Radiation Questions

TomM1956728

Hello,

I wanted to ask for help once again.

My mother is 86 years old. Her cancer has spread outside of her esophagus to multiple lymph nodes in her chest area.

She has been receiving chemo for almost a year. Initially, she was going once every 2 weeks and receiving the Folfox treatment at normal doses.

Since she was having a very difficult time with the serious side effects, over the last 8 months, she has been receiving chemo once every 3 weeks (instead of 2 weeks) and getting lower doses of the drugs. Some times, she was getting two drugs instead of three due to her low blood counts.

Fortunately, the cancer has not spread for now.

However, an endoscopy was done recently and showed that the tumor in the esophagus had grown slightly larger and more ulcerated with some mild oozing of blood.

Since my mother is having more trouble swallowing and more pain than before near the esophagus area, her doctor recommended that she have radiation done 5 days a week for 3 weeks.

Is radiation more difficult to tolerate than chemo? I recall that her oncologist did not want her to get any radiation last year cause he had mentioned that radiation is “more involved” than chemo. I’m still not sure what that means. Are the side effects from radiation more serious than the side effects from chemo?

Since this is the first time she is getting radiation, any advice or information you can provide would be deeply appreciated.

Thank you very much for your kind attention, time and assistance.

Tom

fredswilma

Hi Tom
I am the wife of a stg iv husband with mets to lungs, bones, he is 45 years old and has been through 2 lines of chemo which he tolerated well, tho the last line which was taxol he did not respond to so they stopped all Chemo. They offered my husband one week or 5 zaps of radiation, I do not wish to scare you and keep in mind that everyone reacts differently, he had that done just over a week ago and it really has taken everything out of him, he is on a cocktail of drugs to help with pain, nausea, constipation, basically he is bedridden his weight loss is significant.
I cannot for sure say this is all down to the radiation, and they also say the good effects of radiation can take up to about 6 weeks before we will see if he has responded but I would have to say at what cost? I know others on here who have responded well to radiation but for us I deeply regret not pushing my husband to say NO, no more .
I'm sorry and as I say I do not wish to scare you, but for us this should have been a no brainer, the radiation Doc pushed it because Mark is struggling to eat (only fluids) and he is not a candidate for a stent, so I think they pushed because there is nothing else to offer Mark. I hope others respond with better results but my suggestion to you would be to get personal with your mothers Onc, ask them if this was their Mum would they put her through this?.
It is your Mum's choice but make sure she understands what is involved.
Will be thinking of you as this is one of those decisions that leave you between a rock and a hard place.
Ann

sangora

fredswilma said:

Hi Tom
I am the wife of a stg iv husband with mets to lungs, bones, he is 45 years old and has been through 2 lines of chemo which he tolerated well, tho the last line which was taxol he did not respond to so they stopped all Chemo. They offered my husband one week or 5 zaps of radiation, I do not wish to scare you and keep in mind that everyone reacts differently, he had that done just over a week ago and it really has taken everything out of him, he is on a cocktail of drugs to help with pain, nausea, constipation, basically he is bedridden his weight loss is significant.
I cannot for sure say this is all down to the radiation, and they also say the good effects of radiation can take up to about 6 weeks before we will see if he has responded but I would have to say at what cost? I know others on here who have responded well to radiation but for us I deeply regret not pushing my husband to say NO, no more .
I'm sorry and as I say I do not wish to scare you, but for us this should have been a no brainer, the radiation Doc pushed it because Mark is struggling to eat (only fluids) and he is not a candidate for a stent, so I think they pushed because there is nothing else to offer Mark. I hope others respond with better results but my suggestion to you would be to get personal with your mothers Onc, ask them if this was their Mum would they put her through this?.
It is your Mum's choice but make sure she understands what is involved.
Will be thinking of you as this is one of those decisions that leave you between a rock and a hard place.
Ann

Radiation issues
Ann is right, everyone reacts differently to radiation as well as chemo. I have met folks while I was doing radiation that were having a terrible time. I had 6 rounds and had no issues at all. Now in all fairness, I was doing chemo at the same time and was on three meds for neausea. So I had no stomach issues. I also escaped the rashes and all that. Some have a real problem with sore skin etc. I would suggest you go into it expecting some trouble and then feel blessed if it doesn't happen. There are pills and creams to handle most any side effect. Sam Stage IV

JReed

Your mom
Hi Tom:

My husband's chemo oncologist told us that radiation is 80% of the workhorse in Don's treatment. Don just completed six weeks of daily radiation and five weeks concurrently of carboplatin and taxol chemo treatment. Both of these treatments are cumulative and each person responds differently, but radiation did seem to make swallowing food easier for Don, though he is still being told not to try to eat a cheeseburger or a steak (two of his favorite foods).

