External radiation after Mammosite - is it possible?

LuvRVing · August 2011

I had Mammosite radiation last July after a lumpectomy for IDC. In March of this year, I was diagnosed with a recurrence in the same area that involved 4 axillary lymph nodes and 4 intermammary nodes. Has anyone had external beam radiation after having brachytherapy? Is it even possible? My Dana Farber oncologist said that my radiation would be "complicated". Now I am thinking that they can radiate the axilla and the area of the intermammary nodes, but probably nothing else.

I have one consult scheduled with an RO, and will likely get a second opinion. I'm trying to figure out just how complicated this is going to be.

Michelle

LuvRVing · August 2011

Surely I am not the only one in all of breastcancer.org who has had a recurrence after Mammosite or any kind of brachytherapy??? If so, I'm going to feel really special in a not so special kind of way!!!

Really appreciate anyone's thoughts or experiences.

Michelle

ICanDoThis · August 2011

Actually, you're not, but my Mammosite was cut short by a serious infection, so I didn't have the complete dose of rads.

We finished up with External beam radiation - very directed. Spread out over 5 days - 2ce daily. Really very easy. But I had not received the complete dose during Mammosite, so we didn't have issues with my getting enough.

I can see that yours would be complicated - you might want to ask about maximum lifetime doses to a specific area, and stuff like that. I know that women who have IBC get a lot more greys than I got -

When I get home, I'll see if I can dig some more stuff out.

So sorry you have to even think about this, let alone do it.

LuvRVing · August 2011

Thank you, Sue! I will have lots of questions to ask, for sure!

Michelle

luckygmrabbi · August 2011

I am seriously considering this type of radiation over a 5 day period, twice daily. Did you also have chemotherapy? What were your side effects from this type of radiation therapy? Any particular questions I should be asking my onc?

ICanDoThis · August 2011

I bumped a topic from last week, where I described my experience with this radiation Radiation - 5 day/twice a day - STUDY

I had the same protocol that was followed in the study, but my rad onc wasn't a participant. I found it very doable - and, I was really willing for treatment to be OVER.

Your onc should tell you that this study has not been completed, and that, although results are quite promising, there is no long term data. I was quite comfortable with this, as my lump was small, low grade, and I had amazing margins, with no spots of DCIS anywhere.

Another protocol to consider is the 15 day "Canadian" protocol.

Everyone I know who has these shorter protocols seems to have better skin, but I was just as tired as the 6 week girls, believe me.

If you have additional questions, drop me an IM

LuvRVing · August 2011

Luckygmrabbi - I did not have chemo last year when I had Mammosite. I had very minimal side effects - a little esophageal irritation for a couple of weeks that kept me from eating anything spicy (it hurt going down) and a tiny bit of barely red skin for a couple of weeks after treatment. One of the big risks is infection at the catheter site...I had no problem at all. I had an extremely cautious nurse who used a ton of neosporin and bandaged that baby up twice a day. I didn't have much fatigue, either. As a matter of fact, I walked in the Komen Race (Kansas City) on the Sunday following my last treatment. It is a bit "sci-fi" though. You are left alone in the room and a robotic instrument inserts the radioactive seeds, they are left in place for about 10 minutes, then the instrument removes the seeds and stores them. A physicist comes in with a geiger counter to make sure everything worked properly! A scene right out of the 50's!!!

I think it's a great protocol for anyone who meets the criteria.

Michelle

LuvRVing · August 2011

I'm posting this information because it might help someone else who has a recurrence after Mammosite. I asked my question on the Johns Hopkins website. They have a Nursing Professor who responds to questions about breast cancer treatment. Here is her response, sent to my personal email:

"It (my radiation protocol) will be a bit complicated because there isn't good research yet to direct
radiation oncologists regarding this. it makes sense though that since you had mammosite and therefore your axillary node area and intramammary node areas were NOT previously radiated that you should be able to get that radiation done this time, which is also where you need it most. If you want to come to us for an opinion about this call 410-955-8964."

Lillie
D. Shockney, RN., BS., MAS

Administrative Director

University Distinguished Service Associate Professor of Breast Cancer

Associate Professor, JHU School of Medicine, Depts of Surgery & Gynecology and
Obstetrics

Associate Professor, JHU School of Nursing

601 N Caroline Street, Room 4161

Baltimore, MD 21287

phone: 410-614-2853

fax: 410-614-1947

shockli@jhmi.edu

www.hopkinsbreastcenter.org

Follow the Johns Hopkins Breast Center on Facebook!

I am wowed by this level of a response from "just another" breast cancer patient who is NOT a JH patient.

Michelle

External radiation after Mammosite - is it possible?

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