Careful Preparation Goes Into Planning Radiation Therapy
- “Baywatch” star Nicole Eggert, 52, is prepping for radiation treatment in her battle against stage 2 cribriform carcinoma breast cancer, and she recently took to social media to express her emotions after getting “cancer tattoos.”
- Permanent marks — from a marking pen or more commonly tiny tattoos, like the ones Eggert now has — will direct radiation technicians to ensure that treatment is precisely delivered each time.
- Stage 2 breast cancers are either larger than stage 1 tumors or have moved to a few nearby lymph nodes. Treatment will likely be some combination of surgery, radiation, and chemotherapy. If chemotherapy is also needed after surgery, the radiation is delayed until the chemo is done. The same approach is taken to hormone receptor and HER2 positive as stage 1.
- In Eggert’s case, she has already finished up eight rounds of chemotherapy over the course of six months, and underwent surgery to remove the cancer. She is preparing to undergo breast reconstruction, as well as another 18 rounds of treatment.
Eggert, who is known for her iconic roles in the TV series “Baywatch” and the sitcom “Charles in Charge,” took to Instagram over the weekend to show “pushing” herself to do more cardio and strengthen her core.
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Eggert captioned the post, “In my youth I always wanted those 3 dot in a triangle tattoo. It meant Trust No One. IYKYK Never got it bcz it felt too negative.
“Well guess what?! I just got 3 dots in a triangle from my doctors! Now they have new meaning and I’m calling them No More Cancer.”
She explained in the footage how she had just underwent a CT scan and “mapping” for her radiation treatment.
“When they said they were gonna tattoo me, I didn’t realize that it’s actually real tattoos,” the actress shared in an emotional video clip.
“It’s nothing but dots, but boy, every step of this process is never gonna let me forget it. There’s just always going to be a constant reminder.”
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Eggert also admitted in the footage, filmed in her car, “When they said they were gonna tattoo me … I didn’t realize it was actual, real tattoos, so I was tatted.”
She concluded, “So yeah, I have tattoos. My mom’s gonna be really proud of my neck tattoo, But that’s OK, that’s OK.
“The rest is gonna have to just be me working on myself and how I’m gonna get through it and ignore these new tattoos that I have.”
In another post from that same day, she explained further, “They’re gonna do CT scans and they call it imaging and tattooing of my organs, it’s so that when they shoot the radiation into me, they can hopefully miss most of the vital organs.
“They’ll hit some of them they’ve said to a degree, but hopefully not to a harmful degree.”
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Radiation Simulation: Preparing for Radiation Treatment
Once your doctor has recommended radiation therapy to treat your cancer, you can’t just walk into a room as if you were having a regular x-ray. The external beam radiation (a machine that moves around the body) most commonly used to treat NHL requires that patients undergo special preparation — called radiation simulation — in order to ensure that the right dose of radiation targets the right areas of the body, and that as few healthy cells as possible are affected by the radiation dose.
Dr. Chelsea Pinnix, a radiation oncologist at MD Anderson Cancer Center, says that many people are unnecessarily frightened by the prospect of this treatment. “Radiation for patients typically is a big black box and very scary, initially,” she says. “You read a lot of things online and you see a lot of the older studies that have demonstrated toxicity with radiation.”
Understanding Radiation Stimulation
But what patients are most worried about, she says, is based on how the therapy was delivered years ago. “I like to think about how we’ve evolved [with radiation therapy] as how the cell phone has evolved,” she says. “Several decades ago there were big huge cell phones and now we have everything that we can accomplish in little smartphones. And the same applies to radiation therapy.” While nothing has changed in the way radiation affects cancer cells, “a lot has changed in the way that we do our targeting and treatment.”
No radiation is actually delivered during radiation simulation; it’s strictly a preparatory procedure. It ensures the greatest chance of success once actual radiation therapy begins.
Radiation Simulation Step-by-Step
First, the radiation team has to decide — along with you — what position your body should be in for the treatment. The position needs to give the machine the best access to the radiation target areas. But it also has to be a position comfortable enough for you to remain immobilized for as long as each treatment requires (generally just a few minutes).
You might be lying on your back, your stomach, or your side during treatment, and a variety of special cushion-like devices will help keep you in the exact same position for each treatment. If your head or neck will be receiving treatment, a special plastic mask is molded to your face and then fixed to the table so your head doesn’t move while the radiation dose is delivered.
“We have a lot of fancy devices that we use for setup because we’re able to target down to the millimeter,” says Dr. Pinnix. “It’s really important to be in the same position every day [you receive treatment], given how focused our radiation therapy is now.”
Once you’re positioned and immobilized, you’ll receive a CT scan of the areas to be treated. These scans help the radiation team pinpoint the areas to receive radiation.
The radiation team will then mark your body, with permanent marker or tiny tattoos (about the size of a freckle) so that the correct areas will receive radiation every time you have treatment.
The entire simulation process can take up to an hour, and is a good opportunity for you to ask any questions you might have about the treatment, how it works, and what you may experience.
Radiation therapy is usually painless, although there may be side effects from the treatment. Your doctor’s can give you advice on how best to handle these symptoms.
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Nicole Eggert’s Cancer Journey
Nicole Eggert was diagnosed in December 2023 with stage 2 cribriform carcinoma breast cancer after discovering a lump in her breast while performing a self-breast exam.
A self-breast exam is an easy way to keep watch for anything abnormal regarding your breasts. It involves feeling the breast for any swelling, bulging, or changes in the shape of the breast or nipple. Checking for signs of redness, rashes, or discharge is also part of this exam. If anything is found to be concerning, you should contact your doctor. It’s important to note that self-exams should be done with regular mammograms.
