Collateral damage from radiation?

[Retiredprof]

Happy to hear that someone with Stage 4 is still alive! Congratulations! I was diagnosed with Stage 3 rectal cancer in October. Was supposed to start radiation and chemo but radiation oncologist was afraid rectum might close up completely so she advised a colostomy first which I had on November 10. Still waiting for last bit of incision to heal. I'm scared about the collateral damage that radiation may cause. Any advice?

[O Stoma Mia]

... I'm scared about the collateral damage that radiation may cause. Any advice?

Collateral damage can be minimized by using radiation machines that target specific locations and that modulate the radiation intensity according to the regions that actually need some radiation. In this case, the level of collateral damage depends on the skill of the radiologist who is responsible for programming the machine to target certain areas and avoid other areas.

There are several companies that make linear accelerators (radiation machines) that do targeted radiation. When you meet with your oncologist you can ask which machine will be used in your case and what type of capability it has to target the radiation so as to avoid radiating critical adjacent organs or structures.

For rectal cancer, I think the big problem with collateral damage would be with radiation to the sphincter muscles. If intense radiation is allowed to creep into this area, then I think there will be problems in the future in getting the sphincter muscles to work properly. (This is just my personal opinion)

• Here are links describing a machine that has capability in IMRT and IGRT
  Intensity Modulated Radiation Therapy / Image Guided Radiation Therapy -- a Varian Clinac® linear accelerator.
  
  IMRT. Intensity-modulated radiation therapy will structure the dose to spare healthy tissue
  
  IGRT. Image-guided radiation therapy pinpoints a moving target.
  .
• Here is a document describing the Varian Eclipse™ Treatment Planning System, which is what the radiation oncologist is trained to use in order to program the machine to avoid healthy tissues and organs:
  
  Varian Eclipse™ Treatment Planning System
  .
• Here is a leaflet with a general overview of rectal cancer radiation therapy:
  
  RADIATION THERAPY FOR CANCERS OF THE COLON, RECTUM AND ANUS
  .
• Here's a prior post on this Forum with a link to a video, in case you're interested:
  
  http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=48458#p366423
  
  Here is a direct link to the video mentioned above :
  
  My Radiation Treatment for Colon Cancer
  .
• A special warning: When going in for a radiation therapy session, remember,
  
  Do not bring your cell phone into the radiation bunker, otherwise it will likely be "fried" by the time your session is over.
  
  Do not use any kind of zinc-oxide based cream on your skin because this can cause severe radiation burns (proctitis) due to the interaction between the radiation beam and the zinc oxide.

Zinc oxide induced radiation burns -- "...Although a general consensus among radiotherapy centres is lacking, the advice given to patients has a few commonalities:
• During or after radiation treatment, avoid the use of metallic-based topical products (zinc oxide creams)... because they may increase the surface dose to skin
• Wear loose-fitting clothing over the irradiated area to prevent friction injuries
• Maintain a clean and dry irradiated area
• Avoid extreme temperatures
• Avoid the use of starch-based products because they increase the risk of infection

Reference: Prophylaxis and management of acute radiation-induced skin reactions: a systematic review of the literature


Skin Reactions From Radiation

Radiation Therapy and Caring for Your Skin

.
. ostomamia

[Leighann Sturgin]

There could be some changes in your sexual function. I wish someone would have told me about before radiation.

[Redtexa5]

Mia that was an awesome response to Retiredprof's question. The only thing I might add is that what ever collateral damage the radiation might cause it will be less than the collateral damage you would have with metastatic colon cancer. You need to keep your eye on the main prize darlin your going to pay a price for being cured but the time to total up the bill is perhaps at the end of the journey.

[ab123]

I had radiation to the rectum 2 years ago. The machine they used on me was a Varian TrueBeam, and it reduces collateral damage by shooting from multiple angles - I think 4 in my case. This allows the maximum dose to be delivered only at the intersection of the multiple beam angles. The other areas through which the x-rays travel get a partial dose that is much less damaging. The part that received the maximum dose (the rectum) was, of course, removed during the lower anterior resection (LAR) operation. They were very careful about targeting - using MRI and CT scans to model the exact position of the tumor and then tattooing dots on my skin to align the machine properly every time. I was impressed with the careful process and the level of technology applied to preventing collateral damage to healthy tissue.

Today I notice that when I have to pee I really have to pee - the sensation of having to go can be much more urgent than it used to be. I think that's a result of radiation. Although I don't think I have to go much more often. Sexual function has been ok but possibly affected somewhat.

All in all, I would take these relatively minor side effects any day over the significant risk of recurrence that I have hopefully reduced. So far I'm happy with the results.

[singingholly]

Happy to hear that someone with Stage 4 is still alive! Congratulations!

Did you read a second time your words...?! Personally I keep for myself the answer to such an introduction, it's in italian you know...