BOLICE
YES I MISSPELLED IT!! LOL
Close margins on the skin side of MX (less than 1 mm).
I'm getting Rads and the RO is using Bolus on the skin in one quadrant.
Anyone have experience with this? I was told by one RO that once the skin turns red he discontinues the Bolus. My RO wants to use it the entire 8 weeks (no matter how red or blistered I get).
Has anyone researched this? If so, can you point me in the right direction?
Comments
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This is what I travelled all around getting 2 nd opinions about. I went to md Anderson, and Sloan Kettering. Neither recommended the bolus for me....and I possibly had skin involvement prior to the mx. The bolus at my treatment center is used the last week. So I went with the recommended 25 treatments. I still blistered like absolute crazy and can't even imagine another week of it.
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Thanks Gee for showing me how to spell it!! lol
Could you elaborate on possible skin involvement? Did you have a skin sparing MX??
My RO (just out of residency, but a nice passionate guy) wants to use Bolus the entire seven weeks!!
I've got to research it. My PS cringed when I told him that...lol
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They used Boluce on me the whole time --- 30 sessions, except for one time when they forgot to put it on me. Yes, I did burn and blister but not just where the boluce was. I have a very fair complexion and burn easily. I used a cream called Silvadene and it worked wonders!
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Thanks Faith.
So did you blister all over? I'm very fair as well but the RO said that has nothing to do with how I'll respond because it's not "really a burn." He said he's had fair haired women with no damage, and olive skinned women whose skin really suffered....
I know which I'll be. ~sigh~
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Hi TonLee,
The bolus is a sort of a gel-consistency pad thing they put on your skin. It helps direct the radiation closer to the skin surface than without it, and since you had a very close skin margin - that's probably the reason for wanting more radiation close to the surface rather than deeper.
Hopefully your RO isn't really so set on his plan "no matter how blistered you get," since treatments should always be an art and depend on your reaction to it! Yikes! Any possibility you could get another RO who would be more flexible and open to seeing how things go?
You may be reassured that for me, I'm VERY fair skin with reddish hair and freckles and sunburn VERY easily, and my radiation burns were very manageable. Actually it was the worst after the treatments had finished, but even at its worst, it wasn't as bad as I was afraid of. So your complexion and sun-sensitivity don't always indicate how you'll react to rads.
Best of luck!
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Thenewme,
Thank you!! That's so good to read.
My RO is young, and once the area turns red, I'm going to make him stop (that's my current plan). I talked with another RO who said that he used Bolus, but when the area turned red, he stopped.
I'm pretty forward with my Drs so he won't be surprised when I tell him to stop using it.
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I didn't mind having the boluce. I'm of the thinking that let's do any thing possible to take care of the problem. Radiation was actually not that bad to get through. You'll do fine.
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Are they planning to use the bolus every treatment? Mine was only I think maybe once a week. One suggestion - the radiation damage is very cumulative, so in the beginning be absolutely faithful about being gentle with the skin and using only whatever they recommend on it (I was to use ONLY cornstarch - no creams, lotions, etc, and ONLY Dove extra sensitive soap). Try to wear something very, very soft that won't rub - even if you have to turn a camisole inside out so the seam won't irritate it. Baby your skin even if it seems perfectly fine at first, and you'll be glad later.
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Oh that is good advice newme, thank you so much. It makes perfect sense!
I'm going to be expanded the first couple weeks of Rads....I'm almost dreading what it might do...but the PS says it'll be ok....
Scary.
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I had a close margin and had the bolus (slab) every other treatment until the end when I had it with every boost at the incision (5). My mass was in the upper outer quadrant. I had 36 treatments - my im field was treated with something that didn't go as deep (forget what it is called now). I had some blistering, especially where the im field overlapped with the chestwall, but it cleared up really quickly after treatment. I never had to miss a treatment or anything.
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That's good to know poptart, thank you.
He said I will have 8 weeks...so I'm assuming that is 40?? I haven't signed the consent yet....
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Is he going to use the bolus with every treatment? BY the way, I had delayed reconstruction, had expanders placed after completing radiation and my skin did okay, though my foobs are not that big.
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I had the bolus used every single treatment for 6 weeks, both sides. Even when I was very badly burned it was used. My onco said I could not use it for the last 3 or 4 because I was so bad, but I wanted to know that I had done all I could. Onco said I wasn't the worst burned she'd ever seen but close. Like someone else said, Silvadene worked miracles as did the saline compresses. I spent quite a few hours every day with cool saline soaked cloths on my chest & armpits. I used Base Glaxol 3 x a day for seven months afterward & when I had reconstruction my PS asked if I had rads because he couldn't tell. Good luck!
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Yes I had a skin sparing, and for some reason he said we would never know if icancerous cells were involved in the scar line areas or not. I did have one area near the skin, but it didn't at that time go into it.
I also used the silvadene, after treatments were over. It worked great! Silver is in there and I was told that burning could get worse if I didn't get it all off prior to a rad session. I didn't use soap the whole time during rads. I just got in the shower and let water run over me, no wash cloths either.
40 rads is the most I believe I have ever heard. As a little tip, get the first appointment in the morning ...otherwise the schedule gets fouled up during the day. -
Thanks MFrog and Gee..
Good advice on the morning appointments. I'm going to try and get them.
Silvadene...is that a prescription?
MFrog...where can I purchase Base Glaxol??
I've read women on here use Aquaphor and Emu Oil. Any experience with those?
My RO said I "shouldn't need anything but cornstarch" on the skin....lol. My PS said, keep the area moist as much as you can....as often as you can....
