Experience with Brachytherapy

Finish up Tuesday and I can hardly wait to stand under a hot shower, sleep in my bed, and return to a normal routine. I know this beats the 7 week rad schedule but it is tough none the less. Glad you ladies have had the harpoon removed. Have had reaction to two antibiotics and can't take pain meds so it has been a rough road but this will be behind me in a few days. Sorry if there is a negative note. I really do feel positive about this procedure but it is not a cake walk.

I too just finished partial breast radiation (brachytherapy)using the Savi device. The choice of which device depends on many factors including what is available from your radiation oncologist and the shape and location of your cavity. I had to wait almost 4 weeks after surgery before insertion because my lumpectomy cavity was so fluid filled it didn't close up enough earlier. Waiting and checking each week was hard and I found the treatment process more difficult than I was prepared for. I'm glad I chose that method but it wasn't a walk in the park. I'm a psychotherapist with flexible hours and worked pretty much full time throughout the treatment. I spent at least 4 hours each day devoted to treatment, even though I was only 10 minutes away from the hospital, including driving, parking, walking, changing, an x-ray before each tx, waiting for this and that, etc.



It was never really painful, but at times sore as the device was very close to my chest wall and would hurt if, during treatment, it was pushed into chest wall. Insertion under local anesthesia was difficult but not painful. I felt quite tense and stressed throughout the 8 days the Savi device was in place. I had a hard time dressing to cover the lump formed by the exterior part of the device resting between my boobs, covered over with 4x4's. Usually it's under the arm. I slept as well as I usually do. I broke out in an intense head to toe skin rash, like measles, one day right while I was changing into a treatment gown, which I think was caused by nerves. My doc thought it was an antibiotic reaction. Benadryl took care of that nicely. Even though the Savi device wasn't painful, my body didn't feel right the whole time, like I was having an inflammatory reaction to this foreign body. I was never so happy to have something removed, which also was not painful. The device was in for 8 days because of an intervening weekend and 2 days between insertion and the actual treatment starting. Everyone at Beaumont Hospital in Royal Oak, Michigan was professional, kind, helpful.



Again, I'm glad I chose this type of radiation treatment in spite of the challenges, mainly because of the lack of radiation exposure to healthy tissues and the short time frame. If I had the option, I could certainly see myself not working, getting a driver, and taking something for anxiety during the treatment. It was kind of like having a root canal twice a day.

One week later I'm healing well. I'm still a little tired, although I went for a two mile walk this morning. I felt ill for one day, like the flu, about three days after completing treatment. Other than that I carried on in spite of fatigue. I'm 70. I loved the 'holy shit' and 'thank The Lord' comment above. My thoughts exactly!

Two more things: my treatment team really likes the Savi device because of its versatility and their greater ability to control exactly where the radiation is distributed, so that certain tissues can be avoided like in my case, my ribs. Secondly, I want to thank everyone here for their contributions to this wonderful website. It has been so helpful to me!

Am going tomorrow to have the savi device implanted. I will be glad to share with you my experience. I was where you are last week with trying to decide. But this device is cutting edge and only available under certain conditions

I have been thinking about things I wish I would have known before starting brachytherapy. Firstly, my oncologist will only insert a cath within 2 weeks of original surgery. So, if you are just diagnosed and interested in brachy make your appointment to see your radiologist within a week of surgery. Second, if you have the choice, have your radiation oncologist insert and remove the device. It will save you considerable time and trouble. Professional courtesy would dictate sending you back to your surgeon. In my case, she was out of town so my oncologist inserted the device. It took some painful adjustment to seat the SAVI just right with cat scans between each. If I would have gone to the surgeon for insertion I think it would have been worse.

I completed my rad with SAVI on June 14.  It still feels warm to the touch and now a bit itchy internally.  I was surprised by how painful and uncomfortable I was with the device for the 9 days, as most posts only talk about mild discomfort and how pleased not to go thru the 6-week external rad.  The surgeon and rad dr also never warned me how painful it might be, and I do think this should be taken into consideration when weighing your options.  I would still have gone with the SAVI, but at least I would have known what to expect.

Diane MS1- I too wish I had been better prepared. I would choose savi again only because I know what it is and would be better prepared, but I too found it somewhat painful. I still have minor pain and the savi sight still drains somewhat at night. I still have a very red breast and I completed rads on 6/18. Being a candidate for brachytherapy meant that we were very fortunate to have early stage BC and required no chemo and for that I am very thankful. I start Femara next week and am dreading it. Praying I don't experience the dreadful side affects that I have read about. None of us asked to take this journey but here we are and I pray for good outcomes for all us.

