MIDDLE-AGED WOMEN 40-60ish

Just wanted to check in this morning & let you guys know I was thinking of all you middles! So much going on with each of you! Your all in my thoughts & prayers {{{{{{{{{HUGS}}}}}}}

Hope everyone has stay safe in the snow!

Can't belive you gals from texas had the icy/snow. my Aunt from Waco got delayed comming in last week cause of the unexpected weather you texans had! Hope you all survrived the driving in that stuff!  Thinking of all of you, stay safe & warm!!

Hope you all have a great weekend! Love ya, Gina

I've been posting mainly in the DIEP thread about my on-going saga of getting a PS approved by my insurance who can do DIEP.  I'm frustrated beyond belief and have become very confused about which direction I should go in,  I just love how it is the Doctors who aren't making the decisions any long, but someone up in an office with a red pen saying "approved" or "denied".  The fact that you can't talk to this person drive me batshyt crazy!  Between that and the "used car salesman" PS I went to yesterday afternoon, I may just lose my mind. 

I didn't get any boost in radiation, but they did use the bolus on me, EVERYTIME. My RO told me it was to keep the radiation to the top of the skin. I had a dmx (right side cancer). So at the beginning of every treatment they put the bolus on. They didn't want the radiation to go into my chest wall & rib cage.

This was while they were shooting from the front. When they would go around to the back side they would take it off. The bolus also caused me to have 3rd degree burns since it did keep it to the top. At the end, the RO said we could wait a week before we continued, but I only had @ 3-4 treatments left. I told her to just do it so I could get on with healing.

We finished and I had @ a week of healing with sylvadine(sp) cream. Didn't miss any work for this except the week I was healing. Had to sit around the house with no top on for a week. I have had a sore spot on my back, where the radiation was, ever since, and if I bump it or hit it in any way it hurts. Kind of like someone is shoving a knife into my back. They also radiated my neck. The skin there is always itchy and dry no matter how much lotion I put on it. I have a spot right between my itty bitty titties that itches too. It's also dry and thick.

I just found this on ibchelp.org it explaines it very well.Hope you all don't mind me putting it on here it's kind of long. Sorry in advance if it annoyes you.

Radiation for Inflammatory Breast Cancer Patients:

Radiation therapy (or radiotherapy) uses high-energy rays to stop cancer cells from growing and dividing. Radiation therapy is often used for IBC patients to destroy any remaining breast cancer cells in the breast, chest wall, or axilla (underarm) area after surgery. Occasionally, radiation therapy is used before surgery to shrink the size of a tumor. Radiation treatment may also be used to provide temporary relief of symptoms, or to treat malignancies (cancers) that cannot be removed with surgery.

External Beam Radiation

The most common type of radiation therapy used on women with IBC is called external beam radiation. External beam radiation is delivered from a source outside the body on the specific area of the body that has been affected by the cancer. IBC patients usually receive it in the axillary (underarm) area as well as the affected breast area. They may also receive it in the supraclavicular (above the collarbone) area.

Procedure

Before radiation therapy begins, the physician will measure the correct angles for aiming the radiation beam at the specific area of the body and make ink marks on the patient's skin. Sometimes discreet tattoos the size of pinheads are placed on the chest to ensure the exact positioning and accuracy of the treatment. As part of treatment after breast surgery, patients are typically treated with radiation five times per week for at least six to seven weeks in an outpatient clinical setting.

High energy x-rays are skin sparing. Because IBC requires a need for skin irradiation because of skin involvement by the cancer cells, the addition of tissue-equivalent bolus material placed over the radiation field can circumvent skin sparing. Bolus, a flabby, rubbery material, is used to 'fool' the radiation beam so it will deposit the maximum dose on the skin surface instead of a fraction of an inch deeper, as it would otherwise. Therefore, a skin reaction is almost inevitable in this scenario. Bolus is usually incorporated into radiation therapy when a surgical scar, such as a mastectomy scar, needs to receive a full dose of radiation therapy.

Each treatment generally lasts a few minutes; the entire radiation session after machine set-up typically lasts 15 to 30 minutes. The procedure itself is pain-free. The IBC patient will lay on her back on the treatment table with the affected arm raised above her head. Patients are asked to remain still during the procedure. While the radiation is being administered, the technologist will leave the room and monitor the patient on a closed-circuit television. However, patients should be able to communicate with the technologist at any time over an intercom system.

