I am due to have a lumpectomy and sentinel lymph node removal using radioactive dye. My eGFR is only 23%. After the operation I am due to have radiation therapy. Has anyone else had this done and do you know if the radiation or dye will lower my eGFR of 23%. I am very worried at the moment as I don't want to get rid of the cancer and end up having to have dialysis.
Any advice will be gratefully received
Many thanks
Eve
I had exactly the same concern as found I had CKD stage 3b in late Autumn 2019 (GFR 38) only because I asked my GP and later discovered I had had a low GFR for many years. By July 2020 I was diagnosed with breast cancer. My GFR at that time was 45 and now after all my treatment, although still on hormonal treatment, is 43. I was very worried and got no understanding of this from the hospital. However, I had 7 cycles of chemo, a lumpectomy, radiotherapy and 11 cycles of immunotherapy and the lowest my GFR reached was 40. My intake of water was increased anyway and I drank a lot of water during treatment. I had already amended my diet due to advice from this excellent forum and did my best through cancer treatment. This was due to the hospital advice being 'do not restrict anything and eat what you like' . It was difficult to balance the two but I did my best. I got no help from the hospital dietician as she knew nothing about renal problems. I hope you receive a better attitude than I did but I hope my reply will go some way to easing your concern, especially as I don't think you are going to have chemo . I also had sentinel node removal with dye, several MRI s with contrast dye, a CAT scan and a PET scan also and was as worried as you can be. Your GFR is lower than mine so make sure you are taken seriously and perhaps others on this site will come up with more info for you I wish you all the best with your treatment.
Many thanks esparanta for sharing your treatment and your best wishes. It has eased my worries considerably. Can you let me know what hormonal treatment you are taking as I am on Tamoxefen 20mg but it has stopped working and they need to find another tablet I can take which will agree with my CKD? I wish you all the best for the future.
Hi Eveebear. I am on 1mg Anastrozole. It's an aromatase inhibitor and keeps down oestrogen levels as my breast cancer was HER2 positive. I am postmenopausal and it is suitable for that. It causes tiredness and I have noticed some hair thinning which may stabilize. I was given ibuprofen and paracetamol. I did not take the ibuprofen. I took some paracetamol before coming home and two before bed. I did not have a lot of pain the next day and did not really need to take many thereafter. I did not find it a dreadful operation and was grateful for the breast conserving approach of today. Hope this helps.
Just thought of another question you may be able to help me with." What painkillers were you given after after the lumpectomy and sentinel node removal?" The hospital are telling me I will just need paracetamol
Hi again eveebear. My wife had DCIS in both breasts and had surgery on them at the same time. There is an incision scar about 1.5 inches on each breast. I just asked her and she said she did not have much pain and did not take any painkillers. On a side note, they started her on Tamoxifen after the surgery but that was causing very light spotting and it can cause endo cancer so they switched her to Anastrozole. Her oncologist said he did not think broad coverage radiation would be necessary because her cancer was so tiny it wouldn't be of any benefit. BTW, she has not been diagnosed with CKD although her GFR has fluctuated quite a bit over the past year anywhere between 39 and 54. Best wishes!
Thank you very much for sharing the experience of your wife with me. Much appreciated. Wishing you both well for the future.
I believe the times I needed scans, they used creatinine >2 as the cutoff for using dye. My Nephrologist would make the call as to whether or not the use of dye was really need for that particular scan and say Yay or Nay.
Many thanks for your reply. The breast consultant is meant to be communicating with my Kidney consultant to see if the dye is safe.
I’m so sorry you’re going through this tough season! I was told Lymphoscintigraphy was kidney safe. I’m not sure about the radiation though. I hope everything goes well for you. I’ll keep you in my prayers.
When I had breast cancer my GFR was in the high 20s. I had surgery, chemo and radiation, none of which seemed to affect my GFR The only difference in my experience from the others who've answered is that after 5 years of Tamoxifen, I was switched to an aromatase inhibitor. My nephrologist felt it was affecting my GFR negatively and put me back on Tamoxifen. I saw my nephrologist more often than my primary and he took over all my care. It made things simpler since he often had to countermand what the other docs were prescribing. Amazing what docs will do without looking at your chart particularly anesthesiologists. Finally, my HMO put NSAIDs on my list of allergies. Apparently they'll look at that.
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