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working during radiation

lovemyhubby
Posts: 27
Joined: Jan 2018

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's picture
Donna Faye
Posts: 258
Joined: Jan 2017

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 Laughing (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's picture
cmb
Posts: 387
Joined: Jan 2018

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
Posts: 26
Joined: Nov 2017

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.

lovemyhubby
Posts: 27
Joined: Jan 2018

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

derMaus's picture
derMaus
Posts: 561
Joined: Nov 2016

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's picture
NoTimeForCancer
Posts: 2599
Joined: Mar 2013

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.  

lovemyhubby
Posts: 27
Joined: Jan 2018

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

Jairoldi's picture
Jairoldi
Posts: 215
Joined: May 2017

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
Posts: 27
Joined: Jan 2018

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
Posts: 243
Joined: Jan 2016

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

Takingcontrol58

 

lovemyhubby
Posts: 27
Joined: Jan 2018

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!

takingcontrol58
Posts: 243
Joined: Jan 2016

Sorry, I just saw this post.
I find it sad that your doctor is not looking into the dosage for those
people who are not diabetic.  I was not diabetic. I was prediabetic
and had insulin reisistance.  What are your glucose and insulin levels?

Typically, a person that is non-diabetic is started with 500mg/day. I was
started with 1000mg/day- though I was metastatic at the time. My dose
was upped to 1500mg/day after I finished chemo, since I still had 2cm of
tumors left. I remain on that dose today.

My glucose was alway between 110-120- pre-diabetic-  Today it averages
85-90, which is an ideal number.

This drug also is known to prevent cancer from forming.  I believe that is why I 
have remained cancer free.  So I plan to say on the drug.  I have been on it
now for 3 years and have been in remission for 3 years. Again, if you have some
of the health issues that metformin targets, or the mutations it targets (and it is
well known what it targets), this drug could be very effective for you. But you 
also have to target your other health issues. Metformin may not target anything.

You need to be sure to send your tumor for genomic testing.

Takingcontrol58

derMaus's picture
derMaus
Posts: 561
Joined: Nov 2016

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.

lovemyhubby
Posts: 27
Joined: Jan 2018

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. 

outdoor75
Posts: 2
Joined: Feb 2018

Hey why bring that up. Yes, pelvic radiation is a period where you have to be watchful..but by no means requires thinking about depends..how depressing!  Keep to the bland diet and keep the medication close by.. it can be managed well.  Me.. Pelvic radiation 1 year ago.. tough emotionally but had fantastic techs.

I am totally well now.. my bowels have change a bit.. but never ever not do radiation based on all the scare stories out there.  I did not not do chemo.. I beleive it with radiation is too much.. you will kill yourself.

The 6 weeks of radiation was 'different' but it never meant buying depends as other might have you believe..it can be managed quite well and after it is over it resolves.

 

 

 

 

 

derMaus's picture
derMaus
Posts: 561
Joined: Nov 2016

I'm the person who suggested Depends. It gave my psychological comfort. We're all different and what you find "depressing" another may find useful. 

MAbound
Posts: 877
Joined: Jun 2016

Your experience of radiation was different from what many others have endured, maybe because you didn't have chemo in addition to it, maybe because of the extent of the area that was exposed, or maybe because of how it was delivered. The point is that there are a lot of variables involved and being prepared for whatever may happen is not a bad thing. Diarrhea is a very unpleasant potential side effect especially for those who have any distance to travel for treatments and it would be kind of hard to run out to the store to deal with it in the midst of it. If the Depends aren't needed....hallelujah!....but if they are, having a few on hand would be a Godsend. Why bring it up? Because it happens and this is a place where we can discus and share our experiences and offer advice without having to worry about being judged about it....at least most of the time. You can accept what's offered or not, but let's not descend into critisizing or taking offense at what's offered in the spirit of trying to help.

jodil
Posts: 42
Joined: Nov 2017

I have received such valuable information from this board, some I use,some doesn't fit for me but I hate to feel that if I submit a suggestion that someone disagrees with I might be shamed for what works for me. Who needs that?! As for Depends, totally a personal decision. No need for criticizing someone for what they choose to do. Simply don't take the suggestion if it doesn't apply to you. Personally, it makes me feel better if I am prepared for the unknown. 

 

 

 

 

outdoor75
Posts: 2
Joined: Feb 2018

Use your own instinsts.. do not just say yes to all agressive treatments..  chemo.. with chemo brain.. 

lovemyhubby
Posts: 27
Joined: Jan 2018

Thank you for responding to my posts and I consider all advice given to me from this sight. I am not someone who blindly follows treatment recommendations. As is common with many of us, I do read volumes of research, usually when I can’t sleep at 3 am. The decisions I have made were based on what I believe will give me my best chance for survival, maybe even a cure. I believe we all want the same outcome. I visit this sight to gather information from those who have experienced similar issues, to mourn for those who have lost their battle to this disease and celebrate the victories of those who continue the battle. 

MAbound
Posts: 877
Joined: Jun 2016

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
Posts: 27
Joined: Jan 2018

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.  

MAbound
Posts: 877
Joined: Jun 2016

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.

lovemyhubby
Posts: 27
Joined: Jan 2018

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. 

Violet123
Posts: 26
Joined: Nov 2017

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's picture
NoTimeForCancer
Posts: 2599
Joined: Mar 2013

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.

Violet123
Posts: 26
Joined: Nov 2017

i work in a medical setting.  No way of getting out of the flu shot without a doctors note.

Cass83's picture
Cass83
Posts: 151
Joined: Feb 2017

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).

ckdgedmom's picture
ckdgedmom
Posts: 166
Joined: Oct 2017

My first round of radiation (25 external/3 brachy) I did during the summer and was not working as I work at a high school. It did make me a bit tired but mostly I was fine other than a bit of diarhea and some nausea. I took generic Zofran for the nausea and it helped with the diarrhea as well because for me they go hand in hand...

My second round of radiation (30 rounds to lymph nodes in my neck) I worked through and did fine...not as tired (weirdly as I was working) and managed to work and exercise...maybe it was easier on me since it was not pelvic and abdominal and was less intense. I was having cisplatin infusions as well and that knocked out my platelets, white blood cells and red blood cells...THAT made me tired...

my skin did really well through the treatments...for the abdominal/pelvic I had no skin issues. The radiation to my neck did make my neck area red and the last week of treatment I did get some bleeding and scabbing (it was like a really bad sunburn) but I used Rodan + Fields Soothe cream on it and my neck healed quickly and with no scarring and no signs that I had radiation there. My radiology oncologist is blown away and he keeps touching and looking at my neck when he sees me because he says he has never had a patient have radiation there and come out of it with zero signs that anything was done--until me...so I give credit to the creams...

Oh and I took a probiotic the whole time (and still do)...I order mine through a friend who sells Plexus products but there are many excellent probiotics out there...

Soup52's picture
Soup52
Posts: 902
Joined: Jan 2016

I feel  I must comment on radiation. I had both kinds in addition to 6 rounds of chemo. Both along with surgery have left me Ned for my 3C clear cell endometrial cancer. I did not have diarea but constipation instead. I still battle with this but with the help of a gastroenterologist I am dealing pretty well. For me all of this has been worth it. I have been NED for a year and a half. I never had to have Neulasta or to miss any chemos planned. For me this agressive approach has been well worth it.

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