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Difference between radiation treatments

jackflash22's picture
jackflash22
Posts: 227
Joined: Aug 2013

what is the difference between radiations. What other radiations are there apart from IMRT. Which is the worst one for side effects. 

fishmanpa's picture
fishmanpa
Posts: 1106
Joined: Jan 2013

While I don't know the details of the different types, I had Tomotherapy IMRT (in fact, they named the machine "Tomo"). Tomotherapy is an image guided IMRT which uses a CT scanner to more precisely target certain areas and spare healthy tissue. It operates in a similar manner as a CT scanner in that it rotates around the patients head. I got to know exactly how many rotations it took for my treatment and often would focus on counting the revolutions to let me know how close I was to finishing. 

"T"

jackflash22's picture
jackflash22
Posts: 227
Joined: Aug 2013

That sounds like my treatment plan. When the mask was made I had to wear it in a ct type scanner and they drew marks over the mask, then they all get together with the ct results, and make a plan for the best treatment for me. What puzzled me was when I had my 6 weeks assessment the surgeon said my tongue and neck op was a success. he said the ,clear, margin around the tongue tumour was close to the edge, but he didn't say it was over the edge so I guess that's why I,m having the radiation but there again I may not have really needed it. it,s a case of being safe rather than sorry. I won't ever know . Did you get terrible side effects during and after.

phrannie51's picture
phrannie51
Posts: 3636
Joined: Mar 2012

The most common being loss of taste, dry mouth.....and a bad sunburn on your neck.  I think we ALL had these to varying degrees.  Dry mouth is actually "desert mouth".....a bottle of water will be your constant companion.  There is also a possiblity of mouth sores, sore throat, mucous buildup, and a very tender mouth (that's where the PEG tube comes in handy). 

Within the first two weeks I had the dry mouth and my taster was kaput....I used Mugard for mouth sore prevention, and it worked for me.  I never really had a sore throat, tho my mouth got tender...I started using Boost and Ensure Plus for nutrition, with some soups etc during the 7 weeks of rads.  My bad side effects came with the adjuvent chemo after rads were over, and I don't think you're getting those. 

Just stick close to this board, and we'll get you through many of the side effects.  The Drs. generally don't know about some of the simple tricks to get us through them, but the folks on here know....and we'll help you.

p

jackflash22's picture
jackflash22
Posts: 227
Joined: Aug 2013

I had a letter today from hospital, my op forPEg is 23 sept but my rad starts 18 sept. I phoned my dietician s secretary and she,s going to get in touch with my dietition to see if its Ok to havePEg put in after the rad starts. I have to be in a different hospital close by then they will transport me to my hospital to recover over night. I,m in the first hospital at 8.30 for op my rad is 10.30 each day. I wonder how they can do both my rad and op.........

phrannie51's picture
phrannie51
Posts: 3636
Joined: Mar 2012

only takes about 45 minutes....and they use "twilight" anethesia....I always fall asleep on that stuff just like the big knock out drugs, but you wake up within 15 minutes after it's over. 

Yes you can have the PEG put in after radiation starts....many people have opted to wait and see, then end up needing a PEG tube down the line after rads are started.  Our friend  "T" (fishmanpa) got his PEG tube in the day he finished radiation....

I'm glad they are going to let you stay the night after you get the PEG placed....for some of us, there is quite a bit of cramping for a couple of days (for some others, it was nothing)....

p

jackflash22's picture
jackflash22
Posts: 227
Joined: Aug 2013

I think I shall need the PEG if my throat swells. For a couple of weeks I was Ok with my swallowing but the last week I do nothing but cough when I eat then end with a sneeze, my throat tickles and prickles. I don't know why unless there's something caught in my tonsils near my mended tongue or maybe there's a stitch still in the tongue that's sticking out. I,m getting a bit paranoid that my tongue is rejecting the flap. reading other people's fears I guess we all fear something is going wrong. I keep feeling under my ear where the scar ends and now some feeling has come back, I am qute sore in the ear and have a bit of a swelling around that area. I was so positive when I first came home from Hospital but the longer i wait for the rest of the treatment the  more worried I become that it won't work, are these post op blues........

donfoo's picture
donfoo
Posts: 1166
Joined: Dec 2012

As you are new, you missed the last set of PEG wars around here. I am on the side to not get a PEG until it is needed. Getting one "in case" you need it just sounds stupid toe me. If you need one during treatment get it put in. So you feel like crap, getting the PEG placed then is less hassle than the oft times cited side effects of having to deal with a PEG throughout treatment. don

jackflash22's picture
jackflash22
Posts: 227
Joined: Aug 2013

To be trueful I didn't question it, I thought it was part and parcel of the package. They just said I was getting one so I took it for granted everybody needs one. Its no big deal I may be thankful for it, I had trouble feeding after my op for a while.  It wont be there long and I think its a very quick op. ...

phrannie51's picture
phrannie51
Posts: 3636
Joined: Mar 2012

Some have been around for a while, but are "newer" in terms of being used for HNC.  One of our members is getting SBRT this week.....which I think is realatively new.....Cyber knife is another.....Oh...and Proton RT.  I think these are most often used for reoccurrences.  They supposedly have less side effects because they target the tumor, with less damage to healthy tissue....and I believe that treatments only last a few days to a couple of weeks....where as IMRT lasts for 6 - 7 weeks.

p

donfoo's picture
donfoo
Posts: 1166
Joined: Dec 2012

I'd guess 90% get IMRT for HNC if they have radiation therapy. The RO strive to minimize the damage to your head and neck during radiation and I know in my case, since I asked, why I got the latest and greatest IMRT rather than the other machines. They said because HNC radiation is really involved due to all the nearby fragile organs so they want to minimize the collateral damage.

Based on what you have provided about your case, it seems to fall in line with a "standard" IMRT treatment. 72 grays - 35 x2 grays. 7 weeks 5 times every week. There are some trials and limited cases where deescalation is being done (in the 60-62 gray range) but I would never agree to be a guinea pig in a trial to "test" if lower dosage does not alter morbity rates unless my body was so compromised they refuse to give the full dose as specified by NCI standard of care.

Skiffin16's picture
Skiffin16
Posts: 8058
Joined: Sep 2009

Out of curiosity...

Where did you find that IMRT was stated as "the worst one for side effects....", and which ones were they comparing IMRT with?

Did they give any reference to results as for effectiveness on killing cancer and survivor rates?

JG

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