I consider myself insensitive to discomfort/pain. That being said how long before I quit getting new blisters and the redness and the burning completely disappear? I'm in my 5th week post SAVI. My tumor was stage 1, grade 3, 0 node, ER+, PR+, HER2- invasive carcinoma very high on my right chest. I am radiosensitive (no more dental x-rays because of blisters and sores). My site is not infected. I guess external radiation would have been much worse for me, than the internal SAVI. given my radio sensitivity.

Just a follow up note: I finished the rad tx, and they pulled the catheter a few days ago. Maybe I'm an outlier...but I will say it hurt like hell when they pulled it out. I don't know why they don't use lidocaine for procedural pain like this. It took most of the next 48 hours to get over feeling quite brutalized by the whole thing. If you can deal with having a cavity filled without novacaine, then stick with the "two Tylenol" approach for catheter removal. However, if you don't want very intense, sharp, albeit brief pain, ask for a local anethestic!

Sorry you too had a fairly bad experience. Now that I'm five months post-Savi, I still feel traumatized. In retrospect, I would have done the 30 days of external if I knew then what I know now. I know not everyone has a bad experience, but in talking with my nurse navigator, she feels that patients like me who have it inserted from the side and spanning the entire breast to the other side have had a much harder time. I still have a fair amount of discomfort in the tumor area, and I blame the internal radiation. It's a choice for everyone to make. I just wish they had been more up front about what could happen. And PS, nothing for pain for me either when it was removed. I took a pain pill before, but still screamed when it was removed. Luckily, it comes out fast.

I had brachytherapy last June and while I am still thankful that I was a candidate for internal rads, I have to say it was not a walk in the park. I did not find it brutal but very uncomfortable for sure. Lidocaine was used for insertion and topical lidocaine for removal. Both were painful but tolerable. I was due for follow up mammogram last month but opted to skip until yearly, due to fact that breast is still painful and just the thought of squeezing the poor breast brings tears to my eyes. All Oncs were ok with that decision. All in all I would do internal rads again if I had to make that choice. I had skin burns and savi site still is not 100%. Onc said that had I had external rads the skin burns would have been far worse since internal rads is supposed to spare skin trauma and it occurred anyway. I am sorry that any of us have to be here but thankful to have this behind me. My thoughts and prayers for all still waiting for treatment.

I am scheduled for a lumpectomy on my left breast next Tuesday, Dec. 3 (Age 51, DCIS, Stage 0, Grade 2).  At this point, my surgeon is recommending accelerated radiation.  I have done a ton of research, and I'm still unsure if this is the path I should take.  Sometimes, too much information is a bad thing, you know? 

Blessings to you all!

Dear Claire,

I hope you had time to sort out all the options and you are well along which ever path you have chosen.

I am now one month out from ending accelerated rads and, miserable as the experience was at the time, I will say that now it is all a pretty distant memory. I have only occasional slight twinges of breast pain, all the skin poke sites (biop, lumpectomy, Savi insertion site) are healed with minimal scarring. I had very little in the way of skin harm from the rads, just slight discoloration and the skin pores look bigger and coarser.

With 20-20 hindsight, I do not regret my choice of accelerated radiation therapy.

I also remain really sad/angry/annoyed that the current state of science/research cannot give good enough prognostic guidance to help women safely decide to skip RT altogether when they have small site, low/med grade DCIS. We know a large percentage of women could probably live safely with DCIS treated with lumpectomy only...we just don't know which ones! and none of us wants to roll the dice...

So, safe travels through the treatment pathways you've chosen.

Thinking of you,

RimRoc

Update from last night's post.   SAVI catheter inserted today with no problem.  Lots of chatter to keep me distracted BUT I can honestly say the only discomfort I had was the brief sting from the lidocaine.  They were very thorough explaining what to expect so there were no surprises.  The doctor also asked me several times if there was any pain.  There was pressure as the catheter entered the lumpectomy cavity, but no pain at all.  Procedure took all of 15 minutes.  I felt so good, I stopped off and got some lunch on the way home.  Its a few hours post procedure and I feel no discomfort at all.  

I was initially told no showers, but the nurse said if I have a handheld shower head, I can use it as long as I don't get the area of the catheter wet.  Will have to do my hair in the sink.