If mom can tolerate radiation and wants to do this - it may help. I would hope the doctors would know whether or not mom can tolerate this and what the benefits would be and that should be carefully explained to you.

Wishing you and your mom the best.

Judy

Ginny_B

My mom is 85
Actually she'll turn 85 on April 18th. EC diagnosed his past Sept. Tumor just over 8 cm in size. It is inoperable due to it's location (too close to lungs/heart). They did not recommend chemo for someone her age. They didn't think she could tolerate it, however, we saw a specialist who recommended low doses of 5FU in combination with a course of radiation.

After one week, she landed in the hospital with a chemical imbalance - low electrolytes, sodium, potassium, etc. She went off chemo and rads for about a week.

She went on/off chemo and rads one or 2 other times, but not serious enough for hospitalization. Once her labs were bad, another time her cough was bad, another time her skin burns from rads were bad.

On Jan 6 she completed 30 rounds of radiation in conjunction with low doses of 5FU, via 24/6 pump. (.036 drip per hour). I believe a lot depends on the health of the person being treated. My mom happens to be on the frail side. Legally blind, hard of hearing, tiny and petite. Her weight loss did not help (approx 40 pounds lost).

The rads caused severe burns on her chest. I had been treating her skin before/after treatments with Aquaphor cream, but then I left the country fro a few weeks and no one remembered the cream, so her skin burned badly. Takes a long time to heal.

The other very difficult problem was cough. It went from bad to worse to worse than that! I do think too that there was a drug administered to her (Lisinopril I think) that set off the cough. Combined with radiation, the cough took over. Nothing helped. She ended up losing her voice for a month or two. Her voice has returned but the cough remains though it has changed it's nature several times. First it was dry, then it sounded like a tickle, then it got sort of wet-sounding, now it's very congested-like.

She landed in the hospital a couple weeks back due to breathing issues and weakness. Ended up with them draining fluid out of her lung and cautioned that this could happen again. Dunno where it came from. It was called: Pericardial Effusion and Pleural Effusion.

Last week she went into the hospital (same day surgery) for an endoscope (EGD) and for a G-tube placement. Since then she has been on a liquid/puree/soft food diet. She has not had to use the feeding tube at all.

The scope showed that her over 8cm tumor shrunk to 2cm! We were delighted! She is slated for 4 rounds (once a week for 4 weeks) of Internal Radiation Boost. Her first treatment was supposed to be today, but just as we got the the offramp after driving for an hour early this morning, they called that the machine was down and that it would be rescheduled. (Grrrrrrr). We were told that the Internal Radiation Boost would most likely rid her of the remaining 2 cm.

It is my understanding that the Rads shrink the tumor and the chemo kills the cancer cells. (I could have that backwards.) You might inquire as to your mom going with some mild dose of chemo 24/7 with a pump in conjunction with her rads. Mom lives with me now ever since I got back to the USA in early December. She hardly suffered from nausea, but suffers from constipation due to the pain meds. When they did the EGD, they stretched her esophagus so she can swallow much better. We have a Home Health Nurse who comes over once a week. Best of luck to you! It's hard to see our moms this way, huh?
Ginny

TomM1956728

Ginny_B said:

My mom is 85
Actually she'll turn 85 on April 18th. EC diagnosed his past Sept. Tumor just over 8 cm in size. It is inoperable due to it's location (too close to lungs/heart). They did not recommend chemo for someone her age. They didn't think she could tolerate it, however, we saw a specialist who recommended low doses of 5FU in combination with a course of radiation.

After one week, she landed in the hospital with a chemical imbalance - low electrolytes, sodium, potassium, etc. She went off chemo and rads for about a week.

She went on/off chemo and rads one or 2 other times, but not serious enough for hospitalization. Once her labs were bad, another time her cough was bad, another time her skin burns from rads were bad.

