working during radiation

lovemyhubby

I completed chemo on December 5, 2017 and am scheduled to begin radiation therapy later this month.  I returned to work in January and hope to work full time during radiation treatments.  Radiation therapy scares me more than chemo ever did.  I have had issues with my bowels for years and chemo has further damaged them.  I need advice on how to manage side effects, (especially as they relate to diarrhea), while working.  Does diarrhea start immediately after the radiation treatment or several hours later?  How did all of you who have had radiation manage the fatigue and continue working?  Any tips you can provide would be so helpful.

Donna Faye

What kind?

I have had radiation twice - 20 years ago for BC - 5 days a week for 6 weeks and never missed a day of teaching high school.  In 2017 had 5 bracky and again had no problems and I am old  (77). I had wonderful doctors and techs both times and do think how they took care of me helped.  I do eat well and I exercise 3 days a week even during radiation. I also sleep well at night and get in 7 -8 hours.  If you pace yourself, you should do well. 

If you are having external, others may have more advice.  Don't be afraid. There are meds to help with after effects.

Best!

cmb

Donna Faye said:

What kind?

I have had radiation twice - 20 years ago for BC - 5 days a week for 6 weeks and never missed a day of teaching high school.  In 2017 had 5 bracky and again had no problems and I am old  (77). I had wonderful doctors and techs both times and do think how they took care of me helped.  I do eat well and I exercise 3 days a week even during radiation. I also sleep well at night and get in 7 -8 hours.  If you pace yourself, you should do well. 

If you are having external, others may have more advice.  Don't be afraid. There are meds to help with after effects.

Best!

Dealing with radiation

I've had issues with diarrhea ever since I started Metformin a few years ago. And it was worse during chemo. So I was also very concerned about diarrhea when starting external radiation a couple of months after chemo.

First, I asked for the earliest treatment time in the morning that was available. Then I just didn't eat or drink anything before my treatments. I wasn't on a radiation treatment that required me to drink a lot of water beforehand, so this worked to control the brief queasiness I had right after treatment. And I could be somewhere near a bathroom when I did eat later – just in case.

I also followed the low fiber/bland diet that the radiation team gave me. Initially, I wasn't too sure this would help, given my history, but after a couple of incidents (precipitated by fresh tomatoes from the farmer's market!), I resigned myself to sticking with the diet for the duration. I will say the diet worked for me.

The nurse also recommended taking a teaspoon of Metamucil in 4 ounces of water daily, but I didn't find that I needed to do this.

I wasn't particularly tired during radiation, unlike during chemo. I had a big project that I was working on during this period and was able to complete it on time.

My main side effect from radiation was inflammation of the bladder the last week of treatment that took about 3 weeks to subside. Although I asked for, and received, a prescription, I didn't find that it was all that helpful. Driving in my car was the worst – the seat seemed to put pressure in the wrong place. I made sure I had a pillow to sit on while working.

While I know that sometimes side effects can pop up in the future, I'm doing fine almost five months after the last treatment.

Violet123

Hi love my hubby

We're in the same boat.  I recently finished chemo. Went back to work half way through, and I will be starting external radiation in About 2 weeks. I also am nervous about the side effects. I've been reading that probiotics and Imodium are helpful.  From what understand, the side effects can start around weeks 2-3.  

I have questions about what supplements to take and not to take during the radiation as I've seen conflicting advice on the internet about vit. C, E, A. Is it ok to take milk thistle for liver detox during radiation treatment?

