Mammosite

Fran518 · January 2011

Have any of you had the mammosite (internal radiation) or similar procedure done? Did you have side effects? Did you think it worked as well as regular radiation? My radiation oncologist said I was a good candidate for it, but I wanted a little more info. Thanks!

BeckySharp · January 2011

Fran, I am due to have mammosite radiation on 2/21. I have only found one person who has had it and would love to hear from more people as you would . The person I talked to who had had it had to quit after three days due to the balloon being to close to her skin and burning it. She then had to have five weeks of traditional radiation. Overall, though, she said she would try it again. It sounded as if the balloon had been inserted incorrectly. Any others out there?

bevin · January 2011

Hello Fran, My surgical and radiation consults all offered it and did state I was a candidate if I wanted it. However, they preferred I use the traditional radiation tx as I am young and had a small second site of cancer next to the primary tumor. The radiation docs stated that it was not standard of care yet in NCCN guidlines and unless there was an impact with getting to daily tx they suggested I follow traditional guidelines. I was so confused, I actually sought a 3rd consulst on this who was an Onco , not a radiation, but very respected. He did not want me to use mamosite just because it only radiates the area of tumor. If you have small micrscopic growths they cant see yet, in other areas of your breast - those are missed and left to potentially grow.

Get a few opinions if you can and help sort out what is best for you. Once I spoke to the last Onco, I felt much better about full breast and am glad I did it. You'll do what is best for you based on doctor feedback and our friends here, but I wanted to offer up the reasons I chose not to go that route.

Good luck

Bevin

EClaire · January 2011

Hi Fran,

I am currently doing Mammosite. I have finished three days and have two more to go. As far as how well it is working, well I don't know if I'll ever know. Even if I have a recurrence, it will be hard to tell whether it was because I chose this form of radiation or because of some other treatment decision I made, the skill of my surgeon, the reliability of the pathology report...there are so many factors.

Because he knew I was interested in Mammosite and a likely candidate, my surgeon placed a temporary catheter/balloon during surgery through a small extra incision, then switched it out for the real one a few days later. They do it that way because they don't want to put the real one (which is quite expensive) in until the pathology report comes back showing you are still a candidate. For example, my understanding is that if my lymph nodes had been positive, they would have recommended whole breast instead. I got Lidocaine for the switch to the real catheter; the only thing that hurt was getting the Lidocaine (though I assume the switch would have hurt without the Lidocaine).

The day after I got the real catheter, I had CT scans so the radiation oncologist could review them to make sure the balloon was not too close to the skin and fit evenly in the cavity where the tumor had been. The next morning I went in for my first session. I go twice a day; each time I have a CT scan first to make sure the balloon is still in place. Getting the radiation has been painless and has taken less than 10 minutes each time. I have been reminded any number of times not to lift, use the vacuum cleaner, bump into things with my breast, etc. for fear of popping the balloon. I don't know what they do if it pops.

I am finding it somewhat uncomfortable to have the balloon in my breast, but not to the point that I would have done anything differently. I have been tired this weekend and a little achy all over, but I can't say whether that is from the radiation or from still recovering from my lumpectomy. I also have some skin breakdown, but that is apparently from medical tape, not radiation--the catheter site has to be kept dressed, and my skin has just had it with all the tape after almost two weeks.

Washing up has been tricky since it's important not to get water in the incision where the catheter is. I'm looking forward to a real shower.

I talked to my radiation oncologist about Mammosite vs. external a couple of weeks before my surgery, and I feel comfortable with my decision. My concern was that Mammosite has not been around as long as external, but he pointed out that other forms of internal radiation have been around longer than Mammosite with good results. But it's a very individual decision, and I hope your research and your doctor will help you make the right one for you.

I do feel blessed to be able to do the Mammosite. There's pretty strict criteria, so it's not an option for everyone, and I'm glad it was for me. Only two more days, and I can move on to whatever comes next in my treatment.

Hope this helps. Let me know if you have questions. I only have three days experience, but will be happy to answer what I can (if I'm not too worn out from the next session...I've been napping a lot!)

jo1955 · January 2011

Mammosite has not been around all that long and there is still much to be learned about it. I was a candidate for this but unfortunately, after 4 days of trying, the rad onc could not get the balloon to sit in the right position. There was too much space between some of the tissue and the balloon. I had two balloons put in - RO thought the first one was faulty and the second one confirmed the space wasn't the right shape. There are numerous factors that decide if it will work. Get as much information before you really decide. It sounds really good and I wish ROs were having more success with it.

