3 weeks of radiation

I did the full radiation treatments and boosters and am glad that I did.  I would rather have had a few inconvenient side effects that go away quickly than to have a shortened version and miss those stray cancer cells.  Why even bother at all I guess would be my question. 

The shortened treatment plan is not less rads. It's the same amount of rads delivered in larger doses.

I asked my rad onc about it but the aamount of rads I need is too much for the shortened time - he said the side effects of the dosages they would need to give each time is too dangerous.

Sigh. Six weeks for me.

Leah

Knowledgeforpower, I assume the reason you are only having 15 rads is because you are having chemo, which is normal.  Almost every chemo bc patient has a shortened rad treatment plan, that I know.  Cause with Stage 3 and postive nodes, chemo is always recommended.  Best of luck to you!

The Canadian protocol has been fairly extensively researched, and isn't new. I had the one-week protocol, and that is still being studied.

My rad oncologist said that the primary reason that more places don't offer these protocols is that radiation centers are staffed and budgeted for 6 week treatments.

My rad onc said, at our first consult, that he thinks I would be a good candidate for the 3-week treatment (IMRT). I haven't seen him again yet to schedule but I plan to ask a lot of questions; I have high hopes. From my reading, I gather that, in appropriate cases, IMRT is as, or more, effective than the standard longer period of treatments. This isn't clinical trial stuff; it's in use in some facilities.

https://www.virginiamason.org/home/body.cfm?id=1024

2005 DCIS left breast/2009 DCIS right breast, both Stage 0, Grade 3 with comedonecrosis, ER-/PR-, HER2? BRCA 1 & 2 NEG!
Dx 2009, DCIS, , Stage 0, Grade 3, / nodes, ER-/PR-

Jeanne, I don't know where you live, but studies on shortened radiation have been done in the United States and a three-week course has been proven just as effective (if not more effective, by 0.5%!) than six-week course.  Check out the news... www.medicalnewstoday.com/articles/122616.php The study was done between 1993 and 1996 and then patiens were followed up after 10 years...as good of long-term as any other studies out there.

Some doctors just don't want to do it because three weeks is less expensive. plus many physicians, unfortunately, are still living and operating on old numbers. Talk to your doctor, challenge him or her, you'd be amazed what they tell you once you press them for more information.  Good luck!

ekf, the article you referenced is a report of the Canadian study on 3-week radiation even though the report was presented at a conference in the US. Of course, I don't think that the effect of radiation on cancer cells or breasts changes at the border but there is one possible issue that concerned my rad onc that may not be addressed by a Canadian study.

Both Herceptin and BC rads may interfere with heart function. Of course they do their best to choose angles to avoid exposing the heart to the radiation but they can't be sure it is getting none of the dose especially when radiating the left breast. Because I'm on Herceptin, my rads onc didn't want to give me the higher dose without studies that reported on the safety for women on Herceptin. The Canadian study didn't report whether the women were on Herceptin. I know that in Europe, Herceptin is usually give for 18 weeks so a women getting rads is done with it but in the US it is usually given for a year. I'm not sure which is usual in Canada. I hope that some of the trials of 3 week rads underway in the US will report on that for women going through this in the future. I felt that my rads onc was being over conservative particularly since Herceptin has so far had a negligible effect on my LVEF, but I understand his position.

There is another limitation of the Canadian study that applies to me. The Canadian study excluded women with large breasts due to concern that the higher dose would hurt the cosmetic results for those women. To be in the study, you had to have negative margins, negative lymph nodes and not have large breasts. Something has to be under 25 cm for that last one, but I'm not sure how the measurement is done. I was more concerned about this one than the Herceptin one but it didn't concern my rad onc.

BTW, my HMO owns its radiation facility and has doctors on salary. My rad onc had no financial incentive to do 5-week rather than 3-week. The HMO got a $10 co-pay for the rads consultation visit either way and there were no co-pays for my treatment including the rad onc visits during treatment. Any financial incentive is to treat as cheaply as possible as long as that doesn't produce a recurrence or side effect that they also have to treat (though I feel that they aren't driven solely by that and that I have received excellent treatment). They are participating in a clinical trial of various shorter duration treatments but not at the location where I was treated.

I met with RO today and will be screened for the Canadian protocol. Don't know yet if I qualify. I know the breast measurement will probably be the key. He told me that if I am 1 cm off, he will not do it. It has to be exactly within the guidelines. So we'll see. My RO also had a fellowship at MD Andersonin Houston. This isn't experimental.

I will be having doing the 3-1/2 week treatment option.  My simulation is scheduled on 7/11.

 So first week went ok?  I'm really nervous about all of this, to say the least. 

Lucy

Good luck to everyone, whether its the standard or shorter. As for me, I was given the option of the Canadian protocol but just felt that more treatments at a lower dosage per treatment was preferable both to my skin and also to blasting any stray bc cells. Nothing reported at the time I was treated about the shorter protocol being "better", but there were some concerns about it being more damaging due to the higher dosage per treatment and I did feel like a bit of a guinea pig if I'd gone that route at my place. It is a less expensive treatment plan, which in a socialized medicine environment unfortunately is a factor.

I am starting this protocol on Thursday, of this week.  Nervous, but I've made my decision (finally).  Got my tatoos yesterday.  Ready to get this over with!!! 

Well..I guess its woman's perogative to change her mind. Chickened out and switched to conventional path..5 weeks and possible boosts. Had complete emotional breakdown last 3 days (many contributing factors)..but feeling better now. Start rads on Mon. Yes..pampering in order. And time to focus energy on saving my skin..as best as I can

Thank you so much for the encouragement.  Tomorrow is the 1st treatment.  Time to get this over and done with! 

Lucy