What have others put topically on the skin to treat the irritation after treatment? I am going to try calendula extract and aloe vera to avoid extra chemicals in lotions, especially those with estrogenic effects.

derMaus

Perineal bottle, antioxidants

Over time, I developed dry lizard-y skin on much of my body. It was painless so I ignored it until it started flaking, then exfoliation and lotion got rid of it. I used a loofa and Dove Cream Oil lotion or extra strength Lubriderm. The radiation techs told me to get aloe vera, but frankly I found it useless: I needed something heavier and creamier. I did have other effects almost immediately, though: I threw up within an hour of the first treatment (vagus nerve) and was completely exhaused, sometimes taking 2 naps a day. The tiredness was funny: when it hit, I went down hard, about like a toddler who's running arond and then crashes into a nap. My radiation was both pelvic and abdominal so I was getting a double dose; if yours is only pelvic you may have less. Diarrhea and loose stools were a given and started early on, but were controllable with Amodium and faded a month or so after I ended treatment. You do want to get a good probiotic (40 billion, 8 strands) and take it twice daily; that will help your digestive system a LOT.

I finished radiation six months ago and have no lasting effects other than a proclivity toward UTI's, which dimished with time and with care. I highly recommend getting a perineal bottle (an excellent tip from this board) and using it every time you go pee. You can find them on Amazon, etc., or you can use a small condiment squirt bottle. I'd squirt, then blot, and go on my way. As soon as I started that I never had another UTI.

Also *do not* take antioxidants and vitamins while undergoing radiation unless your radiation onc has specifically cleared them. The purpose of radiation is to damage the cancer cells and anything that protects normal cells also protects them. I stopped several of my supplements and didn't resume until a week after I was done. There's much good information to be had on this board, and everyone was very supportive with any questions I had during the process. Best of luck to you and remember it will be over soon! B

NoTimeForCancer

lovemyhubby, I had both

lovemyhubby, I had both external and brachy.  I worked the entire time.  I TOTALLY understand your concerns re: possible diarrhea - oye!  The radiologist completedly FREAKED ME OUT about how bad it can be, and while I had a slight problem in the beginning of the initial external radiation, I have always took probiotics.

The dietician I met prior to radiation had shared a study with my on women with cervial cancer, where half took probiotics and half did not.  The half that did not had terrible diarrhea - some so bad they were hospitalized with dehydration.  The women who took probiotics did WAY better.  

I would recommend taking probiotics.  I did work throughout all of it.  I will say I did have fatigue that I had never experienced in my life, and radiation can continue to work for up to six weeks.  I would fall asleep at 7 pm and didn't try to fight it.  I figure sleep is restorative - so went with it 

Everyone is different with their reactions as you will see, my external was IMRT and I did not experience any radiation burns.  

Jairoldi

I chose not to work during radiation

I had plenty of sick time in the bank and was able to use my long term disability insurance. After going through surgery and chemo I was already tired. I ended radiation November 30 and started back to work the first week in January. I worked one day then came down with a 24 hour bug. I stayed home the rest of the week. The following week I also got sick one day but recovered more quickly. I worked myself up to 75% time by Feb. 1. I still get very tired but my endurance is building. We only get one good chance to recover well is what my radiologist told me. I am impressed with those that worked full time. 

lovemyhubby

Thanks to you all for your

Thanks to you all for your advice and encouragement.  I have been taking probiotics since I started chemo.   Not sure how much they have helped because I am still experiencing diarrhea nine weeks after chemo.  The metformin (I am not diabetic) may be contributing to this so I plan to stop taking it until after radiation is completed.  Have also stopped using vitamins and supplements as well. 

Low, fiber, low residue diet, perineal bottle, stay close to a bathroom especially after eating, good creamy lotion and possibly aloe vera, sleep when needed.  Check.  Guess I will be making a good run to the store soon to stock up.

I am so grateful for the information and advice I get from this forum.  I was given a pamphlet from my cancer center to help me prepare for this next phase.  However, I get better ideas and advice here.  During the past month I have had two coworkers diagnosed with cancer.  I have told both about this sight. 

 

 

 

 

takingcontrol58

Metformin and diahrrhea

Lovemyhubby,
Make sure you are taking the extended release version of metformin.
See if that helps with the diarrhea.

Takingcontrol58

 

derMaus

Also, Depends

Also, consider a small package of Depends. I was mighty affronted that I had to purchase them, and only really used them once, but having 'em around was a big comfort. I always took a pair when traveling or in other places where I was uncertain of the bathroom facilities. The price of a package is worth it in peace of mind, IMO.

