10 year Radiation Study - Larger Fractions/Shorter Ttmts
Comments
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Has anyone else read this study released this past December at the Ocnology conference in San Antonio? Is there anyone else out there who's had this form of radiation therapy. I am so wondering about the choices we have as I am not there yet but will be soon.
“Long-term follow-up confirms that a lower total dose of radiation in fewer, slightly larger fractions delivered over a shorter treatment time is at least as safe and effective as standard 5-week schedules of curative radiotherapy in women with early breast cancer,” Dr. John R. Yarnold declared.
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I had 19 total rads. it was so easy--no skin problems.
Will you be having radiation?
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Yes, I will be having radiation so I am researching.
I've had chemo and surgery thus far but my chemo was interupted because of pneumonia. I'm waiting for an appointment to get a second opinion about continuing with the chemo or not before moving on to rads. Playing the waiting, healing and getting stronger game til then.
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Please keep us posted on what you decide. Good luck.
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I have my mapping next week and will find out if I qualify for the shorter high dose treatment. You have to be less than 25 cm on the CT scan measurement to qualify or you have to have the traditional longer. I'd rather get it over in 4 weeks. Anyone had the shorter treatment?
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What do you mean by "less than 25cms"? I have been offered a 3 week or 6.5 week schedule, but couldn't get the DR to give me the difference between the two. Was simply told they are the same, except for cosmetic outcomes. This is not what I have read online (which isn't always reliable) so am looking for more info to make the decision.
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The article mentions that "Canada has already switched from the historical standard to 42.5 Gy delivered in 16 fractions..." I live in Toronto, Canada and had 16 whole breast radiation treatments at a major cancer centre here. I believe that is standard of care in Canada now. My 16 whole breast treatments were followed by 8 boosts to the tumour area as the tumour was very close to the chest wall. (.3 mm from chest wall).
Maybe kickingcancersbutt meant 25 mm not 25 cm.
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This is what is confusing for me. I am canadian, but currently living overseas. I consulted a candadian ONC from sunnybrook, who said I "may qualify" as in canada, she said it was mainly used for node negative small breasted women. Then I read this new UK study, which included women with 1 positive node, so that proves for low node involvement, the short course is equivalent. However, the UK data seems to suggest it is not good for women with grade 3 tumors. My best friend and another friend who both had breast cancer last year, treated in canada, were both given the 6.5 wk treatment. Perhaps because one was a high grade and the other had more than one node. But it all leaves me confused about which to choose.... Note also that the UK "3 week" treatment in the study does NOT include tumor bed boosters for lumpectomy patients. So it is really 3 weeks plus 1.5 weeks (8 days), so depending on the place it is 15-18 days plus 8 days, so not a huge difference at 23-26 days from the 32 shot treatment. Slightly better, but if you need the boosters, not a huge difference. The UK study notes they started their research before boosters were proven to be effective, so I would want the boosters.
I haven't heard about this one week treatment. Is this only for node negative women, or does it aso apply to node positive women? I have to travel to another country for the radiation, leaving toddlers and young kids at home so would like to have shorter options.
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I am going for an appointment with a radiation oncologist soon and will ask more about this. Anyone else?
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QueenKong, I was asked by my radiologist if I wanted the 5-day rads. twice/day. It is called partial breast radiation and it is EXTERNAL. Since I am HER2+, I decided not to do it. Instead I did 19 full breast rads (which included boosts). It was a piece of cake. I don't understand why more people are not offered this--I am on the West Coast so maybe this has something to do with it.
Keep us posted.
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I read this study report the day before I started rads. When I went in for my appointment I asked the techs about the shorter treatment protocol and they went and asked the RO for me. She said she wouldn't recommend the shorter treatment for me but I could do it if I wanted - but I wouldn't be able to start that day (because they'd have to recalculate everything and set up the machine differently I presume). Anyway, I decided to go ahead with what they had set up for me (28 + 5 boosts). When I saw the RO a couple days later she explained that the study was done on women who did not need chemo, but went directly from surgery to rads. So there is no data to support the shorter treatment for women who needed chemo for whatever reason. I certainly qualify as "early stage", but I needed to have chemo because I am HER2+ which makes the cancer aggressive. So in retrospect I'm glad I decided to go ahead with the original plan. (11 down, 22 to go as of today, and no ill effects yet.)
