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Missing IMRT treatments

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Posted 12/3/2012 1:59 AM (GMT 0)
I would like to know if you can miss IMRT. My situation is the place took two days off for Thanksgiving and Friday,  . I am going to get 41 treatments, 25 to prostate and node bed. Then 16 to prostate only.  I missed two days due to their person problems this week. Thursday and Friday missed. 

Question is; is skipping or getting out of line for this many treatments OK. Is the important thing just getting in the treatments and missing several here and there ok if they get made up.

I just a guy that once you start something you get it done ASAP. Not use to hit and miss. Of course, if it is OK I can live with it and not worry.

Appreciate comments.

Post Edited (deros) : 12/2/2012 7:13:40 PM (GMT-7)

Posted 12/3/2012 2:58 AM (GMT 0)
Should not be a problem. I missed a few days here and there out of my 39-treatment schedule due to equipment issues and also had a couple days of biz travel. Toward the end of treatment, I had a five-day business commitment from Saturday thru Wednesday and picked up my final two treatments on Thursday and Friday when I got back. My RO said they had some flexibility. The key is to get in all your dosage within a reasonable stretch of time with a fairly steady five-on, two-off regimen most of the way.

If you still have concerns, talk to your oncologist about it.
Posted 12/3/2012 3:57 AM (GMT 0)
I had one long weekend in my adjuvant schedule. I asked about that as well. They said that they did not schedule treatments that would arc Christmas and New Years, as that was their limit, once they added in potential downtime. I did have two days that the machine was down in the morning, but they worked me in later in the evening to avoid missing a day.

It sounds like 4 days might be safe in the circumstance you describe.

Talk to the RO if there are concerns.

Posted 12/3/2012 4:58 AM (GMT 0)
deros,

I missed a two. Once an equipment failure, and once huge snow storm. Nobody seemed concerned. We just made them up.........talk to your radiation onc if you're concerned.

Best....
Posted 12/3/2012 5:01 AM (GMT 0)
Deros--Friendly fire 2 this is friendly fire 1..Glad that you are getting it done!! Drink plenty of water..yeah, my machine had "programming" problems for a day but they made It up..Glad you and ChuLai are doing great on the VBNF..Yeah, I keep track of you--some one has to--LOL..Bill
Age 70--a seasoned vet
Dx'd Sept 2010 t3a Gleason 8 in 5 cores and g7 in 4 cores out of 10. CT and bone neg--79.2g's imrt and 3 years lupron--1year to go.
Posted 12/3/2012 6:25 AM (GMT 0)
My RO said that the only problem with missing a treatment day was that I'd have to make up any missing treatment days at the end. The machine did have problems on one day and we thought they were going to cancel but they got it working and we only had a one hour delay.

They keep track and you just have to get the required number of treatments.
Posted 12/3/2012 7:53 AM (GMT 0)
Missing a day (or two) is not a problem from the treatment aspect, usually only from a planning aspect.
I had a long weekend my first week, but that was 30th April the Dutch National Holiday so it was known about n advance and planned in to everyone's schedule both staff and patients.
On the days my machine had its weekly maintenance check I was treated on a different machine (The department had 9 machines)
There was one major breakdown on one day, but it was deal with in under an hour so that was okay (They told me to have a pee and re start my "drink half a pint" business again)
However I noted on the day of my last check up that they were having to deal with an unscheduled bit of maintenance in the hospital itself on a Friday and there was a sign up explaining how all the people who would be missing their treatments on the Friday were to come in on the Saturday as the department would open specially to keep people on track.
During my SRT they also said that if I knew that there was a particular day during the 7 weeks when I would not be able to make it that they would try and plan a extra session by moving the appointments around on the days each side so that I could have two sessions on one day, but with the maximum possible time between the two sessions eg one session at say 8am and another at 4pm. Never needed to do that, it was easier to move all the other appointments.

But as ever with advice here.
Check with the docs.
All the best with your treatment
Alf
Posted 12/3/2012 3:05 PM (GMT 0)
Thank you. It sounds like the general opinion is that it no big deal to miss a treatment here and there. Just make them up to get to the total. Then total is more important than making ever treatment. You have lowered my anxiety level.



Friendly fire 1, I am happy a "season vet" has found a new home on the Well!
Posted 12/3/2012 3:29 PM (GMT 0)
My center was closed two days for the Thanksgiving holiday and the machine was down two days with computer problems. This just added days at the end of the schedule and didn't seem to be a big deal. The main problem from my point of view is that I have to keep editing my signature to update the predicted date of my last treatment.
Posted 12/3/2012 3:47 PM (GMT 0)
 As further evidence that the docs don't think its a big deal to miss a few days, I always found it interesting that IMRT was not done on the weekends or on national holidays. Presumably, the Pca doesn't care that its a saturday or presidents day, but they dont schedule treatments on those days.  In my case the only pushback I got was that they did not want me to miss 9 days (2 weekends and a 5 day business trip), so I had to cancel the trip.

Posted 12/3/2012 4:11 PM (GMT 0)
I was told that the weekends off give the patient a little recovery time, but my rad-onc confirmed that they too play golf and go to church so they need the time off as well. There were some planned breaks in my schedule as it crossed Thanksgiving and I was given two days off with each of the HDR procedures. Overall they want to give you the maximum dose in the minimum amount of time as that is the most damaging to the cancer. The delicate balance is to give the most killing dose to the cancer and do the least damage to the person., thus the fraction approach. Missing a few days here and there isn't a problem, but they would certainly not want you to take two weeks off in the middle of the treatment period.
Posted 12/4/2012 3:23 PM (GMT 0)
Maybe it is due to different culture. My husband's RO and RT centre have ensured that my husband got 5 zaps per week. When there was holiday, the RT centre would operate on Sat to make up for the holiday zap. When there was machine failure or maintenance, they would work longer hours to ensure all have their daily zaps. Both the RO and the RT Centre staff told us that it is more effective to have 5 zaps per week and they schedule all the sessions according to this protocol.
Posted 12/4/2012 11:16 PM (GMT 0)
Obviously this isn't a democratic type of thing. Your RO is the king of this decision. I assume you aren't just not showing up. Continuity is pretty important to get the full effectiveness of the treatment.
Posted 12/5/2012 1:17 AM (GMT 0)
When my SRT was scheduled, 2 of the weeks contained Christmas and New Years on a Friday. They were prepared to have the two days tacked onto the end. That would have meant me starting another week with the schedule.

I talked with my Onco and we came up with another plan. Monday of each of the two weeks I went in for a treatment at 7am and then went back for another at 5pm. This allowed me to get in the 5 per week (Monday thru Thursday)and kept me from having to add another week beginning at the end. It also gave me a 3 day weekend for Christmas and New Years.

Sonny
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