On Jan 6 she completed 30 rounds of radiation in conjunction with low doses of 5FU, via 24/6 pump. (.036 drip per hour). I believe a lot depends on the health of the person being treated. My mom happens to be on the frail side. Legally blind, hard of hearing, tiny and petite. Her weight loss did not help (approx 40 pounds lost).

The rads caused severe burns on her chest. I had been treating her skin before/after treatments with Aquaphor cream, but then I left the country fro a few weeks and no one remembered the cream, so her skin burned badly. Takes a long time to heal.

The other very difficult problem was cough. It went from bad to worse to worse than that! I do think too that there was a drug administered to her (Lisinopril I think) that set off the cough. Combined with radiation, the cough took over. Nothing helped. She ended up losing her voice for a month or two. Her voice has returned but the cough remains though it has changed it's nature several times. First it was dry, then it sounded like a tickle, then it got sort of wet-sounding, now it's very congested-like.

She landed in the hospital a couple weeks back due to breathing issues and weakness. Ended up with them draining fluid out of her lung and cautioned that this could happen again. Dunno where it came from. It was called: Pericardial Effusion and Pleural Effusion.

Last week she went into the hospital (same day surgery) for an endoscope (EGD) and for a G-tube placement. Since then she has been on a liquid/puree/soft food diet. She has not had to use the feeding tube at all.

The scope showed that her over 8cm tumor shrunk to 2cm! We were delighted! She is slated for 4 rounds (once a week for 4 weeks) of Internal Radiation Boost. Her first treatment was supposed to be today, but just as we got the the offramp after driving for an hour early this morning, they called that the machine was down and that it would be rescheduled. (Grrrrrrr). We were told that the Internal Radiation Boost would most likely rid her of the remaining 2 cm.

It is my understanding that the Rads shrink the tumor and the chemo kills the cancer cells. (I could have that backwards.) You might inquire as to your mom going with some mild dose of chemo 24/7 with a pump in conjunction with her rads. Mom lives with me now ever since I got back to the USA in early December. She hardly suffered from nausea, but suffers from constipation due to the pain meds. When they did the EGD, they stretched her esophagus so she can swallow much better. We have a Home Health Nurse who comes over once a week. Best of luck to you! It's hard to see our moms this way, huh?
Ginny

Thank you!
Hello Everyone,

I appreciate all the information and advice. It was very helpful.

Seems like everyone reacts differently from radiation. I’m really sorry Ann that your husband has suffered so much. I hope he is beginning to improve. Like you say, I will make sure to ask the oncologist whether he would put his mom through radiation.

I’m glad that Sam and Judy’s husband have obtained good results from the radiation. It’s good to know that positive results may be possible.

Ginny, your mother is a very strong woman to be able to be able to endure the chemo and radiation. It’s great to see that her tumor shrunk from 8 cm to 2 cm. That’s awesome! At this point, I’m just hoping my mother won’t get seriously ill from the radiation.

Thank you all for your feedback and kind help!

Tom

Wife of patient 50378

My husband's radiation treatment shrunk his tumor, "no visable sign". How ever swallowing became extremely difficult and very painful. He has alot of scar tissue and an ulcer. Pain relief is a must in my opinion.

First Magic Mouth Wash- termporary pain relief,numbs but wears off fast
Next he tried Carafate- lubricates makes swallowing a little easier
Then a *liquid Hydrocodone pain relief* but will not help heal ulcers

****Prescription Prilosec (omeprazole) sooths and compliments the healing process.

The Prilsec helped tremedously, 2 times a day. Hydracodone he still takes Periodically.

Call the Doc if she has pain. There is no reason she should have to experience pain with all of the meds available. Hope this helps

My thoughts are with you
Sal

monica_sss

No Side Effects outside norm
Hi Tom,

My Mom's situation is much like Judy's (same chemo cocktail + daily radiation). She only has two more treatment days to go!! Aside from continued difficulty eating (it's always hit or miss) and weight loss & hair loss, she has tolerated both well. She cannot say for sure, but she attributes most of the "icky" side effects (nausea, loss of appetite, fatigue) to chemo. She doesn't really associate the radiation with anything other than the need for cream for the itchy spot on her chest. It helps that she really loves the radiation techs. Overall, in my Mom's world view, she sees chemo as being tougher than radiation... but who really knows? She tends to like not knowing "side effects" and just taking it as it comes.

Good luck to Mom,

-M