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Hi, I am waiting to speak with the rad onc about this. I would FAR prefer the week long or three week course, but then, would prefer even more to not do rads at all. I posted a couple of other times today with more detail, but wish I had found this topic sooner. Let us know your thinking.
In my highly inexpert opinion, grade 3 and her2 positive warrants a "throw the book at it" approach. I would go for rads if I had that assortment of features. -
MameMe, keep us posted and good luck with your research.
ps love your Leonard Cohen quote!
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I now have two appointments with Radiation Oncologists on Monday. I'll ask them about this and anything else I can think of and report back. I'm very interested to hear about what others are doing. Thank you for the feed back.
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QueenKong, I am in the RTPG 1005 study, it is in Phase III. It is specifically for TN's and started in Canada (thank you very much!). I am in ArmA, six weeks of rads, of the study as opposed to ArmB -- 3 weeks (shucks!). I have had chemo and must begin radiation within 60 days PFC according to the "rules". I have my dry run tomorrow evening. The set-up is exactly the same for six weeks or three weeks, what is different is the amount of radiation given each time and the boosts. The total amount of radiation is also the same for both the 6 and 3 week arms and the boosts are the same -- however, the boosts are given each day of ArmB rads (3 weeks) as opposed to the last few rads in ArmA. So, given the information I have, I think that there are several studies being discussed on this thread.
Good luck to all!
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PinkyWI, I look forward to hearing more about this. Thanks for posting. (I had 19 rads total- 16 regular, 3 boosts).
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Hi, thank for the info Pinky.
I went to two Radiation Oncologist on Monday and talked to them about the study. They won't change the treatment plane for me. They said because I am triple negative, because there were likely cells in the lymph nodes that there is not enough long term evidence. My tumor was so large too. I am going to get the aggressive standard I guess. Face up, arms over heard. 28 days of treatment and then 5 days of boosts is what it looks like it is going to be for me. A total of 60 centigray. Does that make sense?
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Queen, it sure makes sense to me--I didn't realize your tumor was 6cm and the triple negative. It sounds like you are getting excellent care and good for you for checking this out with 2 radiologists!
A couple of things I might suggest and that helped me...I always used Aquafor--at least twice a day. They had baskets of it in the radiation place. Each day, after I finished rads, I put on the aquafor. A lot of it on my breast and underarm. I wore a tee shirt so it absorbed the gunky stuff. I also did not wear deoderant. I was able to have my appointment at the same time each day which helps if they can schedule you that way. My appointment was always about 10 am and then I was finished by 10:30.
Everyone in radiation oncology was so nice. I actually did not mind going at all as they were always happy to see me--they even asked what music I wanted to hear. Now I will tell you, that when I saw the big radiation machine it kind of broke my denial that I was a cancer patient. It was heavy but I got over it in a day or two. Also, with the arms up, etc., I was able to get with that also. At first I had feelings about it but I'll tell you one thing--it got me over being uncomfortable with my body.
When will you start radiation?
You will have so much help and support here. there is probably a radiation group on the radiation thread you might want to check out.
Good luck, I'm thinking positive, positive thoughts for you.
Lizzie
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Thank you cowgirl. I'm on that thread. I'm not sure when I start. I'm waiting to hear back. It should be sometime in the next two weeks. The sooner the better. I don't care who sees my boobs or whatever. I want to get the best treatment I can so I can survive and be as educated as possible. I am so happy to have found this site with so many posted experiences and information. I've learned so much and feel supported. Thank you!