MAbound

Immune System

One big difference I noticed between chemo and radiation was that my blood work did not bounce back as fast as during chemo. It went down and stayed down during treatment and for several months after. It's important that you had/get a flu shot before radiation and you may want to keep a close eye on what your white count is doing during and after it. It's a really dangerous year for flu and norovirus, so you may want to rethink working when your immune system is compromised. If you have no choice, please consider talking to your employer about any steps they can help you with to limit your risk while you are vulnerable.

lovemyhubby

i also have sufficient sick

i also have sufficient sick days and would like to not work during radiation. However I am not feeling secure with my job right now. I had to take off for chemo due to dangerously low neutrophil and platelet levels. My leave was approved and I belong to a strong teacher’s union so I don’t Think my district will try to fire me. However i feel they are trying to push me enough to get me to quit. That is why I am trying hard to work during radiation. I have a good salary and great insurance and need the stability provided by both. I hope I am one of the lucky ones with few side effects. 

Cass83

check with the Dr of course first

I didn't have external radiation, just the internal, but I was taking Vitamin D and Milk Thistle and was able to take them during chemo and radiation. I always asked my Dr. before taking anything though. Both of those were ok according to them. I continue to take them now (8 months after radiation and chemo).

lovemyhubby

MAbound said:

Immune System

One big difference I noticed between chemo and radiation was that my blood work did not bounce back as fast as during chemo. It went down and stayed down during treatment and for several months after. It's important that you had/get a flu shot before radiation and you may want to keep a close eye on what your white count is doing during and after it. It's a really dangerous year for flu and norovirus, so you may want to rethink working when your immune system is compromised. If you have no choice, please consider talking to your employer about any steps they can help you with to limit your risk while you are vulnerable.

Thank you!  I have been

Thank you!  I have been working hard with my MO regarding my low neutrophil and platelet counts.  My platelets are finally up to 81 nine weeks following last infusion.  The RO does not seem to be as concerned and states radiation should not affect my blood levels.  I want to be cautious and asked that my blood levels continue to be checked regularly during radiation.  The RO did state he would be directing the radiation away from bones producing marrow and did not feel I would need the weekly blood work checks.  

lovemyhubby

derMaus said:

Also, Depends

Also, consider a small package of Depends. I was mighty affronted that I had to purchase them, and only really used them once, but having 'em around was a big comfort. I always took a pair when traveling or in other places where I was uncertain of the bathroom facilities. The price of a package is worth it in peace of mind, IMO.

I bought a bag of depends as

I bought a bag of depends as well.  I hope to never need them.  It never seems to rain when I carry my umbrella.  Hope carrying the depends acts as an insurance policy as well.  Thinking of keeping my port for a while for the same reason. 

lovemyhubby

takingcontrol58 said:

Metformin and diahrrhea

Lovemyhubby,
Make sure you are taking the extended release version of metformin.
See if that helps with the diarrhea.

Takingcontrol58

 

I have been taking the

I have been taking the extended release given one of your earlier posts.  I want to thank you for one of your earlier posts regarding how to approach doctors about Metformin.  My MO thought it was a good idea but said she could not prescribe it. I copied the research articles you mentioned, took them to my PCP and she prescribed it.  She is willing to prescribe it for 6 months but wants information regarding dosage for those of us not diabetic and how long after treatment we should take it.  Any information you could share with me?  Thanks!

lovemyhubby

NoTimeForCancer said:

lovemyhubby, I had both

lovemyhubby, I had both external and brachy.  I worked the entire time.  I TOTALLY understand your concerns re: possible diarrhea - oye!  The radiologist completedly FREAKED ME OUT about how bad it can be, and while I had a slight problem in the beginning of the initial external radiation, I have always took probiotics.

The dietician I met prior to radiation had shared a study with my on women with cervial cancer, where half took probiotics and half did not.  The half that did not had terrible diarrhea - some so bad they were hospitalized with dehydration.  The women who took probiotics did WAY better.  

