April 2010 Rads Group

littletower,

Even a small tumor can have millions of cancer cells.  If a solid chunk of tumor is left it can include cells in that range.  That would require more surgery to try to remove it. Radiation is not so good at the big chunk of cancer, at least not without a much higher dose than is normally used for breast cancer.  

If the margins are clear, there is no tumor on any margin. Good!

On the other hand, a small scattering of cancer cells (visible or not, microscopic or not) may be left somewhere in the vicinity (in seroma, in tissue...?)  after excision (Did they call it residual?  ...or something like that?).  Radiation aims to kill the small scattering and is quite good at that.  Surgery can get the big chunks but may not be able to get every last cancer cell.

It sounds like you have signs of a small scattering of cancer cells, not a solid chunk of tumor.  It is a matter of scale for the number of cancer cells and what surgery and radiation therapy are good at. 

Thanks so much Redsox. Sometimes it feels like all the doctors are simply speaking a different language. It feels like they expect you to know everything about breast cancer, when really, we all start out as rookies. Anyway...thanks.

So this morning, all seemed dark and gloomy and full of scary monsters in the world of my poor radiated boob. 

I spoke with one of the nurses, she bumped me up to the ointment and told me to apply the lotion once a day and the ointment once a day.  (Previously I'd only been doing the lotion once a day, in the dressing room, post-zap.)

And then I went off to have my zap.

And they were running late once AGAIN, which really pissed me off because I had an appointment downtown afterwards.

Today's Zaptrack:  Celia Cruz, No Te Quiere Na which put me in a much better mood and woke up all the zap techs.  I think they're getting quite amused with my daily CDs.  I keep them guessing.  And today at least, I was keeping them dancing.

So anyway, burn-my-flesh torture done, I slathered on my lotion and ran out of there, mega-late, for my next (non-medical) appointment.

And my boob hasn't bothered me at all today.

I really don't understand these pendulum swings.  Some days, or hours, boob is really angry with me; and others she's beyond caring what I do to her anymore.  It's just weird.  Never underestimate the trickery of a scorned boob.  Or maybe that should be a scorched boob.

The weirdest thing about all of this - as I posted earlier, yesterday morning things in fried boobland seemd to be headed in a very unpleasant direction.  This morning, things seem to have stabilized and maybe even gotten a bit better.

So, it is "normal" to expect my boob to be in open revolt on some days and relatively OK with the situation on others, and that I really can't predict her behavior day to day?

Suepen - yeah, maybe I need to force myself to apply more slime.  I hate doing it, and in my opinion the Calendula lotion and ointment they want me to use smells like a nasty swamp.  They claim they studied it and the Calendula got better results. 

Maybe I should try some aloe vera, but I never liked that much either.  I thought we weren't supposed to use Vit E b/c it was an antioxidant?

littletower, I read in one of the books I got from the library that clear margins, while a very good sign, aren't 100 percent reliable, because there can be "skip" areas - a clear margin around a tumor, and then a few cancer cells just beyond.  A lot of things we are told are true are really true about 98 percent of the time, and then there are those weird exceptions.

I went looking for Fruit of the Earth aloe vera gel today - their web site claimed that Target, Walgreens and Walmart all carry the product.  No luck at either Target or Walgreens.  Nearly left Walmart after not finding anything, then I stumbled across some 2-ounce bottles for 97 cents in their trial/travel size aisle.

A few people have mentioned Jean's cream - according to their web site, it's just aloe vera and vitamin E.  You could make your own.  Trader Joe's carries vitamin E oil at a reasonable price.

I can tell it's Monday, breast is itchy/sore and nipple is swollen and  feels like it could fall off. I tried to sleep without a bra Saturday nite and my nipple area just kept getting in the way of being able to sleep. I keep hearing about the rads breast gets smaller after. How much smaller does it get??

MNLinda, hope you're enjoying that wine!  I seem to come up with lots of reasons for that glass of wine myself these days.

I asked about the Aloe and Aquaderm today.......my facility recommends Aloe during the day...and it can be applied several times throughout the day.  In the evening would be the time to use the Aquaderm...some of it will still be there in the morning when I wake up and shower.

Zap number 10 down. 

Today's CD was "Nude and Rude" - Iggy Pop.  Seemed somehow appropriate.

