Chemo / Radiation "breaks"?

[GeoChicago]

Hi All,
My father (86 yrs old) is going through chemotherapy and radiation treatments for rectal cancer (Stage 3, well differentiated tumor). He had 3 "good" weeks so far but last week he complained to doctors that there was discomfort/soreness as a result of the radiation so the doctor(s) opted not to do treatment this past week. Is it fairly common that there are these "breaks" at some point during this treatment? I believe the entire treatment was/is to take about 5 1/2 weeks prior to surgery later on in a couple of months. Would it be the case that they would effectively "tack on" the missing week to the end of treatment? or do they just skip the week he missed and end on schedule? Any thoughts or info is appreciated. Thanks.

Regards,
G

[CRguy]

Initially they would look at "total volume" of radiation = total cumulative dose
they have a nomogram of fractions / intensities and would figure out when enough is enough

a delay in active treatment would cause the docs to assess total dose over fractionated delivery interval to see IF they reached their objectives....
remember that radiation ( especially with chemo ) continues to be the "gift which keeps on giving ! " in that the effects of the radiation persist for a while after treatment ends ( and why surgery is not usually done immediately after neoadjuvant chemoradiation ) to let the tissues "recover" a bit and get the maximum effect from it.

Definitely ask the Rad Oncs about this, depending upon your father's exact situation, they may defer / delay / extend / or adjust his delivery fractions to compensate...... i.e. they may extend OR they may quit on schedule ..... only they can tell you that.

BUTT ..... you just knew there had to be at least ONE !!!!

regarding the side effects / discomfort etc.
You should be all over the Oncs and their assistants about that !
There are and can be a number of things which can be done to relieve problems. Let them know and keep BUGGING them until they get your dad a solution.
there are things which can be done before / between treatments to help
there are things which he should not do before treatments .. AND they should have gone over all this with you / him.

ASK questions, communicate problems to them and do NOT stop until you get answers which help your dad !!!

Cheers and best wishes
CRguy

[MegTayMcc]

Hi G!
I too was scheduled to have 28 total treatments of chemoradiation. After week 4, due to bad burns and much pain my doctor "delayed" treatments for 1 week. That week off landed me back in hospital due to excruciating pain while attempting to have a bowel movement, after a few good pain killer scripts I was back on the right track. I felt deflated, and discouraged delaying treatment but looking back it was the best possible scenario, it allowed a little time to heal up and feel better. It made no difference in the long run, I had complete response. Wishing good luck and sending prayers for your dad.

[GeoChicago]

Hi G!
I too was scheduled to have 28 total treatments of chemoradiation. After week 4, due to bad burns and much pain my doctor "delayed" treatments for 1 week. That week off landed me back in hospital due to excruciating pain while attempting to have a bowel movement, after a few good pain killer scripts I was back on the right track. I felt deflated, and discouraged delaying treatment but looking back it was the best possible scenario, it allowed a little time to heal up and feel better. It made no difference in the long run, I had complete response. Wishing good luck and sending prayers for your dad.

Hi Meg,
Thank you for your well wishes. I just spoke to him tonight/today (we live in vastly different time zones). I thought he might be starting up again being that it's Monday, but the docs told him to take another week off. So looks like he'll be doing a bit more healing before going back in. I sure hope he has as much success ultimately as you did. Thanks again for the prayers.

Kind Regards,
G

[kellywin]

BUTT ..... you just knew there had to be at least ONE !!!!

regarding the side effects / discomfort etc.
You should be all over the Oncs and their assistants about that !
There are and can be a number of things which can be done to relieve problems. Let them know and keep BUGGING them until they get your dad a solution.
there are things which can be done before / between treatments to help
there are things which he should not do before treatments .. AND they should have gone over all this with you / him.

ASK questions, communicate problems to them and do NOT stop until you get answers which help your dad !!!

Cheers and best wishes
CRguy

Yes, make sure they've given him really good instructions:

No harsh soap in the area - Cetaphil makes a good cleansing bar that isn't drying
Lotion, lotion and more lotion - he should be taking lotion with him to radiation and slathering it all over the areas (and I mean all over - in the crack!) as soon as he's back in the room getting dressed. No lotion before the session, but immediate after and each night
Calmoseptine - for the razor blade feeling when going to the bathroom. Again, not until after radiation each day, but it's the only thing that is soothing and is vital for any rawness.
Good pain pills - he shouldn't be shy about asking or taking them. Again, razor blades.