Pain from palliative chest radiation typical? - 1256004

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shinbo
Pain from palliative chest radiation typical? - 1256004

Hello everyone,

My mother just received conventional radiotherapy two to chest tumors that's been causing her some pain and I was just wondering if pain from the actual radiation is typical or not?

She's scheduled to get 10 treatments in a row to try and shrink the tumors but just after one treatment (on friday, no treatment on weekends) She's experiencing a good amount of pain on Sunday. I was just wondering if it's common or not and if there needs to possibly be a change of treatment for her.

Also if someone can please clarify something I read, about maximum amount of radiation a patient can receive. I believe I read somewhere that there is a maximum limit on radiation a person can receive or something like that?

Thank you

Dan

Dr West
Reply To: Pain from palliative chest radiation typical?

I strongly doubt that the pain is from the radiation. It would be far more typical for the pain to be from the underlying cancer (two treatment "fractions" is too short a time to expect to see a benefit, even if it will prove to be helpful later).

There is a maximum amount of radiation that is safe for particular parts of the body, so it's generally inadvisable to go beyond a maximum for an area that has received the most radiation it can safely get, but it's very feasible to radiate a different area, and the radiation to a different area will generally not have any impact. An occasional exception is when someone has received so much radiation to much of the skeleton that it leads to problems with making enough new blood cells, but that's really a very unusual situation and very unlikely to be an issue when the radiation is to the chest. The pelvis is where there is a huge amount of bone marrow, so pelvic radiation is more likely to lead to lower blood counts on a long-term basis.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

certain spring
Reply To: Pain from palliative chest radiation typical?

Just wanted to offer a patient perspective. I've had radiation to the chest and to the tumour but I've only once had pain. It was intense but lasted only about ten minutes, and was a one-off. I'd also strongly endorse Dr West's point that radiation takes a while to kick in (and then goes on kicking for weeks after the actual treatment has ended).
Did I make this up or did your mother have radiation before? Perhaps a signature might be helpful for the doctors. If it's at all encouraging, the targeted radiation I received was helpful in shrinking the tumour and relieving symptoms. Best of luck to your mother.

shinbo
Reply To: Pain from palliative chest radiation typical?

Thank you for your replies. I'm not exactly sure what's going on with my mother's case. the day after radiation she felt nothing, but the next day she felt discomfort and pain.

Everything that I read so far suggests this is not the typical case for radiotherapy, especially after just one session.

Dr West, to get further clarity on your answer about maximum radiation, is there a "lifetime" maximum amount of radiation a person can get to a single spot? for example, if a patient currently gets a max dose of radiation, is it possible to come back to the same spot with more radiation a year or two later (maybe with a different type of radiotherapy) Or is it once you hit that max limit, you are cut off from radiation to that spot?

Dan

catdander
Reply To: Pain from palliative chest radiation typical?

I will contact a doctor to answer your shinbo.

I hope your mother will feel better soon soon,
Janine

Dr West
Reply To: Pain from palliative chest radiation typical?

The answer is that it's a matter of judgment. There are general guidelines for different areas, but in certain cases, when there are no alternatives, some radiation oncologists may consider exceeding those guidelines. This really depends on the exact situation and location, so you'd need to speak to a radiation oncologist directly evaluating the specifics of the case.

For all intents and purposes, there are no absolutely inviolable rules in cancer treatment.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

Dr Gadgeel
Reply To: Pain from palliative chest radiation typical?

The only thing I can add to what Dr. West has said is that sometimes there could be esophageal (food pipe) irritation from radiation to the chest, if a significant length of the esophagus is in the radiation field. This also is unlikely to occur after 1-2 days of radiation.

If the patient has any history of gastritis, reflux then it would be worthwhile to start on a drug like Prilosec. The radiation doctor should be able to determine if esophageal irritation is a possibility.