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May 17, 2017 11:29PM
Hydration and nutrition are key. With any injury, healing requires protein. Try to eat more of it, whether animal or vegetable (if the latter, make sure you’re properly combining the types to get complete protein). Drink as much water as you can. You can’t prevent the immunosuppression (which is much milder than that of chemo), but you can take precautions to lessen the chance of an infection: hand washing, avoiding crowds in close spaces whenever possible. And be kind to yourself when it comes to rest—don’t fight the fatigue if it happens, allow yourself to give in (and give others the finger if they’re unsympathetic).
The damage to the stray tumor cells is—hopefully—irreversible. But take heart: the damage to your skin WILL heal. The damage (sometimes mistakenly referred to as a “burn”) occurs from the inside out. With a true burn, the skin is damaged by external forces and the epidermis (outer layer) will be damaged before the dermis (the layer in which skin cells are generated) is involved, if at all (such as in a third-degree burn). When the dermis generates skin cells to replenish the ones that die off normally every day, the cells make their way to the stratum corneum (outer layer of the epidermis). With radiation damage, the tissue beneath the dermis is damaged first, and the ability of the dermis to generate and replenish skin cells is impaired for awhile. What looks like “burn” damage is epidermal cells dying off as they normally would but not replaced with skin cells generated by the dermis. This will go on for awhile during treatment, worsen for awhile after finishing (remember, the damage is still happening inside the breast), but then reverse itself faster than it first occurred. Patience is the best weapon in your arsenal.
Now, as I said, the whole point of radiation is to damage any stray cells that may remain in the breast (especially the tumor cavity or “bed”). Free radicals are generated, causing oxidative tissue damage in reaction to the radiation. Normally, you’d want to get rid of free radicals to prevent oxidation, and anti-oxidants in foods and sometimes supplements are desirable in order to do that. But since oxidative damage is the whole point of both chemo and radiation, taking anti-oxidant supplements during this time and until you begin to heal is the worst thing you can do! (The amounts of anti-oxidants present in normal moderate portions of food are fine, however).
So eat wisely and healthfully as you normally would (or aspire to do), except with more protein. But stop taking Vitamin C and E and other anti-oxidant supplements until your oncologist green-lights you to resume.
You can’t and shouldn’t “lube up” before starting treatment to avoid skin damage—if it’s gonna happen, it’s gonna happen (sometimes it may not or may be mild—no way to know in advance). It’s okay to moisturize now, but know it has nothing to do with preventing radiation skin damage. Anything beyond your normal routine is like flushing time & money down the toilet. Once your treatments start, it’s okay to apply Aquaphor or whatever your RO suggests or hands out immediately after each treatment and again at bedtime. Some say aloe doesn’t help. 100% pure, clear, unscented, no-alcohol aloe gel (Fruit of the Earth, dirt cheap) did soothe me, as did calendula cream (I used Boiron, which I bought at Whole Foods). You want to avoid any irritants—and that also includes scented soaps or body washes as well as antiperspirant or even some natural deodorants. (You probably won’t sweat under your arms for awhile anyway, nor will armpit hair grow). Use cornstarch (apply gently) if you need to avoid getting clammy. If you must shave, use a well-maintained electric razor. And before you leave for each treatment, completely shower off anything you’d applied the night before.
Finally, do what you can clothing-wise to avoid irritating the radiated area, especially avoiding skin-on-skin contact under your breast. If you don’t want to or can’t wear a bra, some clean soft cloth (like t-shirt material) worn between the breast & midriff helps a lot. I was lucky enough to get partial-breast radiation, and the “field” didn’t include where my bra’s underwires hit. So I wore my normal bras the whole time, though I did find soft-cup wire-free ones less constricting (even though they didn’t support as well). Wearing a bra, even for sleep (soft cotton knit front-hook leisure or nursing bras) prevented skin-on-skin contact.
Meditation, qi gong, tai chi, yoga, massage and acupuncture (avoiding both the operated & radiated areas, as well as the arm & side of your trunk at risk for lymphedema) are helpful if you find them helpful and comforting. The placebo effect often works. But these therapies should be integrative and complementary—they shouldn’t replace medical treatments.
Diagnosed at 64 on routine annual mammo, no lump. OncotypeDX 16. I cried because I had no shoes...but then again, I won’t get blisters....
9/9/2015, IDC, Right, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC)
9/23/2015 Lumpectomy: Right
11/2/2015 3DCRT: Breast
12/31/2015 Femara (letrozole)