Good Luck To You.

Fran518 · January 2011

Thanks for the info. I'm still waiting to see what the surgeon says after he talked to my radiation onc. Hopefully, it can work, but we'll see. At first the surgeon was still leaning towards the standard treatment, but the radiation onc. though mammosite would work. I just thought having that one area done would be better then whole breast because if something else happened later in that breast my choices for treatment and surgery would be greatly reduced. Like I told my onc. - whole beast radiation is like an "ace" card - do I really want to play it now?! I'll let you know!

njmae · January 2011

A week ago I had a lumpectomy & SNB for a 6 mm mixed tubular cancer. The surgeon had recommended Mammosite and put in a temporary catheter at the time of the surgery. I went in for the real Mammosite balloon on Thursday. On Friday I went for the scan for the final go-ahead and...it wasn't a go. Not enough flesh between my skin and the balloon. The surgeon thought she could build it up enough and then the radiology MD nixed that too due to unsatisfactory space between the balloon and my ribs. So out came the very expensive balloon! The surgeon said that whole breast radiation was the next step. Not sure yet. I see the oncologist on Tuesday and will discuss it. I was very disappointed that the Mammosite didn't work out for me.. I was so looking forward to being entirely done by this next Friday. Instead I have no idea what to do. Back to eating my broccoli and blueberries! By the way, make sure you take no anti-oxidant supplements during radiation treatment. It protects the cancer cells. If you have to sacrifice a few of the good guys for the cause, so be it. I hope the Mammosite works out well for you.

LuvRVing · January 2011

I had Mammosite at the end of July. I had no real issues with it, just some esophageal irritation for about two weeks, starting with about day 3 of treatment. I couldn't eat anything spicy because it was painful going down. It wasn't a big deal - I just avoided spicy foods until the irritation went away. It's been six months now and I can honestly say I would do it again, even though the process was a bit "spooky". Thinking that radioactive seeds are inserted in the balloon in your breast reminded me of when I was a child and we worried about nuclear war.

I found it painless and certainly easier than seven weeks of radiation treatment, although it was intensive for the five days. I didn't notice any unusual fatigue and I started within a week of my lumpectomy.

There are several other threads about Mammosite and its side effects under the "Radiation Therapy..." forum.

Michelle

cycle-path · February 2011

Fran, I had something similar to Mammosite, called Intraoperative Radiation Therapy (IORT). It is only recommended for people over 50 who have single site, relatively small tumors, so it may not be for you. But if you fit that description I strongly urge you to look into it.

IORT is a breeze. The radiation is done *during* surgery so you are finished with everything in a single procedure. Trials have shown it to be as effective as partial breast irradiation.

In general, surgeons who don't recommend it do so because they don't have access to it. But it's probably available somewhere near you.

Fran518 · February 2011

Talked to my surgeon who talked to my oncologist and the surgeon is still insisting I have whole breast radiation. So, now I have to talk to the regular oncologist and radiation oncologist again and see what they say. I'm getting really frustrated with these doctors and tired of thinking about all of this. I'm just not sure if I want to do the whole breast. There is no 100% guarantee that cancer will never show up again by doing that. So, if it does and I've done the whole breast then I have no choice but to have a masectomy and who knows what else (chemo?). In fact, there doesn't seem to be any 100% guarantee on any of the treatments. All they can do is hope it doesn't come back and if it does, try and keep it controlled so it doesn't spread. So, now I'm thinking "why put yourself therough any more than you have to?" I'm taking tamoxifen and have made some lifestyle changes. Can that be enough? I have people that say I should have radiation and others that are practically begging me not to. So, what's right? Maybe it will help or maybe it will just add a few dollars to these doctors pockets.....who's to say?

cycle-path · February 2011

You are correct that there is no 100% guarantee in any of this. There's not even a 1% guarantee. There are only calculated odds of a new cancer or of a recurrence of the "same" cancer.

If the surgeon is insisting on WBI and you don't want that, what about getting a second opinion from another surgeon? Also, I don't think you've posted your pathology report. Perhaps with that, some of the other people here could give some additional advice.