I would recommend taking probiotics.  I did work throughout all of it.  I will say I did have fatigue that I had never experienced in my life, and radiation can continue to work for up to six weeks.  I would fall asleep at 7 pm and didn't try to fight it.  I figure sleep is restorative - so went with it 

Everyone is different with their reactions as you will see, my external was IMRT and I did not experience any radiation burns.  

Could you share which

Could you share which probiotic you are taking and where you purchase them?  Boy, they are expensive!

lovemyhubby

Violet123 said:

Hi love my hubby

We're in the same boat.  I recently finished chemo. Went back to work half way through, and I will be starting external radiation in About 2 weeks. I also am nervous about the side effects. I've been reading that probiotics and Imodium are helpful.  From what understand, the side effects can start around weeks 2-3.  

I have questions about what supplements to take and not to take during the radiation as I've seen conflicting advice on the internet about vit. C, E, A. Is it ok to take milk thistle for liver detox during radiation treatment?

What have others put topically on the skin to treat the irritation after treatment? I am going to try calendula extract and aloe vera to avoid extra chemicals in lotions, especially those with estrogenic effects.

Wishing you the best of luck

Wishing you the best of luck with your radiation treatments.  Please let us know how you are doing.

MAbound

lovemyhubby said:

Thank you!  I have been

Thank you!  I have been working hard with my MO regarding my low neutrophil and platelet counts.  My platelets are finally up to 81 nine weeks following last infusion.  The RO does not seem to be as concerned and states radiation should not affect my blood levels.  I want to be cautious and asked that my blood levels continue to be checked regularly during radiation.  The RO did state he would be directing the radiation away from bones producing marrow and did not feel I would need the weekly blood work checks.  

Always so much to think about during treatment

Everyone reacts to treatment differently so your experience may be different from mine, but I thought I better give you a heads up about that particular concern. I don't recall having lab work as often as weekly. I think it was more like the schedule I was on during chemo. Your on the home stretch for getting through treatment! Hang in there and congratulations.

Violet123

lovemyhubby said:

i also have sufficient sick

i also have sufficient sick days and would like to not work during radiation. However I am not feeling secure with my job right now. I had to take off for chemo due to dangerously low neutrophil and platelet levels. My leave was approved and I belong to a strong teacher’s union so I don’t Think my district will try to fire me. However i feel they are trying to push me enough to get me to quit. That is why I am trying hard to work during radiation. I have a good salary and great insurance and need the stability provided by both. I hope I am one of the lucky ones with few side effects. 

I also was concerned about my

I also was concerned about my job, so I went back before my MD suggested. I had the long term disability,  although my protected leave under FMLA was up.  After my 6 rounds of chemo was up mu MD said to get the Flu shot before I start radiation treatment.   I have mixed feelings about the Flu shot but it is mandatory in my office.  This is a terrible year for colds and flu.  I am the only one in my office who hasn't had the cold or flu.  Possibly due to my better diet, no added sugars , and whole grain plant based diet. I also wear the N95  mask in the office and wash my hands very regularly throughout the day.

NoTimeForCancer

Violet123 said:

I also was concerned about my

I also was concerned about my job, so I went back before my MD suggested. I had the long term disability,  although my protected leave under FMLA was up.  After my 6 rounds of chemo was up mu MD said to get the Flu shot before I start radiation treatment.   I have mixed feelings about the Flu shot but it is mandatory in my office.  This is a terrible year for colds and flu.  I am the only one in my office who hasn't had the cold or flu.  Possibly due to my better diet, no added sugars , and whole grain plant based diet. I also wear the N95  mask in the office and wash my hands very regularly throughout the day.

Violet, can I ask what kind

Violet, can I ask what kind of office you work in where the flu shot is mandatory?  I understand requirements, I am just curious.  The N95 is a serious mask!  Technically people are supposed to complete the medical eval to wear a N95 and up - meaning a full fledged respirator.  I will say - that N95 is pretty strong.  Those little dust masks or hospital masks don't hold water when compared to them.