Number of Treatments And Dosage

mdmurphy

Does anyone have any information concerning how the Medical Oncologists and Radiation Oncologists calculate the dose and number of treatments? I have tried to extract this information from my two doctors, but have received somewhat of a "are you questioning me, the Doctor" response. Is it a coincidence that there are so many 30-35 treatment periods--almost regardless of the type of cancer,etc? Please help me to regain my confidence in a treatment system where I am now starting to suffer the side effects.
Thanks,
Michael

TereB

Hi Michael, Sorry you have to have radiation. Don't know exactly how radiation treatments are calculated. I've had radiation many times and my radiologist knows how many doses I've had and how much I can receive in the same area again. Usually I get five days each week for about 4-5 weeks. Once dose was doubled so I had radiation for two weeks only. I trust my radiologist and he will answer my questions. Radiation has worked for me and my doctor helps me with the side effects which do not last forever even though sometimes they are not pleasant. Each case is different. It is the radiation oncologist who decides which is the best dose and for how long. He should also see you once a week during radiation treatment to check on how you are doing and take blood samples, etc. once a week. Usually radiation on abdomen causes a lot of nausea. I've had radiation in abdominal area, head and neck areas. I hope you can get answers from your doctor and that the side effects you are starting to feel are not too bad.
All the best,
Tere

nckaren

From my own experience, my doctor researched what the "usual" dosage and length of treatment for my cancer was and went from there. As it was, I did have 30 treatments which left me very ill. I am still in recovery, but with the odds in my favor that I am totally cured, it was worth it. Karen

LostinVA

I am also sorry that you have to suffer through radiation and its side effects. What type of cancer do you have? I had Nasopharyngeal Stage III which spread to the lymph nodes. I got 39 rad treatments and 2 chemo. The rad oncologist used statistics based on what worked in the past for my cancer and stage. I am 7 weeks out of treatment and finally turning the corner, but it was a rough time. The good news is that all looks good. All the suffering paid off. If you have any questions about side effects and coping, I would be pleased to help you.

mdmurphy

Thanks for the feedback so far on my questions. I am however, still at a loss as to how the treatments and dose is calculated for my tongue cancer. I am starting to feel like few people are asking these questions and wondering if they ever had--my doctor was dumbfounded that I would ask such a question. And that leaves me with a real concern that the treatments and dose could be calculated with considerations that don't totally center around me, the patient. Suspicous? I am trying to remain positive thoughout my treatments, but things like this really bugs me. If my doctor handed me a print out of the specifics used in calculating my treatments and dose, I would have been much happier. I will be upset if I find that corporate profits and convienence are any components in figuring out treatments and dose--and hence the costs, pains, and aggravations I am going through. If there are any Radiology Oncologists out there, please give me some peach of mind!!!
Michael

AuthorUnknown

mdmurphy said:

Thanks for the feedback so far on my questions. I am however, still at a loss as to how the treatments and dose is calculated for my tongue cancer. I am starting to feel like few people are asking these questions and wondering if they ever had--my doctor was dumbfounded that I would ask such a question. And that leaves me with a real concern that the treatments and dose could be calculated with considerations that don't totally center around me, the patient. Suspicous? I am trying to remain positive thoughout my treatments, but things like this really bugs me. If my doctor handed me a print out of the specifics used in calculating my treatments and dose, I would have been much happier. I will be upset if I find that corporate profits and convienence are any components in figuring out treatments and dose--and hence the costs, pains, and aggravations I am going through. If there are any Radiology Oncologists out there, please give me some peach of mind!!!
Michael

I had 5 treatments a day Monday through Friday for the months of November and December. Both are 5 week months, but because of the holidays, I had 4 of those days off. They didn't work on Thanksgiving or the day after or on Christmas Day or the following day, since this would have been a Friday.

The total dosage of radiation I had was 7200 rads in those 46 treatments.

Every case is different and depends on the size and location of the tumor. You just have to have faith and confidence in your radiation oncologist that they are giving you the proper dosage in order to treat you properly.

DANorton

I have(hopefully had)cancer at the base of my tongue. It was classified as stage 4 due to the size of the tumor and the fact that there was early lymph node involvement. I had 39 radiation treatments. In asking my doctor (radiation oncologist)about how it was planned he said that it was based on the size of the tumor, my health condition at the time of treatment, and the machine they were using on me. (ERT I believe)He showed me a file that detailed the planning which included computer images and all. In glancing at it it was well beyond me. I put my trust in him and went for it. I finished treatment April 15 04 and at this time they say that MRI imaging and looking down my throat with scopes shows no evidence of disease.

RadOncResident

mdmurphy said:

Thanks for the feedback so far on my questions. I am however, still at a loss as to how the treatments and dose is calculated for my tongue cancer. I am starting to feel like few people are asking these questions and wondering if they ever had--my doctor was dumbfounded that I would ask such a question. And that leaves me with a real concern that the treatments and dose could be calculated with considerations that don't totally center around me, the patient. Suspicous? I am trying to remain positive thoughout my treatments, but things like this really bugs me. If my doctor handed me a print out of the specifics used in calculating my treatments and dose, I would have been much happier. I will be upset if I find that corporate profits and convienence are any components in figuring out treatments and dose--and hence the costs, pains, and aggravations I am going through. If there are any Radiology Oncologists out there, please give me some peach of mind!!!
Michael

Hi,

I just replied to your post in another thread, so I will keep this one a bit shorter.

Radiation Dose is calculated to maximize "therapeutic effect" which is to ideally maximize tumor kill while minimizing toxicity to the surrounding normal tissues.

Generally speaking, most cancers grow less with smaller, frequent doses of radiation as compared to a large single dose.

These doses are based on not only laboratory data with cell lines and rats/mice, but also clinical trials which have looked at the use of radiation in cancers such as yours. We want to give as much dose to the tumor as possible without hurting the surrounding structures (like the mandible, or jawbone in your case).

For more detailed accounts of how and why doctors have arrived at the therapy you received, I recommend you thumb through a radiation oncology textbook (try a local medical school library). There is an excellent head and neck cancer textbook by Louis Harrison, which I think is available online at www.lww.com, but it costs a pretty penny. There is also a general oncology textbook by Vincent DeVita that is very good as well. You will find that much of the material is over your head, but it should give you some idea of how and why we do what we do.

Let me know if you have more questions.

kiren

DANorton said:

I have(hopefully had)cancer at the base of my tongue. It was classified as stage 4 due to the size of the tumor and the fact that there was early lymph node involvement. I had 39 radiation treatments. In asking my doctor (radiation oncologist)about how it was planned he said that it was based on the size of the tumor, my health condition at the time of treatment, and the machine they were using on me. (ERT I believe)He showed me a file that detailed the planning which included computer images and all. In glancing at it it was well beyond me. I put my trust in him and went for it. I finished treatment April 15 04 and at this time they say that MRI imaging and looking down my throat with scopes shows no evidence of disease.

Hi I have recently been diagnosed with squamous cell carcinoma at the base of my tongue. I am waiting for the doctor to confirm my MRI resluts and as far as she said the results show some lateral involvement and an enlarged lymph node( not sure yet whether it is involved)I am due for a surgery and kind of scared from it all. any comments.