I am struggling to understand how the RO determines the exact amount of radiation that each individual patient receives. My father currently has 14 more treatments to go and the RO told us today he is reducing the amount that he is giving to the non cancer side of his neck and the top of his lung area. We were told that he would receive a total of 66 cGy at 1.8 per day. I am just scared and worried is that enough and should he reduce the other areas. He has had 22 treatments so far. His neck and checks and upper chest are very badly burned at this point. The sides of his neck have certain cracks and were bleeding slightly yesterday. I don't want him to have more than he needs but I want it to be enough. Any insight anyone could provide about their own experience on others would be greatly appreciated.

It would be dangerous to speculate on cgys of radiaton and where they should be applied. This is highly individual, but based on a particular patients situation. You are askijng people here a question that no one can give you a definitive answer for, nor guide you in if this enough or not. There is also no correlation between tissue damage in the form of burns and what is actually happening with the malignant cells as a result of radiation. Radiation burns and other issues are not plesant, but you do not want to have him not complete hes prescribed course of treatmnet unless absolutely necessary.

Thank you Brian for your reply. I am curious to know what other's in this forum have received as total cgys. I am more worried about my Dad not receiving enough radiation. I am just trying to find at least ranges that are reasonable.

Radiation Oncologists are highly trained and skilled individuals and they take you (the patient) right up to the threshold of lifetime maximum burden. Don;t try to 2nd guess them, it will only cause you grief and stress.
Darrell

Brian
I have also read that this therapy is a "no pain, no gain" type of therapy. In otherwords the more your mouth and throat are on fire and the more everything taste like tinfoil the better? Any advice/

Darrell,
I would be less inclined to second guess the RO if my Dad was being treated at a major CCC and if he didn't have unknown primary. A large variance exist among RO's for treating unknown primary, even at the major CCC based upon the literature. I could not convince my Dad to even obtain a second opinion so I guess that is why I am more inclined to doubt the RO.

I would definately NOT be in the "no pain no gain" school of thought. Regardless of the disease and the types of treatment, proper pain management is essential to the patient's well being through the process. The doctors should be on top of this. You don't have to "tough it out" to get through treatments. I was in really bad pain for a few days, but my treamtnet staff saw that I had enough pain meds of differnet strengths to put everything from the daily pain to the peak pain under control, and in my posession for use as it was needed. Radiation does do significant damage as a by product of freeing a person of cancer, but you shouldn't have to endure unnecessary pain in the process. Unless something is going very wrong... second opinions in the middle of treatment are hard to get. Doctors themselves are not inclined to second guess a current doctor's midterm plan.

Hi Sue-
During Charlie's treatment-even the slightest movement of his neck would cause his skin to bleed. It looked like his whole neck was covered in thick scabs. And it would flake all over. He didnt want to go out of the house because he didnt want people to stare.
But it did get better! It started clearing up with one week left of treatment. Now two weeks after treatment- it is nice (new) skin. I know how scary it is to see, but our oncologist told us "If it is this bad on the outside-imagine what it is doing on the inside".
I remember thinking that it was too much, but I trusted the doctor and he madeit thru treatment!
If you have concerns-talk to the doctor- I'm sure they can calm any concerns you have.
Charlie also got thick cream to put on on the weekends only and cold compressess when it started to hurt. Ask the nurses or doctor when you go the next time. Anything to help him get thru treatment! Best of Luck for you and your father!

Sue, even RO docs in small towns have the necessary training to do their work. Try not to dwell on this aspect of his treatment. It is easy to get into a spiral of second guessing that is not productive. Hang in there and focus on the other aspects of getting through treatments.

Sue, I live in a small town with a small hospital and a new cancer treatment center. The chief RO in this little town is straight from MD Anderson and the second in command has similarly impressive credentials. It might be the climate, but is most likely the world class windsurfing that is the draw, but if they had been here when I needed treatment, I would not have driven to the Big City. Mark is right that small town docs can know their stuff.

As far as pain control, speak right up. It is your dad's right to be given drugs to control the pain. Even severe treatment can be accomplished with little pain, and I can testify to that.

I wish you and your dad the best possible remaining treatment and recovery.