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Thread: Accidental Overexposure During Radiation Treatments

  1. #1
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    Accidental Overexposure During Radiation Treatments

    Also posted in "Cancer Pain" forum

    Greetings, forum. I am new here and speaking on behalf of my partner who finished treatments for Stage IV Squamous Cell Carcinoma. For the purposes of background information - he is a 48 year-old-male (non-smoke, not heavy drinker) who was diagnosed in November of 2016 via pet scan, biopsy of a neck lump, and, subsequently, a tonsillectomy. He then underwent robotic-enhanced surgery to remove the mass and the surrounding tissues. Because of a small amount of "bad cells" in the marginal areas around the lump, he was referred then to a radiation oncologist for a course of radiation therapy. Somewhere about two or three weeks into the treatment, he was accidentally exposed (human error) to approximately twice the normal units of radiation. Essentially, we were told that it would not be "a big deal" (though the incident had to be reported to some state authority). After the six weeks of treatment, he had rather severe radiation injuries to the skin on his neck (more so than would be expected, but not so severe that it required surgery or hospitalization). Those cleared up rather quickly using moist dressings and such. Normal stuff, basically.

    However, in the two months since his treatment ended, there has been significant throat pain, burning, swallowing issues, etc. The RO treated him for a thrush infection - but that did not solve the problem. The RO now believes that he has ulcerated tissue that is constantly aggravated and prescribed a combination of Vitamin E and a medication that increases vascular blood flow. Admittedly, the RO says that his patient's recovery timeline is atypical. This got the both of us thinking that maybe the overexposure he received might be the cause of the slow recovery. Then I did a little research and began to understand that the overexposure could lead to significant and possibly sever consequences, even as far as a decade from now.

    So my question is this... if the RO continues to say that it was "no big deal," from whom are we to get real answers to this problem? His current difficulties, I believe, may have been caused by the overexposure incident, which is supported by the fact that the RO stated that he should be doing better than he is. Has anyone else experienced these issues? Any advice about what to do going forward?

    Thank you in advance to all who respond.

  2. #2
    Administrator Top User lisa1962's Avatar
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    Sorry to hear of your partners ongoing issues. While i can not offer any particular helpful advice specific to your partners situation, please do check back often on this thread for any responses.

    I did delete the same questions posted im the cancer pain forum as that constituted a duplicate thread and can become confusing. This side of the forum has more visability than the cancer pain forum so most likely the responses will be made here.

    Good luck to your partner and hoping, in time, the effects of radiation treatment will subside.

    Lisa

  3. #3
    Moderator Top User IndyLou's Avatar
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    Hello, AMartin-

    Welcome to the forum, though I'm sorry that you have to be here. I am a head and neck cancer survivor as well, though I was treated with radiation and cetuximab--I guess they hadn't perfected the robots just yet--but I am over 4 years cancer-free, and I suspect that when your partner heals from his radiation treatments, his cancer will be a fleeting thing as well.

    First, let me tell you--radiation in the vicinity of the head and neck area is harsh, much more than a patient might be led to believe. While I have a tendency to agree with the radiologist that one higher exposure might not be something to worry about, that was concerning that human error caused it to happen. Regardless, the neck "burn" you described two weeks after treatment is quite common. It was described to me as similar to a sunburn. Your skin turns red as part of the healing process. During treatments however, the continual barrage of radiation doesn't allow your skin to burn until after the treatments have stopped. But that's just the external damage.

    Inside the throat and mouth, radiation is insidious. Every person reacts differently of course, but I think that many experience some of the similar effects that you described. Myself, I had a horrible case of mucositis. My tongue and gums were bright red and swollen, and my upper palate was very sore. I had to take liquid pain medication because swallowing a pill of any kind was nearly impossible. Naturally, my food intake suffered and despite having a feeding tube, I lost about 25 pounds. I assumed that shortly following the end of treatments, I'd heal and be back eating again, but that was not the case. Chewing, and swallowing, were very difficult. My tongue felt as though it had paper cuts all over it. It was difficult finding foods whose taste wasn't offensive.

    Even months after my treatments ended, my throat and voice did funny things. It's as though my voice box became inflamed, and I had this raspy, deep voice--I worried that it would affect me for the remainder of my life. Gradually, all of that went away after a while. My swallowing function is only about 90%, even today. It may never fully recover. Some foods still get stuck in my throat, and a ready bottle or glass of water is needed.

    As far as advice, please try to be patient as a caregiver, and encourage your partner to do the same. Trust in your RO, as they should be very familiar with recovery following radiation treatments. There are numerous oral solutions that can be gargled or swallowed. If you're not seeing gradual improvements though in the next weeks and months, let your RO's office and their nurses know. Remember that the healing from this will be measured in months, not days or weeks.

    Additionally, I would monitor your partner's dietary intake. It's easy for them to give up on food altogether, but maintaining an adequate diet is so important for healing. Hopefully, your partner also has a feeding tube? If not, you should speak to a dietitian about liquid nutrients. The throat will be sore for a while, so continue to manage the pain. Your partner should have some type of narcotic-consider adding Murilax to their liquid intake...it's very easy to become constipated from the narcotics. I would also inquire about a speech or occupational therapist that can help with the swallowing and other functions affected by the radiation. Finally, encourage your partner to maintain good dental hygiene. The radiation may have affected the teeth and jawbone. It's important to avoid any kind of serious cavities or root canals.

    I hope that helps. Please feel free to ask more questions.
    Age 54 Male
    early Feb, 2013 - Noticed almond-sized lump in shaving area, right side of neck. No other "classic" cancer symptoms
    late Feb, 2013 - Visited PCP for check-up, PCP advised as lymphoma. Did blood work, orders for CT-scan, referred to ENT
    3/7/13 - CT-scan inconclusive, endoscopy negative
    3/9/13 - FNA of neck mass
    3/14/13 - Received dx of squamous-cell carcinoma, unknown primary
    3/25/13 - CT-PET scan reveals no other active tumors
    3/26/13 - work/up for IMRT
    4/1/13 - W1, D1 of weekly cetuximab
    4/8/13 - W1, D1 of IMRT
    5/20/13 - complete 8 week regimen of weekly cetuximab
    5/24/13 - Complete 35-day regimen of daily IMRT
    mid-July 2013 - CT-PET scan reveals no active tumors, but shows necrotic tissue at site of original tumor
    early Sept 2013 - partial neck dissection to remove necrotic tissue. Assay shows no cancer present.
    Spring 2014 - No signs of cancer
    Spring 2015 - NED
    Spring 2016 - NED
    Spring 2017 - NED
    Spring 2018 - NED
    Spring 2019 - NED

 

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