If you don't have a copy of your pathology report, GET ONE!

Fran518 · February 2011

Diagnosed: 11/16/2010, Surgery - Lumpectomy 12/23/2010 DCIS, 2 cm, Stage 0, Grade 3, 0/5 nodes, ER+/Pr+, also showed LCIS. I think the radiation oncologist will send me to another surgeon for another opinion, but I'm almost running out of time for a mammosite. He said it needed to be done soon.

BeckySharp · February 2011

EClaire

Did you finish your mammosite? How is it going?

Fran518 · February 2011

No, afraid not. We've had a lot of ice and snow all this last week so I haven't been able to do anything with that - plus so many places were closed. They have to do it before that area heals up too much to put the balloon thing in, so I'm cutting it pretty close time-wise. Maybe this next week I can get things going. Guess that's the bad thing with any kind of treatments. When the weather is bad there's not much you can do. If I had been doing regular radiation, I would have missed almost the whole week too.

EClaire · February 2011

Becky,

Sorry I disappeared. Going for Mammosite twice a day and napping two or three times a day kept me pretty busy. I didn't have any problems like skin issues with the Mammosite. I was pretty tired, but it's hard to say if that was from radiation or still recovering from surgery. I also had some trouble sleeping just because I'm usually a side or belly sleeper, which wasn't feasible with the catheter in. So lack of sleep may have factored in, too.

I am grateful I was a candidate and glad I chose to do it. If I have a recurrence, I may be singing a different tune, but for now, I'm very satisfied with my choice.

BeckySharp · February 2011

EClair

I am happy it is over for you. Hope it goes as well for me. I, too, am a right side and belly sleeper (bc is in right breast) so I know lack of sleep will be an issue for me too. I already had trouble sleeping on my left side or back after biopsy. But what is, is. Waiting for my surgery is the hard part.

Fran,

Hope your weather gets better so you can get on with a decision.

worldwatcher · February 2011

I had the Contura Partial Breast Irradiation procedure...had surgery on July 16, and finished with the radiation on August 31.

I was fortunate in that as the radiation onc said, the cavity left by the surgeon was perfect for the Contura balloon.

I had some pain the last three days, (Sunday, Monday and Tuesday) but only had to take two or three painkillers for it.

I am now past the five-month mark since the surgery and the radiation and am happy to say I'm having no problems with effects from either procedure. Not only was I done in eight days (weekend) but I saved quite a lot of cash in co-pays.

I would just advise anyone considering the Partial Breast Irradiation to research and also to try to find out how experienced your doctors are in it....mine were pioneers in the Mammosite procedure so I had a high degree of confidence in them.

Charlotte10 · February 2011

The Mammosite technique doesn't always work out, despite the best efforts of your doctors. My surgeon thought I was a good candidate and that it would save me a lot of driving over seven weeks of traditional radiation. The insertion of the device seemed to go OK, but several hours later blood gushed everywhere and I rushed back to the surgeon's office for help. I was OK and the bleeding stopped quickly, but it meant the end of the Mammosite effort, and the balloon device had to be removed.

My radiation oncologist was not unhappy about that, because while trained and willing to perform Mammosite radiation, from the start he said he preferred me to have traditional radiation over 7 weeks. That would give me the full impact and best chance of no recurrence, he said, and he would want his wife or mother to have the traditional treatment. And in the long run, that's what I did.

Note that the type of radiation chosen seems to change the order of things. I had had a lumpectomy, and no nodes were involved in this stage 1, grade 3. But instead of going from surgery to Mammosite radiation to chemo, I had to quickly reschedule to go into chemo first, with radiation after that.

lingay · February 2011

I have my Mammosite catheter in place now. I have had 2 days of twice a day radiation with 3 days left. I was diagnosed w/ BC 3 days after I graduated from nurse practitioner school and did a full rotation with a breast cancer surgeon 2 months before my diagnosis. How ironic that I would become the patient. My surgeon/preceptor highly reccommended it.

I prayed as my surgeon was inserting it that if it was not meant to be it would not fit correctly. Well it did. Everyone commented on how well it looked on the CT scans. Still a little sore but not too bad. I did research about the recurrence rates and both traditional rad and mammosite had the same recurrence rates. My radiologist also said I could go either way. So you do the best you can with the knowledge given.

Mammosite

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