Radiation, Left Breast Cancer, and Deep Inspiration Breath Hold

My sister, Diann, recently finished Radiation for Stage 3 breast cancer of the left breast.  One reason she drove 120 miles round trip daily for 7 weeks was that a newer technology called “Deep Inspiration Breath Hold” was available.  This technique helps protect the heart and lungs from radiation while the left breast area is being treated.  The patient dons scuba-like gear and has to hold their breath for 10 to 25 seconds periodically during the radiation process so the chest wall pulls away from the heart and lungs and thus, the radiation stays away from the heart and lungs as well.

When I had radiation three and a half years ago, also for left breast cancer, I did not have this, nor did I know it existed.   This is a marvelous breakthrough to help women prevent heart and lung damage.  I suffer from both heart and lung damage from cancer treatment, so I am grateful my sister was able to have this technology.

If you need radiation for left breast cancer, I would URGE you to seek out this type of radiation treatment.  It will most likely take some research on your part, but it will be well worth it.  I hear from so many women that have heart damage years later because of radiation damage.  Just this week, I spoke to a 77 year old woman who needed a valve transplant due to damage 10 years after radiation for left breast cancer.

This picture of Diann shows her with the apparatus– the interactive device between patient and radiation.  Notice the glasses as well.  The patient interacts with the radiation technicians and the computer screen which is visible to the patient through the glasses.

Deep Inspiration Breath Hold Radiation Left Breast Cancer

 

This following is a terrific video from the United Kingdom that explains in simple terms more about this technology.   PLEASE take this into consideration before you get radiation for left breast cancer!

 

Tips for Radiation during Breast Cancer

My radiation treatments for Breast Cancer will soon be over.  I had 28 regular radiation treatments and now will have 5 boosts to the scar area of my mastectomy.  My treatment was on the left side of my body.  My experience through Radiation was better than I had imagined.  I am so grateful for this.  It is time consuming because you have to go to the hospital or clinic on a 5 day a week basis, but it truly flies by.  Plus, I had amazing Radiation Technicians.  They always put me at ease, told me getting tired was for older people,(since I am in my 50s this made me feel good) and explained every procedure that was done to me.

My skin got red and itchy, but nothing like the horror stories I imagined.  More like a day at the beach and you forgot your sunscreen on more than one occasion.  Of course, I slathered and lathered potions and lotions on it.  Damage to my lungs and or heart was another major concern.  So far so good.   And 6 weeks into it, I am still wearing a bra.

Here are my recommendations for Radiation and Breast Cancer:

1.   Buy at least two 100% cotton tank tops.  I laundered them only in hot water as I didn’t want irritation from laundry soap.   Each day, I put the tank top next to my skin.   I then put on a 100% cotton sports bra in a size larger than what I wear, and inserted my foam boob (did not wear regular prosthesis) between the tank and the bra.  The cotton tank helped with any irritation.  It has been great!

2.  I had all kinds of lotions, but the two that helped me the most were Calendula Ointment (I know sell this in my shop at www.hellocourage.com ),  Hydrocortisone Creme which helped with itching and rash and Miaderm for radiation burns.   The other things I had caused me to itch late in the game (Aloe, Calendula Creme).  My Radiology Oncologist said that happens so just use the Hydrocortisone Creme.  I did and it worked.  The Miaderm helped the redness and burning the last two weeks of Radiation.

Put these cremes on at least 4 times per day – immediately after treatment and 3 other times spaced throughout the day.

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3)  For bath soap, I used Dr. Bronner’s Organic Bar Soap for babies.  I would lather my hands and just lightly wash the radiated area as to not cause irritation.  I had absolutely no trouble with this soap and probably will continue to use it.

4)  It is necessary that you stay out of the sun during radiation.  That was challenging since I am in the middle of summer, but I did it.  If I had to be in the sun I wore a hat, covered up with clothing, and wore sunscreen on any areas that were exposed.

5)  No swimming in chlorine pools or lakes during Radiation Treatment.  The chlorine is too drying to the skin, and swimming in lakes can cause infection.  My Radiology Oncologist said wait at least 2 weeks after treatment.  If my skin has no open sores or blisters, go ahead and swim.

6)  During Radiation to the breast area can put you at risk for pneumonia or pneumonitis.  One thing I did to help my lungs was to use one of those small, plastic breathing machines called a spirometer.  They always give you those when you are in the hospital to prevent pneumonia.  I found my lung capacity did shrink during Rads, so this helped me deep breathe and expand my lungs. Mine is called a Voldyne 2500.  You can find one on ebay for under $10.00. You should use them 15 minutes a day twice per day.   If you don’t get one of these, at least do deep breathing exercises.

