Brenda! Have I missed your post re: IMRT??
 

Brenda,

I have just spent an hour! (snail pace dial-up) looking for your report on the last two tx's and week plus post the IMRT ...

How are you feeling? Any S/E's that you've noticed??

So sorry if you've continued your great 'diary' on this subject and I've zoned out to it......

hugs,
patty

Oops, sorry PZ! I forgot the final follow-up post! Probably because the last two treatments were like.... nothing happened!

I did day three and still felt a little tired, slightly agitated, and that mild queasy post taxol/carbo feeling, but nothing out-landish or debilitating. It all did continue to dissipate every day like the rads onc predicted.

Day 3 was a Friday, so I had the weekend off. I felt just generally crummy all Saturday and Sunday (like mild flu or bad allergies). It was tolerable, not terrible, but no-one likes feeling yucky, so I nursed it with a lot of sleep and TV...

Monday morning I woke up and felt (get this) 100% better and normal! I was thrilled. I went in for IMRT, and powered through with no SEs at all. Then went again Tuesday morning for my final treatment and again felt terrific. No SEs at all. Nothing. Nada. I even attended the Austin City Limits Music Festival for 3 days starting on Friday (walking for miles every day, in minor heat and dust) and NOTHING. I was a good as new.

I guess those two days over the weekend were really all my body needed to recover, rebuild and re-strengthen and get used to the beams... and it was really a breeze on day 4 and 5.

We will do a follow-up MRI in 5 weeks (6 weeks from finishing) to see the results. He said we should see 5 necrotic spots and not to expect sloughing off of them for about 6 months.

All in all, I couldn't ask for a more painless and tolerable brain radiation. A few days of mild crumminess. Like I haven't already had to live through that for months and months at a time! LOL

Today I am off to my first Herceptin treatment since we suspended it to start Tykerb/Xeloda 18 months ago. So now it is Tykerb/Herceptin... and I am keeping all my fingers and toes crossed.

Brenda, glad all went well with the remainder of your treatments. I am hoping your new chemo does the trick for you. Will keep my fingers and toes crossed for you also and send an extra prayer for you!

Keeping fingers and toes crossed with ya!

Hi Brenda,

Thanks for updating us. I'm so happy that you ended the tx feeling great. A gift....forsure!

I hope the next round of tx is just as easy on you.

Sending love and a hug,

Mary Jo

Alrighty then!! Thank you for this frank and ultimately uplifting detailed account, Brenda!

The only other side effect I see as a possible is your ENERGY and strength, LOL!! That's a whole lot of walking in short order...

So glad for you, in all ways, lady :)

hugs to you,
patty

p.s. could ya' keep us in the know as to how you're doing?? Take time out now and then from posting your great support to others??

Brenda,
I have everything crossed for you also.
You are one of my special heros Wonder Women.

Love Ya,
jean

Brenda
Crossing my ears for you. Hang in there kiddo. Peace KS

Brenda -

Good for you - you go girl!!

all the best
caya

Only 13 More Shopping Days...
 

Hey Birthday twin-
I had my herceptin today too. Along with some avastin and a quick zip of zometa. Advanced a level of sudoku (sp?) during my drip which thank god was uneventful.

Near as I can tell you ARE the iron woman. Keep it up. Sending an air kiss (LA Style) and a big hug. --Flori

Hi Twinkie! Herceptin and Zometa for me, too.

Now it looks like I won't be in the LA area in Oct... bummer. I wanted to see you!

Hi Brenda, just curious why IMRT was the treatment you chose. Was there something specific that IMRT offered?

I'm always checking out treatment options to see what I might be able to draw on in the future.

Hi Esther - here's a great video about my treatment center and my doc, Dr. Dzuik. It's also really informative about the type of radiation beams and machine he works with and the what to expect in the radiation experience. He is basically Patch Adams. Everyone in the video are my nurses and technicians. He is an amazing doc. About 1/2 way through the video you will see a woman in a pink shirt laying on the table and they are putting a formed head and shoulder mask around her and snapping it to the table, that is what I had done everyday to immobilize me for my treatments. http://www.swrcc.com/services/radiation_center.htm)

My doc has used Cyberknife as well, but last year he chose to go exclusively with the Varian IMRT machine. He has nothing but good to say about Cyberknife, but he came to prefer the IMRT technology.

Also, here are a couple of links comparing all of the targeted radiation techniques:
http://www.radiologyinfo.org/en/info.cfm?pg=imrt&bhcp=1

http://www.comhs.org/cyberknife/advantage.asp
This second link is a good comparison of the 4 types of beams (Gamma, Cyber, Linear Accelerator, IMRT), but please note on this link the disadvantages stated for IMRT are INCORRECT. The type of head immobilization that is used is NOT the one they describe, therefore it does not create the described issue, so it has become a premier method of treating brain lesions.