Side Effects

Side effects of external beam therapy vary among IBC patients. These possible side effects depend on the dose and schedule of the radiation and the previous chemotheapy that the patient has received. Some patients require an antibiotic or steroidal cream or ointment. Some also need pain medication until a burn heals.

Patients who have received chemotherapy shortly before or during radiation therapy are more susceptible to a skin reaction, and the higher the dose of radiation therapy, the greater the risk of a skin reaction.

The side-effects include:

* Fatigue and malaise

* Erythema (reddened skin)

* Edema (swelling)

* Desquamation (The sloughing-off of the outer layer of skin)

* Hyperpigmentation (Increased skin pigmentation)

* Pruritus (Skin itching)

* Skin pain

* Atrophy

* Increased susceptibility to infection

* Neutropenia (reduction in white blood cells)

Lymphedema:

Radiation therapy of the axillary (underarm) lymph nodes may cause lymphedema (chronic swelling of the arm) in some IBC patients. Patients who have radiation to the lymph nodes will usually be instructed on arm exercises and other activities to help prevent lymphedema.

Care for the Side Effects:

The following recommendations may help reduce pain from skin reactions to radiation therapy:

* Avoid any additional sun exposure to the area

* Wear loose-fitting clothing, preferably cotton or other material that 'breathes'

* Use warm or tepid water when bathing, rather than hot water

* Avoid constricting bras (if a bra must be worn at all)

* Use cool compresses (not cold or ice packs, as that may cause additional skin damage)

* Lotions or powders on the treated area are generally not recommended

* Specific creams should be approved by the radiation oncologist. Often, there should not be any substance on the skin that could affect the radiation treatment or lead to a more serious burn injury (such as oil).

* Patients should talk to their physicians about soothing oils or creams that may be allowed between (not during) treatment sessions.

Hope this helps to answer some questions.

My tumour sat on my chest wall at the bottom of my left breast alone the wire-line at 6 o'clock. I knew better than to try radiation as it would have surely affected my heart and lung. I chose mastectomy instead. Reading all these horror stores validates my decision. My heart alrady has issues and I'm pretty sure radiation would have finished me off!

leisa - thanks for your post. Very interesting and informative - I like to know how to take care of my skin and how to prevent problems in the future.

My RO told me the boosts (I had 5) were focused on the area surrounding the tumor, because he said IF the cancer recurs, 80% recur in the same area as the original tumor.

elimar - Love the box of chocolates at the top of the thread.

Eph--mine was sort of like yours.  When I had 5 regular tx left they did the 5 boosts to give my skin near the clavicle a break and then finished those 5 regualr tx after the boosts.  That really helped a lot!  The bolus was used on me every other tx, but not during the boosts.  The boosts were jsut for the scar area. I had a left mx, but still needed rads due to 3 nodes.  My skin peeled, but never blistered or got real sore.  I used Aloe and then Aquaphor when it got bad.

 Good evening A little emotional today told my family they have been very supportive.  I know I have all your support to.  I am glad I have found this website I will have many questions along the way. 

Okay now for some other opinions!

Rads - I had boosts and was told it was for the "target" where the tumor was, same as (sorry, someone, Barb?) said.

The new study - I wish like hell that was known when I had my tx.  I had one sentinel light up and they took my axillaries - I later developed LE (lymphedema for newbies) but no axillaries were positive.  From all I have read on that new study, and I think I read it all, there was no reason to take my other nodes, meaning I would not have developed LE, which is not the highlight of my life to put it mildly.  I am trying to put a good spin on it - that others won't go through what I am and will always go through, and that truly makes me happy for them.  For me, not so much...sorry, I get pissy about the LE now and then.  On the up side, I liked the part of the study where htey said that early BC with only "mild" positive nodes were over 80% free of cancer or likely recurrence AFTER 5 yrs.  Music to my ears

Barbe - I agree with you.  It would make more sense to hit the target area first then move to the other areas.  When I think about it - it seems the ROs do it bass ackwards.