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higher dose/shorter term versus lower dose longer term?

4 REPLIES 4
sarcath
Member

Re: higher dose/shorter term versus lower dose longer term?

Have just finished 15 sessions of radiotherapy to chest wall, armpit and collar bone area and have had no ill effects whatsoever apart from a slight reddening to the chest. Did as instructed and applied the cream twice a day before and during. Also had only used natural deo for months since surgery.

Well that sounds good - but I feel worried, when I read of the problems others have had, that perhaps they were missing the mark on me! Since for reasons best known to himself and not revealed to me, my surgeon did not do node clearance even though the nodes removed initially were positive, I find myself wondering if I needed more treatment to combat almost certain cancer as opposed to possible. Not at all happy - we really are at their mercy!

Good luck anyway
Sarcath

Jo_BCC
Member

Re: higher dose/shorter term versus lower dose longer term?

I have posted this for new user Mo,

Jo, Facilitator

Hi Trish,
I'm just finishing chemo (mastectomy and reconstruction of right breast) and am due to start radiotherapy in Mid March. I'm very lucky that all my treatment is private, through my work insurance.
If it's any reassurance, my radiotherapy consultant has also advised 15 sessions over three weeks. I can't believe cost is a factor here, as it's all rechargeable to someone else. She advised that research (don't know which) has shown that three weeks treatment is equally effective to longer treatment.
I know this msg won't make you feel any better about NHS service levels, but I hope it will be reassuring about the three week piece.
Best wishes... and best of luck with your treatment,
Mo

ForumMember
Member

Re: higher dose/shorter term versus lower dose longer term?

You're right Mole the START trial showed no difference in outcome but it started in 1999 when the waiting lists for radiotherapy were considerded politically and medically too long due to a shortage of trained staff. Have spoken to a radiographer friend who said that, that was the principal driving force behind the trial.They are still following up the long term side effects. Was also told that most radiographers regard the lower dose/longer time as a gold standard against which anything different is measured.
The reason that I'm concerned is that BC is in right breast. My left arm is paralysed due to polio as a child so anything that can damage my right arm means I could be well and truly up sh*t creek with regards to daily living. Breast surgeon was great, he took this on board and promised me he would take extra care with right arm and node clearance to make sure I would have no problems using arm again. True to his word, I've had no problems so I need to make sure onc takes this on board too.
I'd rather have more trips to hospital and less side effects than the other way round.
You may be right about throughput and fitting in with work patterns and if the drivng force behind the START trial is anything to go by not particularly patient centred.
Definitely something I intend to bring up if and when I ever get to see an onc(another story, staff shortages in my area.) Will let you know how I get on
Best wishes
Trish

Molennium
Member

Re: higher dose/shorter term versus lower dose longer term?

I was told the START trial had shown no difference in outcome but they do tend to jump the gun and I'd like to know how they take into account worse side effects. By the time I had them about 13 days in, it was too late to switch to a longer time period. But I don't know what the side effects would have been like in my case if I had had more sessions ( I had 15 days altogether), I did have about two to three years swelling afterwards but again, I don't know if i would have had this regardless. The skin problems did get better after about two weeks after treatment and the advantage was fewer trips to the hospital although easter and weekends meant my treatment still lasted over four or five weeks despite only having 15 days in total.

I felt it was all about throughput and fitting in with the working patterns of staff, not patient centred.

Mole

ForumMember
Member

higher dose/shorter term versus lower dose longer term?

I'm trying to get my head round the side effects (long and short term) for radiography. I've read a number of research reports that state that there is little difference in terms of recurrence between having a higher dose of radiation over a shorter period versus the opposite. However all reports state that there needs to be longer term follow ups to be certain. I also noted that the research involved modern, state of the art equipment, and all reports commented on the cost effectiveness of adopting this approach for NHS. I realise I'm quite cynical when it comes to cost effectiveness
At diagnosis(Dec 07) breast surgeon mentioned possibly 3 weeks of radiotherapy after WLE . This suggests I will be having ahigher dose for shorter time.
I just wondered if anyone had any further knowledge or information that I could check against. Also how do we find out if our radiology dept has up to the minute equipment and expertise or is this like everything about this disease 'just the luck of the draw?' I guess I'm being paranoid but I because I can't get a definite date for treatment, after a good initial start I'm losing faith in the authority I,m under to do the best job they can.
Thanks for any info
Trish.