Thanks Brenda for the links. There is so much information there, that I'll have to review them a few times to absorb it.

I hadn't known that IMRT was an option for brain mets, so this was useful knowledge for me. Good to know also that they will treat 5 lesions at once.

Hope you get positive news in 5 weeks. At Cedars-Sinai they told me it can take a year or longer to see the full results from treatment.

Hey Esther,

Since I'm also trying to keep up with all the rad options, this is what I found available locally, described in general terms... and talk about a bit confusing!

here goes:

Radiation Therapies

Radiation therapy is administered either externally or internally. External radiation therapy is usually given during outpatient visits using a linear accelerator, a machine that directs the high-energy rays or particles at the cancer and the normal tissue surrounding it. Internal radiation, often called brachytherapy, uses a radioactive source sealed in applicators, which are placed directly into a tumor or body cavity.

Brachytherapy
This procedure applies radiation internally by placing a radioactive source very near or in the tumor itself, while sparing the normal tissue and surrounding organs. Brachytherapy delivers a higher dose of radiation to help destroy the main mass of tumor cells in a more concentrated fashion.

Endocavitary Radiation (ECR)
This form of therapy is a specialized method of delivering a very large dose of radiation therapy to a very small volume of tissue in a cavity of the body. This specialized equipment is used for early stage colorectal cancer.

External Beam Radiation Therapy
This is a type of therapy that uses a beam of radiation created by the linear accelerator and targeted at the tumor. The machine produces ionizing radiation to destroy cancer cells in the tumor and surrounding region.

High-Dose Rate (HDR) Brachytherapy
This form of therapy uses computer planning and a network of catheters inserted in the tumor to deliver radiation to specific sites. The concentrated radiation remains at each site for a few seconds, minimizing radiation to surrounding healthy tissue. HDR brachytherapy is often used for treatment of gynelogical cancers and can be delivered in an outpatient basis, allowing the patient to go home immediately following the treatment.

Image-Guided Radiation Therapy (IGRT)
Image-guided radiation therapy is performed by a linear accelerator equipped with an on-board imager (OBI). This new technology is designed to improve the precision and effectiveness of cancer treatments by giving doctors the ability to target and track tumors more accurately. An automated system for IGRT, the OBI enables clinicians to obtain high-resolution three-dimensional images to pinpoint tumor sites, adjust patient positioning when necessary and complete a treatment, all within the standard treatment time slot.

Intensity Modulated Radiation Therapy (IMRT)
In this form of treatment, the radiation is broken up into hundreds of tiny pencil-thin radiation beams. The beams enter the body from many angles and intersect on the cancer. IMRT provides a high dosage to the tumor and a lower dose to the surrounding healthy tissues. With the radiation intensity altered, the doses are spread over the tumor for the desired concentration.

Prostate Seed Implant Therapy
This is a form of brachytherapy that uses permanently implanted radioactive seeds to treat prostate cancer. The seeds damage the cancer cells so the tumors die as they try to grow and reproduce.

Stereotactic Body Radiation Therapy (SBRT)
This new technology allows precise delivery of high does of radiation to the tumor, while maximally sparing adjacent normal tissues. SBRT requires special equipment to accurately verify position of the patient and location of the tumor. This equipment also takes into account normal respiratory activity and rapidly delivers treatment. SBRT is an outpatient, non-invasive procedure. Radiation treatments are delivered in large doses over one to five treatment days. SBRT can potentially be used in cases of lung cancer, liver metastases, and kidney and pancreatic cancers, among others.

Stereotactic Radiosurgery (SRS)
This is a one-time, nonsurgical procedure that administers precise, high doses of radiation to cranial abnormalities. Specially adapted external radiation equipment deliver a single, highly concentrated dose of radiation. Stereotactic radiosurgery uses computer imaging to precisely locate the lesion in three dimensions.

Stereotactic Radiotherapy (SRT)
This treatment method delivers radiation to tumors over a period of time, reducing radiation exposure of nearby structures. Stereotactic radiotherapy uses a 3-D grid system to map where therapy will be directed and the patient receives multiple doses of radiation spread over several weeks. The procedure is important for treating lesions near sensitive tissues.

Three-Dimensional Conformal Radiation Therapy (3-D CRT)
This treatment identifies in three-dimensions the tumor and surrounding normal tissues and customizes the radiation beams. 3-D CRT conforms to the shape of the tumor and uses 3-D treatment planning computer and CT scans to focus in on tumors. Tumors are treated with a high dose, while surrounding tissue receives a lower dose.