7)  If you have Lymphedema or are at risk for it because of lymph node removal, see if your hospital provides lymphatic massage or see a lymphedema specialist.  I was fortunate to have both during Radiation Treatments.  It helped keep my Lymphedema arm under control and the massage helped the radiated areas be more supple and less like fried, crisp bacon.

8)  Do exercise stretches of the affected area several times a day.  My arm and breast area were particularly tight in the morning.  The first thing I did upon waking was do stretching exercises.  This will help you in the long haul, and help you feel less pain.

9)  I really was fortunate and wasn’t that tired during Radiation.   I may have gone to bed a little earlier, but it was nothing like Chemo Fatigue for me. Chemo Fatigue was debilitating.  Radiation Fatigue was not.   If you are tired, rest.  You are still in the middle of cancer treatment.  Your body has been through so much.  If it cries out for rest, do it!

What is Radiation like during Breast Cancer

Oh how I dreaded Radiation.  Probably more than Chemo.  My aunt was a Radiation Tech back in the 1950s and told me all of the horror stories.  However, my actual experience has been far better than I hoped it would be.  Thank you modern technology.

After your initial CT scan, not a diagnostic CT, Radiation Oncologist maps the area.  The Rad Onc team figure dosage, and try to miss your heart and lungs and in my case the esophagus.  That’s all scarey, but I don’t have any control over it.  I chose my physician and facility wisely, and that’s all I can do.

The 5 days a week going to Radiation is tiring, but it goes by quickly.  I am half done (almost) and it does fly by.  When I get to the hospital, I get called back usually right away, take off my upper clothing, get under the machine in my custom fit body mold that was done previously.  The Rad Techs line you up with the miniscule tattoos that were placed on mapping day.  There are laser beams located in the radiation room that align with your tattoos, and you are in alignment. I’m getting so good I can almost line myself up now.

I really like my Rad Techs and nurse, so I probably talk to them more than I should.  After all those months of Chemo locked up in the house with little socialization, when I get out now, I want to talk!   When they finally can get out of the room, the machine is on a pre-programmed cycle and is pretty much the same every day.  Mine lasts for about 8 minutes. You have to put your hands over your head.  I tend to squeeze the bars too hard and cause myself tension.  It is frightening the first two times, then the high powered machine sort of becomes your friend.  You get used to the sounds and noises.

Once a week, the Radiology Oncologist checks you, your vitals, your skin, and your side effects.  And also once a week, a couple of x-rays are taken under the machine to make sure you are still lined up properly.

Side effects –

Skin – every day I slather my lotions and potions on my Mastectomy breast, up to my neck because they radiate up to the upper lymph nodes, under my arm, and on my entire back as treatment is received there as well.

Immediately after treatment I use www.mygirlscream.com which has done really well for me.  It was developed by a woman who had Radiation Treatment for Breast Cancer.   The other lotions I use are Aloe (recommended by Rad Onc), Cortisone 10, and Miaderm which is for radiation burns.  I’ve not used the Miaderm as yet.   I put on the lotions at least 4 times a day.

My skin is holding up well so far.   My sun damaged areas are worse than the areas that never saw the sun.  That surprised me.

No Bra – So far I figured out a way around this rule because I needed to be more balanced.  A Breast Cancer Survivor shared this tip with me, and it works!   I bought an inexpensive 100% cotton thin white tank top (got mine for $5.00 at Walmart).  I wear that next to my skin.  When I launder it, I just wash it in hot water no laundry soap.  Then over that I wear a 100% cotton front-snap sports bra in a size larger.  I then insert my foam boob aka foob in it.  I do not wear my heavy prosthesis.  Then over all of that, I place another cotton tank top.   It has prevented my skin from chafing and not caused any irritation thus far.

Lymphedema – I had 14 nodes removed and 9 had “activity”.  So I get hit pretty hard with radiation in the lymph area.  This can cause lymphedema.  I’ve already had Lymphedema problems, so I see a Lymphedema specialist for massage, and another massage therapist the hospital provides to help the lymphatic flow keep moving during radiation.  This has been a tremendous help to me and thankfully, my insurance has paid for it.

Tightness in my arm is a big problem so it is essential you do your arm exercises every day if you had node involvement and are being radiated for it.  I don’t like this imagery, but I read that radiation can make your muscles curl up like frying bacon, which makes sense.  The minute I get out of bed, I do my stretching exercises.  It helps tremendously.

