc was not pleased but I had already asked for help and did not get it.  I did complete the "boost" but am not so sure I would do that again if faced with that.  As time went on during treatment it took longer and longer each weekend to "recover".  I guess I was a "bad girl" but I'm entitled at my age(66).

     Sue

  • christina58
    christina58 Member Posts: 10
    edited March 2010

    Hi Raili,

    I, like others above, had treatment during the holidays so I had a couple weeks of only 4 treatments.  I also missed a day due to a fever, but my Onc told me it was important to get three treatments in without a break between them.  I was lucky to get sick on a Thursday.:)  As for the amount of treatments, the time may be about the same but the size of the area may be different.  I know other women that had one or two areas done and were in and out in 15 minutes.  I had 5 done and was there 45 minutes every day.  I hope you get a chance to talk to your doctor about your questions, and good luck with treatment.

  • edenh
    edenh Member Posts: 16
    edited March 2010

    I too wanted to miss a day because of a field trip at my son's school. I just rescheduled the time of my treatment. So, I didn't end of missing any time. I have finished 10 out of 33 so far, talk to your doctor, I'm sure you can miss one day.

     Good LuckLaughing 

  • NativeMainer
    NativeMainer Member Posts: 10,462
    edited March 2010

    I had a week's vacation scheduled for the middle of rads--scheduled before I was diagnoses.  I went on vacation as planned, the rad onc was pissed and let it show, but he couldn't give me a good reason why it would be any kind of problem.  If rads really need to be daily, then they wouldn't take weekends and holidays off.  Also, radiation therapy hasn't changed in decades, and is no more or less effective now than in the 50s. 

  • redsox
    redsox Member Posts: 523
    edited March 2010

    NativeMainer wrote:

    Also, radiation therapy hasn't changed in decades, and is no more or less effective now than in the 50s. 

    Wow! ..so not true!

    In the 50's mastectomy was the only option for most breast cancer patients, radiation was only used for some nodal fields if the cancer had spread, the machines were completely different and less effective, the planning was standard instead of customized, the results were much worse, etc. ....

    If anything, the biggest problem with radiation therapy is that it is changing so fast that it is hard to be sure all the doctors are up on the latest techniques.

  • Raili
    Raili Member Posts: 435
    edited March 2010

    Thanks, everyone... I feel better now! 

    And NativeMainer, I totally agree with this - 

    "If rads really need to be daily, then they wouldn't take weekends and holidays off." That's what bugs me.  The fact that radiation is Mon through Fri is more for the doctors' convenience than anything else...it's due to the fact that the center is closed on weekend, not anything to do with what our bodies need.

    MarieKelly and 3montsmama, your explanations help, too.  I remember when I was a young teenager and took an over-the-counter pain reliever for a headache or something, I asked my dad, how does the medicine know that it's my head that hurts and stop the pain just in my head??  He told me, it doesn't.  It numbs all the pain receptors in your body, and thus, your headache goes away by default.  I remember being mad about that, mad that my whole body was affected when all I had was a headache!  My expectations were too high, and decades later, still are.  I continue to be frustrated by the "standard of care" that does not/cannot take individual differences into account.  This "one size fits all" approach makes me distrustful of the treatments, because there's no way of knowing if I, personally, will really need and/or benefit from the treatments...and yet, I'm going through with the radiation anyway, I guess because I'm not comfortable with taking the risk of NOT doing it, not having a better option right now.  I believe that with enough time and information from other sources (e.g. my naturopath/alternative health practictioners), I could devise an effective, individualized treatment plan... but I just worry that I don't have enough time to do that.  I was dx'd 4 months ago and have just now completed the surgical phase.  Argh...

    Thanks for letting me vent.

  • Leah_S
    Leah_S Member Posts: 8,458
    edited March 2010

    Raili, the rads are not a "one size fits all" treatment. The simulation is to target the area(s) to be radiated. The amount of radiation given is determined by your specific diagnosis. Sure, a lot of that is "standard" but I got more rads since I had Stage II (of III - long story) than a woman who had DCIS.

    Ask your rad onc how many Grey (measure of rads) you will be getting and ask for an explanation of why/where etc.

    Leah

  • Leah_S
    Leah_S Member Posts: 8,458
    edited March 2010

    Raili, the rads are not a "one size fits all" treatment. The simulation is to target the area(s) to be radiated. The amount of radiation given is determined by your specific diagnosis. Sure, a lot of that is "standard" but I got more rads since I had Stage II (of III - long story) than a woman who had DCIS.

