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Old 07-26-2008, 09:54 AM   #1
Faith in Him
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Question Radiation with heat?

I did not get clean margins on my mastectomy several months ago. Unfortunately, I am still trying to get rid of what the drs are calling mircomets in my skin. I have been referred to UCSF for a special radiation treatment.

The name escapes me now but the procedure is to give radiation to my right chest wall, collar bone area and torso and then apply heat to the skin for about an hour. I will do this five days a week for four wekks. Apparently, I will burn badly and can expect the skin to breakdown significantly.

Has anyone else been through this? Also, my med. onc wants me to stop gemzar/herceptin for the procedure but the rad. onc believes I can stay on with just a little longer recovery time. Any suggestions?

Needness to say, I feel a little overwhelmed by this treatment but know that God will get me through this again.

Praying for all of you.

Tonya
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DX 02/01/07
2.5 cm, Er/Pr-, Her2+++
18/20 Nodes
03/07 CT & Bone scan - Clear
AC x 4, Taxol x 4, Added Herceptin
Radiation until 09/07
Herceptin every 3 weeks until 06/08
01/10/08 local recurrence -IBC
01/28/08 CT & Brain MRI - clear
02/08 - Navelbine & Herceptin
05/08 -MRM
05/08 - Gemzar & Herceptin - didn't work
09/08 - Hyperthermia rads
03/09 - Tykerb/Xeloda
05/10 - Tram flap to fix wound
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Old 07-26-2008, 05:04 PM   #2
Joan M
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Hi Tonya,

I think that you might be referring to hyperthermia, but I'm not exactly sure since there's a few variations on combining heat and radiation.

http://www.oralcancerfoundation.org/...sp?newsId=1188

I'm glad that you will be getting what appears to be an aggressive, if somewhat novel, treatment, which is not done everywhere.

Please let me know when you find out the name of the treatment.

Your oncologist seems to be on top of things.

I'm praying that you'll be NED after the treatment.

Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 07-27-2008, 02:00 AM   #3
Mary Anne in TX
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Hi Tonya! I don't know about the treatment, but I'm sure praying for it to be just the thing for you to be NED and have no more problems with micro skin mets or anything else. When do you start treatment? What is the source of the hour of heat? Please let us know what is happening and how you are doing. Much love and many prayers, ma
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MA in TX.
Grateful for each and every day....

Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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Old 07-27-2008, 08:46 AM   #4
Becky
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Dear Tonya

I do not know anything about the radiation with the heat treatment after it. However, in general, I do know that adding chemo to radiation intensifies the radiation treatment.

I have several bc friends here from my cancer center who had local recurrences. Since they had masectomy and did not receive radiation, rads ended up being a big part of the treatment plan (both of these women I know had their tumor recur on the masectomy scar-line). Both had more surgery then rads but the medical onc and the rad onc added Xeloda to the plan while undergoing rads (neither was Her2+ but if they were, they probably should have had Herceptin too).

If I were you, I would discuss at least remaining on Herceptin during rads as this has a synergistic effect and then really, really talk to both doctors (rad onc and medical onc) on how much burning you could expect with just rads versus rads w/heat vs rads w/heat plus staying on Gemzar with Herceptin.

I know that you won't have just rads but for some women, it causes burning and rads with chemo causes more and I would guess rads with heat causes more burning than rads alone so would rads w/heat plus chemo put you into an area where you might not be able to finish treatment? That needs to be taken into consideration as you must finish the rads w/heat as it sounds like it should do the job and staying on the Herceptin throughout shouldn't affect the burn factor.

You need to explore that burn factor in order to assess whether to stay on the Gemzar or continue Gemzar afterwards. I hope this helps. Maybe others who have had a local recurrence and had rads can respond and help you with additional questions.
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Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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