FAST Foward radiation treatment schedule option
Hi, this is my first post. I’m also not sure if my dx signature/details automatically attaches to my post. But I’ll add those details if I need to.
I’m in Canada. The radiation oncologist gave me the option of the Fast Forward dosing schedule of treatment. It’s not first in line protocol here yet because it hasn’t been done long enough for gathering stats and data. But according to studies in the UK, it shows comparable efficacy and the side effects the same as a regular dosing schedule.
In my case FAST Forward would be 10 treatments total. 5 whole breast + 5 targeted. ( Or with regular dosing schedule it would be 20 total, with 15 whole breast + 5 targeted. )
I’m wondering if anybody has experience with the fast forward? Are there things I should be taking into consideration for making a decision? I’m leaning towards choosing this option.
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Hi pearlyeve,
I'm in Canada as well, being treated at PMH and the 5 fraction regime (+/- boost, as indicated) seems to be standard for early breast cancers. I expected to be through it by now but I had to go back for re-excision after positive margins were found after the lumpectomy I had in January. I now anticipate starting radiation in May. Still waiting for pathology on the second surgery though, so who knows.
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Thanks for your reply Rideau. I hope the margins are clear this time for you. I find Waiting for results to be very nerve wracking.
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Hello pearlyeye and rideauwood,
I too am in Canada and will begin 10 courses of radiation in the next 2 weeks. Whole breast 5 days + boost 5 days. ILC, Stage 2, Gr2, neg nodes.
I am 6 weeks post-lumpectomy/SLNB and have developed tendonitis (at week 5) in my shoulder along with cording (at week 2) in the surgery arm. Treatment through physio and massage and thankfully the nodes (arm-lifting) will not be irradiated.
Hanging in there, but I AM a bit anxious of potential new side effects from the rads.
How you are faring with your rads treatments? Wishing you the best!
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Hi birdlife,
I started radiation on Monday and had my 3rd treatment today. I’m experiencing some redness, tenderness, swelling and very tired. But nothing unbearable. I live 40 minutes away from the centre. So the commute is longer than the treatment itself. I’m glad I picked the FAST forward option of 10 total (5 whole breast,5 target boosts)with the higher dose of radiation per treatment. It would have been exhausting with the alternative of going 5 days a week for 4 weeks.
I also had the cording develop a week after surgery. Physio has been helpful with that. I found the cording to be quite painful. The worst cord is almost unnoticeable now. But new ones seem to keep developing. I need to research more about whether this will be an ongoing issue. Or does it fully resolve at some point? I’m worried about getting chronic lymphedema though. There is a mild puffiness that comes and goes. So I’ve had one message so far to help with drainage.
Sounds like we have a common interest in birds (given your user name).😊
Wishing you the best also.1 -
Welcome, @pearlyeve and @birdlife! We're so sorry you both find yourselves here, but we're glad you've joined our community and hope this place can be a source of support for you.
Also, we want to let you know we offer very supportive, moderated Virtual Community Meetups. There are a number of different groups and times, so if you're interested, please check them out here: Virtual Community Meetups.
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@pearlyeve I hope you're doing well and you have likely finished your treatments by now. My last one is this Monday, it's gone really well - so far 😀 I'm off work right now and am grateful for the daily routine the hospital visits bring and am indulging in lots of rest.
I too am a bit worried about the swelling that comes and goes in my hand and lower arm, I'm trying to figure out what brings it on. Cording seems to be lessening but is now stubbornly in my hand.
Yes, I totally love birds and have spent many hours in my backyard (in the city) enjoying the spring migration. Take good care, would love to hear how you're doing.
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@birdlife time does fly. I finished my last radiation treatment 2 weeks ago. The daily commute to treatments was a bit of a drag. But I’ve been happily surprised that the side effects have been better than they warned about. A few small blisters, some skin texture change, brief occasional shooting pain. There is a small strange patch of itchy rash like bumps on edge of breast and chest. Also fatigue has been a bit of a challenge but not debilitating. I’ve been resting whenever I need to.
The mild puffiness I get is usually between wrist and elbow. It appears to be brought on by activities like gardening and lifting too much. The cording is still an issue. Some of the cords are seemingly gone. But new ones have cropped up. I was taking a break from physio while I did radiation. So I’ll probably start that again. I just really needed a break from constant appointments and treatments. I also started on an estrogen inhibitor called Anastrozole. Which they said will be for 5 years.