Had a long talk with rad onc about several things, the most concerning being that depending on the tech, they seem to take a lot of precision lining me up or it seems like they almost plop me down anywhere.  Rad onc said that the tech who works with me most often will have the easiest time lining me up while the ones who are not used to working with me will have the hardest, and that it's not cause for concern if my usual tech to get me lined up really really fast.  Moreover, even if things were off a little bit, it still wouldn't be cause for real concern.  I'm doing right sided prone (on my belly, breast dangling) rads, so she said it would take a f*up of STELLAR proportions for my heart to be involved, and while there could conceivably be scatter into my right lung that it wouldn't be severe enough to be concerned about.  I'll take my rad oncs word for it.

Also had a convo with the main nurse about the lotion business.  Apparently, the bottom line is all about preventing the skin from cracking, which might allow for infection.  So it's not so much about moisturizing for pretty skin or comfort, so much as it's about preventing infection.

She said that they want to radiate the skin and therefore WANT to see a skin reaction, so pink is GOOD, but they don't want the skin to break down.  She also said that there was a randomized trial in the UK with 1000 women testing various lotions, and the Calendula proved to be best.  

She said they used to use aloe and/or biafine (I remember she mentioned those specifically, she may have mentioned others) but the marigold in the Calendula had additional antiseptic/healing properties, so my center uses Calendula now. 

If that's so, I'll deal with the fact that I think it smells like a swamp.

Rad onc said that the recently developed raised reddish brown spots are reactions from (I think) sweat glands in the skin, and were common.  She said if they started to itch to use 1% hydrocortisone cream which is available "over the counter", without a prescription.

All in all, she said that I'm looking perfect and perfectly on schedule with the SEs, so that's good.  The swelling I was having has stabilized so that's not freaking me out anymore, and the shooting pains have subsided too.  Now it's just skin stuff that's annoying me, but it's not as freaky as the swelling and pains were, so I'm less of a basket case.   And if I slather on some lotion or ointment it seems to help.  So.....another day down and 15 to go.

I asked if there was a book on radiation oncology she could recommend, since for me information provides a calming illusion of control.  She recommended Susan Love's book, and I made a face.  She insisted it would be helpful, I just re-read the rads section and it's worthless to me.  So, if any medical professionals are reading this, feel free to recommend a professional level book which explains rads treatment.  What are we doing and how and why, how exactly we are disturbing the DNA of all the cells, why the cancerous ones get too damaged to replicate but the healthy ones still can, etc - and not a book written for patients.  I might be a freak, but knowing this stuff makes me feel better.  

Thanks Redsox!

I was already starting to investigate some of those on Amazon. 

I think rad onc is an assistant prof at the med school, so I'll definitely push. 

(Actually, this is the stand in for my "real" rad onc, who's way too much of a rockstar to be around that early in the morning.  It's OK, I like the stand in.)

I will be half way through tomorrow (and this is with a boost every day), and so far have had zero side-effects.  No skin change whatsoever!  I was thinking that was a good thing, til I read what sweatyspice's rad onc said about how they want the skin to turn pink   (Just kidding, I think; I'm guessing it's still better not to burn!)  No swelling or pain either.  I'm seeing my rad onc tomorrow, so I will see what she says.  She was surprised last week that I'd had no skin change; will be interested to see her response now.  The tech person did say to me that some people, especially those who tan easily (which I do), don't burn but just get a tan. 

 Keeping my fingers crosssed.

I am late joining this discussion - just haven't had the energy!  Finished #21 of #28 whole breast rads today with 8 boosts to follow.  Actually had 1st treatment on 3/25 and after #7 got an inflammatory reaction to the radiation resulting in pericarditis and a 5 day stay in the hospital.  Anyone else have this side effect?  Now on heavy-duty anti-inflammatories and holding my breathe (both literally and figuratively) until 5/19!  (Skin, however, is doing great other than a rash!)

11 down.  14 to go.

I itch when I sweat.  EEEW.

But not when I don't sweat. 

Glad it was cold for most of the day. 

Too bad it's gonna be warm this weekend!

Today's CD: soundtack from the movie "The Harder They Come"

AND they were on time today.  Just when I'd given up all hope of them ever being on time again!

Welcome npgbold, sorry to hear about that "little" SE. Sounds awful!