Deciding on Radiation : Photon or Proton?

Posted by anjalima @anjalima, Aug 7, 2024

I’m in a decision process for full breast radiation. I would be interested in hearing about side effects particularly regarding contracture and skin and subsequent surgery on the skin.

Thank you

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Thank you and best to you as well.

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Profile picture for flatland @flatland

I am a 73 yo with ductal carcinoma in the right breast, triple positive. After chemo and lumpectomy, I had 21 days of photon radiation. I never experienced fatigue, or any skin issues at all, and I wouldn’t hesitate to recommend it. Good luck!

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Thank you for your encouraging words. Best to you.

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Profile picture for dick61 @dick61

I had a left mastectomy on 4/1/21 and, after healing from surgery, had 16 PROTON BEAM radiation treatments at MN Mayo. Proton radiation is the safest form of radiation because the protons release all of the energy at the target and nowhere else. I had 4-5 weeks of sunburn and used Vanicream twice each day. No skin peeling, no damage to heart or lungs, etc. Toward the last few treatments, I experienced some fatigue cured by afternoon naps. My radiation treated the entire upper portion of my let chest, the armpit and the underside of my left arm from the axilla to the elbow. I had no other problems. Don't hesitate to choose proton radiation. It's the safest and most effective!!! I am 84+ and doing fine.

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@dick61 I too am wondering how they treated such a large area with the proton radiation, expecially avoiding the heart area? Thanks for any info.

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Left breast cancer. Dr. Recommends proton. But ins doesn’t auto pay. How to get insurance to cover it ?

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Profile picture for UCFsig85 @ucfsig

Left breast cancer. Dr. Recommends proton. But ins doesn’t auto pay. How to get insurance to cover it ?

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@ucfsig Best thing is to have the doctor fight for it. If they recommend it to the insurance company and show evidence to the insurance company why they believe it's the best option and the benefits for it. My oncologist has had to fight my insurance company over pretty much everything he wanted to do. Insurance didn't want to cover the targeted cancer medication, didn't want to cover the genetic testing, didn't want to cover the proton beam radiation, didn't want to cover my pain pills...etc...etc. At the beginning of my diagnosis and treatment process it was just constant denial letters arriving. I would bring them in to my oncologist and he would be so angry and have to call them up and demand to speak to the doctors at the insurance company. Asking them how they could possibly claim to know what is better for his patient. They would then cave and agree to the prior authorizations to cover it. I have found that having a great doctor who is willing to fight for you is very important. If you find that they are not willing to advocate for you, switch doctors.

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Profile picture for coco46 @coco46

@ucfsig Best thing is to have the doctor fight for it. If they recommend it to the insurance company and show evidence to the insurance company why they believe it's the best option and the benefits for it. My oncologist has had to fight my insurance company over pretty much everything he wanted to do. Insurance didn't want to cover the targeted cancer medication, didn't want to cover the genetic testing, didn't want to cover the proton beam radiation, didn't want to cover my pain pills...etc...etc. At the beginning of my diagnosis and treatment process it was just constant denial letters arriving. I would bring them in to my oncologist and he would be so angry and have to call them up and demand to speak to the doctors at the insurance company. Asking them how they could possibly claim to know what is better for his patient. They would then cave and agree to the prior authorizations to cover it. I have found that having a great doctor who is willing to fight for you is very important. If you find that they are not willing to advocate for you, switch doctors.

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@coco46 Thank you for the advice. I’m sure it made a bad situation worse having to battle the ins company. As I am sure you are well aware, it is very stressful not knowing what is going to be covered to potentially save your life. Thanks again

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In had photon whole breast radiation after rt side lumpectomy 2024. Lymphedema was the result. I used Mepitel Film which prevented all most all irritation. Skin did change color and you get a mini lift!
Just finished Proton to my neck lymphnodes, was told by one Dr that insurance would not pay. It was my neck and the side effects can be bad. I paid up front. Insurance denied and on Proton Centers appeal it was approved. I again used Mepitel Film, harder to keep it on a moving neck. Otherwise Proton went well. 1 month out still struggling with pain in lyphmnodes…. Dr. Said it is not unusual. Hard to not think it is the cancer.

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Profile picture for coco46 @coco46

@ucfsig Best thing is to have the doctor fight for it. If they recommend it to the insurance company and show evidence to the insurance company why they believe it's the best option and the benefits for it. My oncologist has had to fight my insurance company over pretty much everything he wanted to do. Insurance didn't want to cover the targeted cancer medication, didn't want to cover the genetic testing, didn't want to cover the proton beam radiation, didn't want to cover my pain pills...etc...etc. At the beginning of my diagnosis and treatment process it was just constant denial letters arriving. I would bring them in to my oncologist and he would be so angry and have to call them up and demand to speak to the doctors at the insurance company. Asking them how they could possibly claim to know what is better for his patient. They would then cave and agree to the prior authorizations to cover it. I have found that having a great doctor who is willing to fight for you is very important. If you find that they are not willing to advocate for you, switch doctors.

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@coco46 I want your oncologist!!!

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I had TNBC in left breast (1.7 cm tumor) in 2023 and had lumpectomy, chemo and then 30 days of Proton radiation because the tumor area was directly in line with my heart. I had no side effects whatever with the radiation. However, my TNBC came back in the same spot within 6 months. I started Keynote 522 protocol last December and just had a mastectomy 4 weeks ago. My surgeon (Dana Farber in Boston) said I could not have reconstruction because my skin was damaged by radiation. (The damage wasn't apparent to me, but I didn't want reconstruction anyway). They took chest wall muscle with the breast, and my scar is brutally tight. The PA I saw last week took one look/feel and said, "this is tight as heck!!". I'm glad I was offered and accepted through insurance for Proton, as I minimized damage to my heart, but the tight, absolutely hard as a rock chest is pretty annoying. I do not have lymphedema though!

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