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Judy M.

SBRT

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Had my first SBRT treatment for the 3 tumors in my lungs. The way they are doing it seems unusual possibly and interesting so thought I'd share. They are treating all 3 tumors each session consecutively. This involves laying perfectly still with my arms stretch above my head for about 1 1/2 hours. This is a bit uncomfortable since I have a hinky left shoulder and had a port place in my upper left chest a couple of days ago, but it is doable. They will do 5 treatments spaced 2 or 3 days apart to give me a bit of a rest. Has anyone else had multiple consecutive SBRT treatments. I'm thankful I can have these since they do seem to have a good success rate as far as eliminating existing tumors. I do wonder why chemo was not done first to try to stop any spread though. They seem to be looking at it as get rid of the lung tumors then do chemo as a sort of mop up of anything left now. My plan seems to have sort of evolved between the 2 Radiology Oncologists and the Medical Oncologist over the last 6 weeks as it kept changing.

Judy M

 

 

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Judy,

Our experience has some similarities. I only had 1 tumor to treat. My treatment was administered 3 consecutive days but the treatment cycle was about 30 minutes a session. So 3 tumors @ 30 minutes each yields your 1.5 hour treatment time. 

I think your doctors are considering your SBRT as a surgical procedure. The point of after surgical chemo, as I understand it, is to eliminate cells dislodged during surgery. SBRT does excite the tumor and perhaps cells can be discharged from this treatment, thus the post treatment rational. Better answer, ask you doc. 

I'm excited you have this opportunity. I've often wondered why SBRT has not been used in circumstances like yours. I wish you success. SBRT worked for me!

Stay the course. 

Tom

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Thank you, Tom. I'm glad for this opportunity also. I hadn't realized SBRT could excite the tumor. Before my port placement and first treatment I'd felt perfectly healthy. The only symptom I had was an occasional cough. Since I've had some soreness in my neck, dizziness at times, and a little more tired than usual. Nothing major, just not as perky as I was before. By exciting the tumor do you mean this could actually cause the cancer to spread?
Judy M

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Judy,

To your question, does excitement (my word) cause the tumor to spread. I don't know. I don't know if a radio oncologist would agree with the word excite as a descriptor for gamma ray bombardment. I used the term because the radiation actually destroys the cancer cells by applying vast amounts of energy. I don't know enough about how the cells die but at the molecular level, fundamental physics suggests increased cell activity as it absorbs and reacts to gamma ray energy. So I thought the word excite would substitute for the previous long winded explanation.  A good question for your radiation oncology would be to explain the mechanics of cell activity to radiation.

I know post surgical chemo is a precautionary treatment. It is done to kill cells in the blood stream be they caused by surgery or normal metabolic or metastatic activity.  I believe your SBRT is considered to be a surgery equivalent procedure. Thus they are following treatment protocol. 

Stay the course. 

Tom. 

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Thanks Tom. The physicist who was involved in planning my SBRT was actually present at my last treatment and I got to meet him. And I see one of my Radiation Oncologists each week. I may ask the question just to see what they have to say. It's an odd thing. I've been told by doctors that questions are good. But I've also seen doctors look irritated by my many questions. My Medical Oncologist's A.P.N. told me the last time I saw her that those in medicine need to be challenged. or they won't grow. I like that idea.
Judy M

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Tom,
Just had 2nd SBRT treatment. My physicist says he'll be present for all of my treatments, and he's very happy to answer questions so I ask away. As far as SBRT exciting the tumor he says no, it won't. The reason being because the fractionations are so high. Pretty much the little devils just don't stand a chance. But he said, on the other hand, if I was having standard radiation it would be bad if I missed a treatment because the tumor knows it's being threatened and will quickly develop radiation resistance. I also now know that Gy stands for a gray and is sort of like a degree on a thermometer except it's a particle of ionized radiation. And, like you, he calls that energy. I'm receiving 10 Gy from 5 separate angles on each tumor for each treatment for a total of 50 Gy to each tumor for each treatment. Being you, you probably already knew most of this. But you're so good to answer all our questions that I wanted to pass on what I could. Thomas, my physicist, is great to talk to if you have anything else you want me to run by him
Judy M

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Judy,

Thank you for the explanation. 

Take good notes on your treatment. Your's is a unique treatment experience. Perhaps you could write a blog about your treatment in the blog section of our forum so we can all learn from your experience. 

So glad things are going well...and...

Stay the course. 

Tom

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Tom
I haven't found a blog section. And I wouldn't have any idea how to write a blog. But will try to share what I learn along the way. Although maybe not so much. As you've probably guess I talk a lot. Lol.
Judy M

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Hi Everyone,

Finished with S.B.R.T. to the 3 tumors. Received50Gy/5 Fractions with treatments being every 323rd or 4th day. Don't know why the 2 or 3 says between except that Radiology Oncologist says it was to give my normal tissues time to heal. And I'd had standard radiation less than a Year ago. Perhaps that made a difference. At the conclusion 1 tumor was disintegrating and they thought the other 2 had shrunk, but hard to tell because of scar tissue. So we wait and see. The B.E.D. for the radiation was 1000. Hoping Tom knows what that means as far as standard S.B.R.T. goes. Chemo has been changed from Cisplatin/Taxol to Cisplatin/Alinta. Tom, you were right. They are treating this as though I've had surgery on the 3 tumors. Medical Oncologist said as much. The reason he gave for the switch in chemo is interesting. He said 5 years ago they weren't very sophisticated and gave the same chemo for every type of lung cancer. But now they have the chemo more fine tuned. Cisplatin is still given but they've learned that Alinta doesn't work well for squamous cell, but works very well for Adenocarcinoma. Will have 2 treatments 3 weeks apart, then scan. If all looks good that's it. If not 2 more rounds of chemo. Good news is I won't lose my hair with the Alinta. Both Radiology Oncologist and Medical Oncologist think I have a good chance with this treatment and the day things have gone so far. Just updating since my treatment continues to be rather unique and I have no idea how do start a blog.

Judy M

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Sorry about all the errors in the above. Have a new phone that likes to try to think for me. The chemo drug is Alimta. And hope it doesn't change it yet again when I post this.

Judy M

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Judy,

BED means biologically effective dose. I don't know what the number 1,000 means in relationship to a BED. 

I bet the other two tumors are fried also. It is hard to hide from SBRT. 

Let us about your chemo after your first infusion. 

Stay the course. 

Tom

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