Everything has been an overwhelming whirlwind. I feel like I was functioning off of stress. Now that things have settled down, I’m feeling both physically and emotionally drained.
Thanks for checking in. Hope you are doing well with the radiation, and not getting too many side effects. 😊
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hello @pearlyeve ! So nice to hear of your progress. I would love to know how the medication is going for you and hope that the side effects are minimal. I am to start letrozole next week and hopefully won’t experience the muscle aches and joint pain that can be a feature of those meds while my shoulder has not yet settled! And weird swelling in my hand and fingers. Take good care and wishing you the best.
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Hi @pearlyeve and @birdlife
I forgot to come back here and check in. I finished treatment just shy of three weeks ago. I had ultrahypofractionated radiation, 26 gy over five days. I enrolled in the RAPID2 trial which is investigating whole vs partial breast irradiation. Officially I don't know which group I was assigned to - but the burn pattern makes it pretty clear. ;-)
I'm light skinned, sunburn pretty easily and have somewhat sensitive skin, so I was expecting damage. It hasn't been as bad as I feared, but not fun either. I was okay during the week of treatment (some reddening, a bit of sensitivity) but as promised things got worse after the end of treatment. The burn pattern bloomed over time, starting with a little rosiness in one quadrant after the very first treatment. Eventually it spread to the whole treatment area, and to my surprise after the first 10-14 days it has spread up into my armpit. There was no lymph node radiation deliberately planned, so I guess it's just in the spill over zone. I had a lot of swelling for a while but that has eased. The skin has been kind of pebbly over all, but my areola feels rubbery, which is odd. I've been fortunate to have no lymphedema after surgery and no sign of it with rads either, so I hope I've dodged that one.
I've had no blistering or peeling, but I have had an intensely painful nipple! That started about 10 days after the end of treatment, with the nipple turning cherry red and looking raw and chewed up. If any of you have breastfed babies you may know what I mean. On the advice of the radiation nurses I've been using saline soaks followed by 1% hydrocortisone cream (over the counter) and then a barrier cream. It's much better than it was, but still very sensitive. Putting on and taking off a bra is unpleasant, but it's better than braless because fabric brushing against the nipple is very much not okay!
The other thing was fatigue. During treatment, people kept asking if I felt tired and I was absolutely fine. A few days after the end it hit me hard, though. Like, have a shower and make lunch then need to lie down! It would come in waves - the kind of thing where you can have a nap and wake up less sleepy but not really less tired. I've only ever felt this kind of fatigue during a nasty dose of flu. It's a lot better now, but I'm still not back to normal.
This afternoon I have a phone appointment with the medical oncologist and have to make a final decision about hormonal therapy (low risk of recurrence = letrozole, tamoxifen, or nothing, my choice, eek!)
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Hi @birdlife and @rideau_wood
I finished radiation May 17th. (7 weeks ago). I was happily surprised that the skin side effects were less than I anticipated. One small blister during treatment. Like you rideau, my nipple/aereola area thickened. Then shortly after I finished, an itchy rash formed on the inner side of breast and part of sternum area. It resolved after about 2 weeks. There has been ongoing fatigue. So I pace myself and it can be frustrating. Also thickening with that “orange peel” effect has just cropped up during the last week. However, I’m not sure if it’s due to an infection that developed last week, along with an abscess.
With the infection, the breast became extremely painful, swollen, hot and red. At the beginning it caused fever, chills and body aches. I felt horrible and it kept getting worse on oral antibiotics. So I went to ER and they administered IV antibiotics. An ultrasound a couple of days later revealed an abscess. I had to go in every day for an IV infusion (yesterday was the last one). While the infection symptoms have improved. An ultrasound yesterday showed the abscess hasn’t changed. Next step will be draining it. I’ll hear after the weekend about a date for that. Which, needless to say, I’m not looking forward to. I really hope that things continue to improve smoothly.
I am on Anastrozole endocrine therapy now. (This one is used in post menopausal women). But same purpose being an estrogen inhibitor. I don’t want to jinx it lol, but the only side effect that stands out so far is increased hot flashes.
Best wishes to both of you @rideau_wood and @birdlife. I’ll provide updates as things move forward. If you are up to it I’d love to hear about your continuing journeys. Take care.💕
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