Question about criteria for Canadian protocol

Lillibelle · February 2016

Hello-

I'm about to start rads and my rad onc was asking me if I needed a shorter treatment for any reason like a vacation coming up. I said no but then started looking into it and I think I may want to do it.

I had lumpectomy (plus re-excision to get clean margins) in October. No nodes. 3.5 cm mass ILC. I did chemo (4 rounds of TC b/c I had an oncotype of 26--not due to remaining mass). Would I still qualify? The studies I've read mention participants not having done chemo for treatment of cancer, but mine was done for prevention of reoccurrence.

I'm just so wiped out still from chemo (finished 2/9) that I want to do anything to prevent MORE fatigue, and the Canadian protocol seems to do just that.

I have a call in to my onc but am just anxious about it.

Thanks!

GG27 · February 2016

I had the longer protocol but that was because I had a BMX & wasn't sure if I was going to have reconstruction. But if I wasn't have recon I would have had the shorter. With a lumpectomy you can probably have the shorter with no problem.

Hopeful82014 · February 2016

Suitability for the Canadial protocol depends on a number of factors and, at least around here, seems to be determined on a case-by-case basis.

I had a lumpectomy but was not able to do the shorter protocol, per 2 different ROs in 2 different cancer centers. It doesn't hurt to have a good discussion of it, however.

GG27 · February 2016

And I forgot to add that every province is different & even within the province every health authority has different protocols.

barbe1958 · March 2016

I'm about to start rads - mapping is tomorrow and I asked about the Canadian "way" - I didn't remember what it was called and my RO shook his head "no". I am about to have a huge area done - chest wall, left armpit and lower neck. Could that be why? Is the short version only for a small area???

Hopeful82014 · March 2016

My (limited) understanding is that in the US it is not offered to node positive and other high risk patients.

barbe1958 · March 2016

I'm in Canada....it's "my" protocol...hehehehehee

Lillibelle · March 2016

Hello all-

Well it seems it's a case by case basis sort of thing. I was node negative and I'm kind of small. My doctor OK'd it for me--I'm getting 16 treatments and then a boost.

My RO said that in general it's better for smaller breasts. He had a woman ask about it with large breasts and he did not OK for her.

So--I had my first one yesterday! So far so good.

barbe1958 · March 2016

Maybe it's more focused? I have a pretty large area to cover (no breasts).

Hopeful82014 · March 2016

Hi, Barbe - Yes, I did think it ironic that you were told it wasn't appropriate for your tx.

I have fairly small breasts (a blessing where radiation is concerned) but wasn't eligible due to need to go beyond the breast and treat the axilla and supraclavicular regions. A shorter regimen would have been nice but it all actually worked out better in the long run.

If you are starring radiation soon it wouldn't hurt to start moisturizing now, rather than waiting. Good luck to each of you.

Kathy044 · March 2016

Well I was node positive and had the short course 16 tx treatment in 2010. It was strongly suggested that I do the upper axillary and superclavical areas too but I refused due to increased risk of lymphedema. If I had had it done it would have been added at the end of each treatment so still only 16 tx. I was 66 yo, small tumour, clean margins so that is probably reason did not need extra boosts.

I believe the eligibility for the shorter treatment depends on the aggressiveness and activity of the cancer.

Six months after rads the study on the risks and benefits of regional radiation that was being done in Ontario was published. There was a benefit.

Kathy

Martini · March 2016

I live in Ontario, in the middle of 25 rad treatments (I opted out of the 5 recommended boosts), breast, clavicle, underarm. I asked about the Canadian protocol. My RO, who came from another province had trained with that protocol. However, When he started doing it at our cancer clinic, for cases like mine, he received so much flak from the administration he no longer does it that way. Still amazes me there is really no continuity.

Hopeful82014 · March 2016

Hi, Kathy - thanks for adding your insights. I suspect that the differences may be regional (you're in BC, Barbe's in Ontario - and I'm in the Pacific NW). It is interesting to know that you were able to do the CP, even with a + node. This certainly is a great demonstration that where bc is concerned, no two of us have the same tx!

(PS - I don't blame you for being concerned about LE; I fought pretty hard to avoid ALND due to the same concerns. I hope you've managed to avoid LE. Cheers from Oregon!)

barbe1958 · March 2016

I already have truncal LE...sigh. I asked today as they were mapping me, but they said that the CP is for focused treatment, just like I thought. Some tumours are beaten down by rads before surgery, but the area I need done is just too large.

Hopeful, thanks for the tip on moisturizing now!! I thought I couldn't do deodorant or moisture before rads and I can do both! They said don't come in gleaming with a thick layer of anything, but first thing in the morning is fine.

Hopeful82014 · March 2016

You're welcome, Barbe - I hope it helps!

I had a.m. appts. for radiation, so I waited until afterwards to apply anything (I think the rule of thumb was to allow 4 hours between application of lotions and radiation). Then I spent the rest of the day applying stuff as often as I could! I didn't use deoderant though, and I don't sweat on that side anymore, do it's a moot point for me. I don't have to shave on that side, either. I don't miss it, either.

Have a good weekend!

Question about criteria for Canadian protocol

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