Guess which I'm going with?
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Silvadene is a prescription & my understanding is that shouldn't be used until the skin breaks. Your RO will prescribe it when the time is right.
Here is the link for glaxal base (I always screw up the name), I'm in Canada so I don't know your stores.
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I post all over the place, so apologies if I repeat. I get lost!!!
yes, emu oil. It's all I used. I put it on several times a day. I only used silvadene once the skin was broken at the end...and my sweet little rad tech had a secret stash of it and made me a container. He was adamant I not touch it to contaminate the cream, using a wooden tongue depressor to smooth on my skin then just leave it thick on there. I did that about a week. The only place I blistered is under my arm, axillary area. Do not ask me why I forgot to put emu oil there every day. I was so focused on my boobs not frying that I forgot my armpit. YOWEE! -
I am in a Cancer Treatment Center..........run by Fox Chase Cancer Cernter in Phila...........I am on my 3rd Rad.................I have never heard that word used....................It is foreign to me............Not sure I would want soemthing that would be that tough on my skin, or an RO who said "I'll continue no matter what............sounds scary to me, but I'm sure they kow what they are doing.............good luck
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Thanks MFrog, I will order some of that..I like that it is marketed for people having treatment to the skin....nice.
Gee...so I should def. use it under the arm too...lol. Gotchya.
Right now these seem to be the two (and aquaphor) that I hear work best....I may start the emu oil as soon as I buy it. Should I get it on line? Or is it best to buy in stores? I know some oils break down if they are exposed to light and air....
Ducky, Bolus is used during Rads on women who have skin involvement, or skin involvement is expected...I've read only about 30% of women who have Bolus are satisfied with the cosmetics of their reconstruction becuase it is so hard on the skin.
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My rads Dr. used one, in one area for 25 treatments. They stopped, put it on, zapped and removed and continued. My tumor area was my entire breast...ILC. My skin did well until the end and then I blistered and peeled pretty intensely; I used those moist gel gauze pads that they use for burn patients, and vinegar and water wash clothes(Sounds strange but it worked) ...it healed well.I also had prescription for a silvadine salve. My treatment was at Mayo Clinic in MN.
I had a consult for DIEP surgery in Feb. in NOLA and am scheduled for late May. Dr. seemed to think the skin was in pretty good shape...my rads ended in September 09.
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So is this for only women who are getting reconstruction?...............If that is the case then it is understandable why I knew nothing about it.............so much to learn
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Thanks no words...
Ducky..it is used for women who have SKIN INVOLVEMENT with their cancer, or close margins.
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A bolus is usually used for women having rads after a mx since the rads need to be brought up to the skin. Apparently the most common place for a local recurrence after mx is the scar line.
I had a bolus for the last 13 of 25 treatments. I didn't have bad burns but I used enough aloe vera gel to make the plant an endangered species.
Leah
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In addition to the first-hand experience other members have given, here's some more information about how and when a bolus may be used, from the Daily Radiation Treatment Regime section at Breastcancer.org.
"If you are receiving radiation after mastectomy, the therapist may place a bolus (a flat piece of rubber-like material) on top of your skin, which increases the radiation dose to your skin and to the tissues right below it."
There's lots more to learn at the links on that page too.
Judith and the BCO team
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I had lumpectomy, but I got the bolus (flexible pad thingy) during my 7 "boost" treatments at the end of regular whole breast radiation. The boost area was a much smaller oval area, and I got the bolus because my tumor was very close to my skin surface. Actually, they removed some skin so the whole tumor scar got the bolus treatment.
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Leah, I use Aloe Vera on sun burns and it works great for me. Is the Rads "burn" hot?
Judith, thanks! I didn't see that but will check it out.
Elimar, I didn't let them remove my skin but agreed to rads because of it. They won't be placing Bolus on my incision (Which was once my nipple). My tumor was at a high 11 o'clock..so we're hitting the 9:30-12:30 quadrant.
I wonder why some women only get a week, and others the entire Rads cycle.....if I find it, I will share!
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I had 28 treatments, had bolis every other one, they put a wet towel on me before the rads. started. i burned pretty bad in those areas, but not until i was almost completed, i couldnt put my arm down, my underarm was really bad. it wasn't until i found emu oil that it started to heal quickly, i guess i would say i was in pain for about a week. not a long time but the pain was pretty bad. good luck
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Thanks Pegs....I have read about the emu oil. I'm starting it a few days before Rads begins...I will be expanded the first few weeks of Rads...
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TonLee,
You don't have to be completely expanded before starting rads? my rads doctor said I needed to be completely filled before i start rads because the skin will change after each fill and will affect the radiation plan. i know all doctors are different
peg
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Pegs,
My RO wanted me to start rads two weeks ago...as soon as I healed and without expansion at all...(he doesn't "believe" in reconstruction).
My PS wanted to wait until I was fully expanded (12 weeks).
So I called my RO into my PS's office and we hashed it out. I've had two fills (need 2 more, maybe 3 but we're going slow since last time filling popped me open).
The PS said the last two fills can be done during the first few weeks of Rads.
The RO agreed that after every fill those first few weeks he will "recalibrate" .. remark, re-CT Scan, all of it. (Which will be at most 3 times).
My facility doesn't tattoo patients..they use perm. marker and then cover it with a type of clear medical tape that doesn't come off in the shower, then replace the tape as needed.
I'm impressed the RO was willing to work with me for exactly the reason you site...
I went today for my marks, and he's going to call me tomorrow to determine when we'll start.
Hope this all works out....but you know? I'm not holding my breath.
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