Fatigue – They always throw “fatigue” at cancer patients no matter what because it becomes a way of life.  But after so much Chemo where I was so drained that I couldn’t get out of bed, this has been a cinch for me.  I do go to bed early and rest an hour or two before my actual sleep time, but the fatigue has not been bad.

No swimming – Since it is 100 degrees here today, the no swimming in chlorine pools is disappointing.  And no swimming in lakes that could cause you infection (all of them in my area of the Great Lakes could cause infection), so swimming is out for me unless a kiddie pool up to the waist.

Drink lots of Water – No one in the medical field told me this, but I figure it is a cure all for everything else, why not!  Plus, it would help lubricate the area I would think!!

Don’t Read the Internet too Much – Oh my, there are a lot of stories out there that will put real fear into you.  Don’t read them.  If you made up your mind to have Radiation, have Radiation.  Make a wise facility choice, and do the best you can.

Radiation Treatment, Breast Cancer, and a Sense of Humor

Radiation Treatment began for me – the first treatment of 33 was June 11, 2012.  Previously, I had my mapping sessions, tattoos placed, and met with Radiation Oncologist.  Radiation can be very emotional for many women who have gone through surgery and Chemo.  I cried for 3 days after I met with my Radiation Oncologist because it seemed as if I had just ran a marathon, and suddenly someone was telling me I had 10 more miles to run!

On the first day of Radiation, I was extremely nervous.  It felt like I was starting a new job since I would have to be there every day at the same time for 7 weeks.  I received Radiation Treatment at a local hospital, even though the rest of my treatments have been at the University of Michigan Breast Cancer Care Center which is 60 miles away.  Pure convenience made my choice for me.

Arriving at my first treatment, the very nice middle-aged female tech, Pat, told me to remove my clothing from the waist up.  So I did and laid them on a nearby chair and put on a hospital gown.  Just then, Pat says, “Oh your other tech will be Brad.”  Just then Brad appears and is a very attractive, hunky late 30s early 40s male.  First words out of Brad’s mouth were, “Oops, you dropped something.”    I look down and there is my Foam Boob aka Foob lying on the Radiation Room floor!   I busted out laughing and said, “That broke the ice” and Brad says, “Oh, we see all kinds of things in the Radiation Room!”

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Radiation is a lonely experience.  Although Chemotherapy is hellacious and watching those poisonous drugs go into your body is extremely horrifying, the Chemo infusion experience is very personal and caring with a lot of human interaction.  With Radiation, you have little human interaction, and the rest is just you and the machine that hovers over you and moves all around.   The first day takes more time because the Radiation Oncologist has to check the alignments, pictures need to be taken, and extra care is needed.  On Day Two, it is a “slam bam thank you ma’am” kind of experience!   You get in, take your clothes off, get under the machine, and boom, it does its thing.

The rest of the day you have to slather your breast area numerous times with lotions and potions to prevent skin damage!  There is Aloe, Miaderm, My Girls Cream, Jeans Cream, Calendula Cream, Emu Oil, to name a few!   The other adventurous part of Radiation is you should NOT WEAR A BRA to avoid irritation which means no prosthesis!  Now I have one big boob, and one boobette.  It is almost the first day of summer and has been over 90 degrees on many days.  How is a woman to disguise that fact?

One solution I real about was to wear a 100% cotton tank top underneath a Sports Bra that is a size too big for you.  I have chosen to do this for awhile and see how it works out.  Since I can’t wear my nice supportive bra with my $400.00 prosthesis, this Foam Boob and sports bra is a source of much entertainment!   Foob over Boobette is riding just under my chin while Big Boob is hanging just above the waist!  You have to have a sense of humor to deal with this!  Today, I found myself reaching down my tank top in a public place to shove Foob down and it popped out under Sports Bra!  I mean, you never know where that Foob will end up.  They have a life of their own!  Also, I have been trying to come up with an ingenious way to carry my purse over my chest in an inconspicuous way.

Scarves are another solution, but since I already am wearing my hot wig, two tank tops, a sports bra, a jacket or sweater to help with coverage, adding a scarf in 90 degree weather is strictly to mop up the sweat!    Another coverage solution are vests which are more difficult to find in summer fabrics than winter fabrics.  Wearing my goose down padded vest with nothing underneath would be cooler than what I am wearing!

One side effect of Radiation is fatigue.  Of course there is fatigue. I don’t think it has anything to do with the Radiation Treatment killing your cells. Duh, fatigue is from driving back and forth to daily treatment, dressing and undressing, slathering lotions and potions, and trying to tame Foob and Big Boob into some kind of order!   I didn’t need a scientist or a doctor to figure that one out!