    Ask your rad onc how many Grey (measure of rads) you will be getting and ask for an explanation of why/where etc.

    Leah

  • Leah_S
    Leah_S Member Posts: 8,458
    edited March 2010

    Don't know why it posted twice.

     Leah

  • Cgirl
    Cgirl Member Posts: 14
    edited March 2010

    Leah S  is correct , and you'll want the weekends off.  My rad onc developed with the staff an individualized plan based on where the tumor was, my breast size and the dose was different. the number of treatments may be "standard of care" but the plans are different.  who has her arms above your head, who lays on your back, or stomach, etc.

    for me  I had 23 full breast treatments and 7 boosts to the tumor area with the maxi um dosage available for all 30 treatments. Due to holidays I was treated on the weekends and at the end  the boost area was treated, that area was defined by the tumor markers left in my breast during surgery).  I asked for and got New Years Eve off .

  • Bethie1
    Bethie1 Member Posts: 393
    edited March 2010

    In my case, my skin was breaking down from radiation faster than it was healing and the radiation oncologist gave me a week off.  This part has flexibility, so you're fine

  • painterly
    painterly Member Posts: 602
    edited March 2010

    I missed a day because the treatment centre had a holiday. No one mentioned that it would matter or not by missing a day. Also, I had 15 radiation treatments and 5 boosters. When I asked how come I am not having more, the reply was: because you have little boobs! I am not sure that is right as a friend of mine has tiny ones and she had more rads.

  • cary1
    cary1 Member Posts: 372
    edited March 2010

    Because my center was closed for Thanksgiving and the day after, I went 4 days without zapping. Frankly I wanted to get it over with so that I could be free to leave town for an extended time so going every day wasn't an issue.

  • Chelee
    Chelee Member Posts: 513
    edited March 2010

    Raili & MarieKelly, You both had  "great" post!    I could not of said it better if I tried.  I so agree with what both of you said. Right on point!  I am currently doing radiation on my femur...not breast...but since rads is so important I find it interesting that since no one works weekends...they say we don't get rads to give the body and skin a break.  Couldn't be that it's just as simple as ppl don't work weekends.  I've been having some problems since I started radiation and right in the middle of it my Rads onc said I could just take the day off and at the end we could give me a boost or double dose to make up for the missed one.  (Makes no sense to me you can just miss days since this is so important.)  I told her no thank you...I don't want to be double dosed to make up for a missed day.

    I am a firm believer that one size does not fit all...it's time they changed this way of thinking.  I asked how they come up to 10 days for my femur.   It is all about the "standard of care" as MarieKelly said. I just asked my rads onc yesterday how they decided on how many days each person gets?  And she pretty much echo'd what Marie said:  >>>>treatment is prescribed according to what's been determined to be most beneficial for a large group of people<<<<<.  So I said we know that the 10 days is enough in the case of my femur?  She said she hoped so but of course there is never any guarantees.  (Which I know this but it sure is frustrating to have to go thur all this cancer trt and not know  who it will benefit from it and who won't.) 

    But that fear comes into play as someone here already mentioned.  I worry that if I don't do that 10 days as scheduled...if my cancer returns in that area I will feel its because I didn't complete the full course of rads.   When it comes to our cancer fear plays a big part in having trt.  We are all so different..so I wish they would get away from one size fits all.  But that is too time consuming it seems.  (Venting a bit.)

    Chelee

  • Raili
    Raili Member Posts: 435
    edited April 2010

    Thanks, Chelee... great vent.  It IS so frustrating, isn't it!!

    I'm a week and a half into rads now, and find myself tempted to skip all the time...because like you said, if daily rads is SO IMPORTANT, why allow us weekends off?  Really, what would be the difference between a Wednesday or a Saturday?  My very first rads day, I broke a tooth 20 mins before the appointment, and was still crying when I arrived, because my dentist is 4 hours away from home and I knew I'd have to miss a day of rads for it and was freaking out because I didn't think I "could" miss a day.  But the techs were like, "Oh, it's okay, we know things come up like this, it's okay to miss a day to go to your dentist, really!!"  Um, okay.  That's kind, but also worrisome.  It just makes me confused.  Rads is so important that we all MUST go EVERY day for 5-7 weeks... but if we need to skip a day here or there, it's okay?  Well, which is it??  What would happen if I skipped EVERY Thursday, for example, or decided to end rads a week early?  I get the sense that no one really knows, or there's no way to really tell how much radiation an individual needs, in comparison to the "standard of care."  Maybe I'm being over-radiated, or under-radiated...who knows.

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