RADIATION AFTER R-EPOCH

Unbreakable1

After seeing a specialist, I was told that it is highly unlikely that I will need a Stem cell transplant. However, I will need some radiation.  I have had 6 chemo treatments consisting of R-EPOCH. Any know what that radiation will be like and what to expect?

po18guy

Well...

It is dependent upon where the tumor(s) were, the Ki67 rate of the tumor cells, how many Gray they intend to administer and vital organs in the vicinity of the rads - as well as other factors. I had total body irradiation to kill my marrow and I have noticed no ill effects. You can get a second opinion on the radiation, and that might be a good thing, simply for peace of mind. 

Max Former Hodgkins Stage 3

R.T.

Un,

I studied radiation therapy (R.T.) not from my lympohoma experience, but rather five years afterward, when unrelated prostate cancer was diagnosed.  R.T., very generally, is usually much easier to tolerate than surgery or chemotherapy, especially initially.   In most cases the side-effects are minimal to virtually undetectable.   There are exceptions, and many variables willl determine specifically how it goes for you.   Compared to SCT, rads should literally be like nothing at all.

RT is un-common, especially by itself, for blood cancers, since blood cancers are systemic -- potentially spread to everywhere in the body.  RT is best when there is an isolated, identifiable tumor, or set of tumors in a narrow area.   Hence, RT is mostly used against organ cancers that are considered non-metastatic.  Prostate and breast cancers are the most common that are successfully treated with RT, but it is also a common tool agains lung, brain, and some other cancers. I was at a presentation given by a hematgologist once, and she referred to RT as 'spot welding.'   That is, you find this one defect, and you fix it, locally.  

In current times, therapeudic radiation is usually delivered in a very narrow, precise area -- which is called SBRT.   When the exact borders of a malignancy are not certian, more of a 'field' is irradiated, which is dubbed 'fractionated' RT, and the technique is called IMRT or IGRT.   SBRT is commonly referred to today by its trade names (given by the machine manufacturers), which are Cyberknife or Varian True Beam. (Note that Cyberknife involves no cutting or surgery; the 'knife' is the radiation beam.)  But all radiation is highly precise, and heathy tissues are almost always avoided, something that was not possible as recently as a few decades ago.    Someone's experiences with adjacent tissue burn from 20 years ago would have little relevance to how radiation is delivered today.

When side-effects occur, they are usually mild buring at the entry point of the beam, often described as a sort of sunburn.  Damage can occur to healthy tissue, even today, but is rare.  In cases with high dosage, fatigue and weakness are possible, much as with chemo.  Combining rads with strong chemos still has a small, slight possibility of increasing the later development of leukemia in the patient, but this increase in chance is probably less than the liklihood of combining strong chemo (like EPOCH) with SCT.

Unbreakable1

Max Former Hodgkins Stage 3 said:

R.T.

Un,

I studied radiation therapy (R.T.) not from my lympohoma experience, but rather five years afterward, when unrelated prostate cancer was diagnosed.  R.T., very generally, is usually much easier to tolerate than surgery or chemotherapy, especially initially.   In most cases the side-effects are minimal to virtually undetectable.   There are exceptions, and many variables willl determine specifically how it goes for you.   Compared to SCT, rads should literally be like nothing at all.

RT is un-common, especially by itself, for blood cancers, since blood cancers are systemic -- potentially spread to everywhere in the body.  RT is best when there is an isolated, identifiable tumor, or set of tumors in a narrow area.   Hence, RT is mostly used against organ cancers that are considered non-metastatic.  Prostate and breast cancers are the most common that are successfully treated with RT, but it is also a common tool agains lung, brain, and some other cancers. I was at a presentation given by a hematgologist once, and she referred to RT as 'spot welding.'   That is, you find this one defect, and you fix it, locally.  

In current times, therapeudic radiation is usually delivered in a very narrow, precise area -- which is called SBRT.   When the exact borders of a malignancy are not certian, more of a 'field' is irradiated, which is dubbed 'fractionated' RT, and the technique is called IMRT or IGRT.   SBRT is commonly referred to today by its trade names (given by the machine manufacturers), which are Cyberknife or Varian True Beam. (Note that Cyberknife involves no cutting or surgery; the 'knife' is the radiation beam.)  But all radiation is highly precise, and heathy tissues are almost always avoided, something that was not possible as recently as a few decades ago.    Someone's experiences with adjacent tissue burn from 20 years ago would have little relevance to how radiation is delivered today.

When side-effects occur, they are usually mild buring at the entry point of the beam, often described as a sort of sunburn.  Damage can occur to healthy tissue, even today, but is rare.  In cases with high dosage, fatigue and weakness are possible, much as with chemo.  Combining rads with strong chemos still has a small, slight possibility of increasing the later development of leukemia in the patient, but this increase in chance is probably less than the liklihood of combining strong chemo (like EPOCH) with SCT.

My mass is in my chest, so

My mass is in my chest, so hopefully the side effects are very minimal. The specialist also mentioned that the strength of the radiation shouldnt be as strong as someone with breast cancer or lung cancer. I'm still waiting for the specialist to review the actual CD's from my PET scans and other tests. Then she is going to refer me to a radiation oncologist. She said I would need a few weeks of radiation.

Max Former Hodgkins Stage 3

'A few weeks' very likely

'A few weeks' very likely suggests IMRT as an adjuvant.    Please share how things go for you, and good luck with it.