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Lots of studies showing 10 history of success w shorter course radiation. I will be doing the 3 week/5 day week course...I did a great deal of research to find this. I am also doing prone radiation. My breast is large enough to hang down and so the rads will not enter my body as with supine (on back radiation). I also searched for this...I am in a larger city with a progressive large research hospital... lucky! Although, I would have traveled to find prone radiation. Hope this helps.. What I am trying to find out is whether the side effects from shorter term rads are more severe--like fatigue, due to the higher dose, even though shorter. I start in 2 weeks. Thanks
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Newbee, how cool you get to do the 15 day. does that also include boosts? I had 19 total treatments. It was very doable. Never had a problem with my skin or anything.
Liz
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So jealous, Newbee! I am in armA -- the standard. I have two more rads and then the boosts. So far, so good except, I didn't realize how far up under the arm the rads go and was not putting my boob lube up that far, so now I am paying. They gave me Restore to use and I think it works pretty good. Glad I had the weekend to heal a bit. No blisters or anything but very red.
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I am halfway through with the 20 treatments. 16 reg and 4 boosts....so far no problems...slightly red but that is it. Using pure Aloe Vera afterwards and when I get home from work.
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I begin on Monday 1st of 16 treatments, here they follow the protocol from Canada. Any tips on what kind of bra is good to wear?
Thanks
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I didn't wear a bra. just wore a T shirt which really helped as I was covered in Aquaphor. Good luck! its very do-able. I had 19 total rounds. no problem with my skin at all.
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Yeah I don't bother with a bra much these days either. I go to rads at 8:15 each morning, so most days I show up in a t-shirt (under a hoodie or fleece) and yoga pants -- basically my pajamas! ;-) Makes changing in and out of the hospital gown much quicker. I shower after I get home because I want to slather on lotion after showering. If I showered before going to rads I wouldn't be able to apply lotion.
Started boosts on Friday. Whole breast was finished on Thursday. Monday will be the last clav zap, then it's just boosts -- so glad to be in the home stretch! My skin is really starting to show the wear and tear. I'm using silvadene cream this weekend. My poor armpit is very tender, but fortunately it won't be treated anymore ... Hope it heals quickly!
Today I noticed the distinct square shape of the table on my back from my "tan line" near my shoulder. I will ask the doc, but in the meantime can anyone answer this -- does that area get zapped from behind (I lie face-up on the table -- my left side gets treated and my head is turned to the right, so I can't see what happens on my left) or is that the radiation zapped in my clav area traveling out through my back? If the latter, it's a little horrifying ... And where did the rads go that didn't show up where the table mark blocks the "tan"?
Hope this makes sense to those who've gone through it, and I don't mean to scare the new people. -
I had some red (very feint). I'll have to check and see if its stll there. finished with rads 3 years ago.
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Hi all. I'm new to this forum, probably won't be facing radiation for another 4 months- after chemo- but I met with my radiologist yesterday and we had a very interesting and informative conversation. He gave me three choices. Standard six weeks, three weeks or 2x a day for 5 days. This was at a very respected research hospital in Philadelphia. I asked why people were still receiving 6 weeks of radiation when studies have shown that over the course of ten years the three week treatment has proven just as effective. His answer? Many facilities like the added revenue stream of 6 weeks vs three and also that older doctors like to stick to the tried and true. Of course, there may be reasons that particular individuals may need six weeks, but please question your radiologist closely about his/her reasoning. Regarding 5 day radiation treatment, long term studies about effectiveness only go out 5 years at this point, although most local recurrence is within 5 years. He is quite comfortable offering me 5 day partiol breast radiation. I have time to decide- it's either 3 weeks or 5 days for me. Hope some of you find this interesting.
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I am getting the shorter protocol, 16tx's, prone position. I sought out the treatment. Had to go to the biggest city near me, not available in my area. If not for finding it, I would have had a mx and reconstruction. I know not everyone has a choice, but so far rads is easy peasy, esp compared to chemo, which for me was very rough.
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My ro said the shorter protocol would work for me because I am small framed. Had nothing to do with breast size. 16 + 4 boosts. Not too bad, just itchy where I didn't put lotion. I didn't realize the radiation was hitting my chest until too late. All healed
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