Tuesday, February 28, 2012

"Radiation Information" (Being a poet again!)

You got that right, Maxine - especially as I am going through rads! 

I am far enough along in my radiation treatments (had 19 of 33 today), that I am beginning to experience tender, rashy, itchy skin in the radiation area.  I have searched ad nauseum on the breastcancer.org community forums & have googled for answers on what is the best products to "prevent" and/or "heal" skin problems.  Then, today, I found that someone posted an answer to those questions written by a Radiation Oncologist.  It was eye-opening as to what is actually happening to the skin during radiation & what control you do or do not have over what happens to the skin.  To make a long story short, this RO said there is nothing you can put on the skin to prevent irritation & nothing you can put on the skin to heal the irritation.  The RO said just to use whatever makes your skin feel better during this period.  Well, I have indeed found a couple of suggested creams & ointments that do soothe the tenderness & itching.  So, it is what it is, & just make the best of the situation.  Don't try to manage something out of your control!   Also, I have considered burning my bras because they rub & bind - ha! I agree with Maxine again here:

So that you won't have to go look up this message written by a RO to radiation patients going off the deep end & getting & giving bad advice  about radiation, I copied & pasted it here for your own knowledge - for either yourself or someone you love that is going through radiation.  It certainly has helped me to realize it is what it is & the importance of dealing with it as it is - not as some of the ill advice given out there in cyberspace.

Hello- I am very sorry for your pain and suffering. I am going to offer some information, but it is important to me that you understand I am not arguing about what you have been through or trying to minimize it- just helping you with the terminology.

Radiation wounds are not really burns, and they are not rated by degree. Medical professional who are trained in radiation usage will generally not use degrees to rate the wounds. Instead, they will use "grades" from the internationally accepted CTC (Common Toxicity Criteria) that is used by all major cancer research organizations (that is why it is call "common"). The reason you can't use degrees is that burns start at the top, and spread downward, and the "degree" of the burn has to do with how far through the skin thickness it caused damage. That isn't at all what happens with radiation- therefore the degree system isn't very useful. .

Radiation wounds are not "damaged" skin, per se, as much as they are "missing" skin- let me explain- radiation causes skin to fail to reproduce properly, and thus as you "use up" your normal skin, like we all do all day, there are no new layers of skin coming up from the bottom. So eventually the area can ulcerate. This might look like a thermal burn, but it has very little in common with a thermal burn, and the treatments for thermal burns will not help much.

Let me be clear- many skin reactions don't need, nor will they find benefit from a 100 dollars worth of potions and lotions from the herbal medicine shop. You expect me to say that because I'm a doctor. Perhaps some will stop listening to me now because I don't think that a plant from the middle of the jungle ground up and slathered on your skin will fix the problem (why would it?). But, allow me to also say- most skin reactions don't need, nor will they benefit from 100 dollars worth of laboratory chemicals stuffed into a brand name prescription from the pharmacy.

Neither approach will help heal the skin very much, and neither will prevent the damage in the first place. Do I believe in natural cures? You bet. Your body, in its natural amazing way, can regenerate skin without lotions or potions or pills most of the time. Very few radiation reactions need serious supportive care, most (not all) will just get better. Of course, there are some severe wounds that will require medical attention, but without an understanding of what is wrong, no one, be they MD, DO, ND or Shaman, can be expected to properly assist you.

Now, keep in mind, I said herbal potions and laboratory chemicals won't heal the wound much faster- I didn't say they wouldn't soothe the area and ease your suffering while your body repaired the damage. That they are very good at. For a grade I skin reaction, a good non-alcohol containing aloe is about as good as anything that costs a hundred times of much, in my opinion. I would rather a patient use aloe, but there are also some lidocaine containing topical medications that are helpful if they insist. Colloidal silver (a very natural medication for the record, despite being sold at the pharmacy) can inhibit the growth of bacteria, although it may not cure an active infection. Infection in general is actually not that common in radiation wounds- but it can happen and should be treated when it does.

Rarely, radiation wounds do need more assertive supportive care. I'm truly very sorry that you had to experience such a situation. Keep in mind, you don't have to clear or remove dead skin from a radiation wound like you might from a thermal burn- at least not aggressively. The problem is missing skin, not damaged skin, or at least that is the more logical way to model the situation.
Missing skin can't be healed with an herb, or a medication, and missing skin sure as heck can't be scrubbed at until it isn't missing anymore. Missing skin, for the most part, needs to wait until the body grows more skin. That can take 2-4 weeks for very mild reactions, to several months for serious radiation injuries.