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Eggert said she initially started experiencing “terrible pain” and rapid weight gain that she first dismissed for signs of menopause. However, after she discovered a lump during a self-exam, a mammogram and multiple biopsies confirmed that she had breast cancer.
The rare type of breast cancer Eggert has is often slow-growing and low-grade, according to Breast Cancer Now.
“I can definitely feel it. It’s there. It needs to be taken out. So it’s just a matter of do I have to do treatment before the surgery or can they perform the surgery and then I do the treatment after,” Eggert told People earlier this year.
Eggert’s treatment plan included eight rounds of chemotherapy over the course of six months, and was followed by surgery to remove the cancer via a mastectomy.
She’ll soon be undergoing another 18 rounds of treatment.
Understanding Stage 2 Breast Cancer & Coping With Surgery
Stage 2 breast cancers are either larger than stage 1 tumors or have moved to a few nearby lymph nodes. Treatment will likely be some combination of surgery, radiation, and chemotherapy. If chemotherapy is also needed after surgery, the radiation is delayed until the chemo is done. The same approach is taken to hormone receptor and HER2 positive as stage 1.
In Nicole Eggert’s case, her treatment included eight rounds of chemotherapy over the course of six months, which was followed by surgery to remove the cancer. Now she’s waiting to start up on another 18 rounds of treatment.
When it comes to deciding to get a mastectomy, like Eggert underwent, is a considerable step you and your care team must carefully go over.
A mastectomy is the removal of the entire breast during surgery. There are several factors to weigh when considering a mastectomy, such as if breast-conserving surgery (or lumpectomy) is possible. Your doctor will evaluate the size and features of your tumor and your family history to make a recommendation.
In some cases, a double mastectomy is a viable treatment option. During this procedure, both breasts are removed to get rid of cancer. A double mastectomy may also be performed as a preventative measure for women who are at a very high risk of developing breast cancer.
WATCH: When to consider a mastectomy?
Is Tattoo Ink Dangerous?
Tattoos have changed dramatically over the years, and so have safety precautions. In the past, red tattoo ink contained dangerous substances such as mercury. This is hardly the case anymore, as tattooists now use safer red ink since people can have life-threatening allergic reactions to mercury. However, the type of ink in your tattoo can depend largely on your tattoo artist and the studio you go to.
A leading expert previously spoke with SurvivorNet about whether there is an official link between tattoo link and cancer, and shared some guidance for those who might be worried.
“First of all, it is very important to note that the jury is definitely still out on whether there is a link at all,” Dr. Ilene Rothman, Associate Professor of Oncology in the Department of Dermatology at Roswell Park Comprehensive Cancer Center, tells SurvivorNet, referring to how tattoos and their link to skin cancer.
According to a recent Pew Research Center survey, approximately 32% of adults in the U.S. have a tattoo, including 22% who have more than one, meaning millions have some form of body art.
Additionally, the study found that the most commonly cited reason people get tattoos “is to honor or remember someone or something,” which 69% of tattooed adults say “this is either a major or minor reason they got any of their tattoos.”
“Just under half (47 percent) say they got a tattoo to make a statement about what they believe, and 32 percent say they got at least one to improve their personal appearance,” the survey found.
Dr. Rothman also pointed out that over a 40-year period there have only been reported 64 cases of skin cancer occurring within a tattoo. That being the case, and given the fact that there’s no official research on this topic, it’s too soon to deduce whether there’s a scientific link between the two.
“These cases may certainly be coincidental, [meaning] skin cancers occurring on skin that just happens to be tattooed,” Dr. Rothman said. “We just don’t know at this point because there have been no long-term large-scale studies.”
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As for the safety of ingredients, Dr. Rothman explained, “Some tattoo inks contain ingredients that are potentially carcinogenic. Current inks are believed less likely to contain potentially carcinogenic substances, but since the composition and sale of tattoo inks is not regulated, this is not known definitively.”
The main issue between tattoos and skin cancer isn’t in the ink itself, but rather that among people with many tattoos, skin cancer diagnoses can be missed. If more surface area of the skin is covered in tattoos, it makes it more difficult for dermatologists to examine the skin effectively. Without a proper examination, it’s possible moles and other signs of skin cancer could be undetected.
“Tattoos can camouflage skin cancers to both dermatologist exam and self-exam,” says Dr. Rothman. “Additionally, the instruments we use to examine the skin help us analyze patterns of skin pigment and other skin features, and tattoos can impede this to some extent. For patients who have numerous moles, we sometimes look for, and encourage our patients to look for, what is known as the ‘ugly duckling sign’ which refers to a mole that stands out from the rest.
“This is definitely confounded by extensive tattoos. We can certainly still diagnose skin cancer on tattooed skin, but tattoos can make it harder for people to find skin cancer on their own skin or on a friend’s or family member’s skin,” she added.
Back in 2022, a study out of State University of New York (SUNY) took samples of 56 different tattoo inks, and found that nearly half had azo compounds, or synthetic compounds, that can possibly mutate under ultra-violet light/sunligh orr when exposed to certain bacteri ainto cancer-causing chemicals.
Additionally, the researches found that many of the ink samples had substances that were not listed on the label.
Leading chemist on the study Dr. John Swierk told DailyMail.com at the time, “It’s possible that you might have pigments that by themselves are safe, but that photodecompose into something of concern.
“Big companies manufacture pigments for everything, such as paint and textiles. These same pigments are used in tattoo inks,” Dr. Swierk further explained in a news conference.
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The tattoo industry, they say, is “largely unmonitored,” therefore these experts are focused on building a “comprehensive database of ingredients in different tattoo inks” in the United States.
The European Union banned two specific types of pigments, blue 15:3 and green 7, after similar finding in a 2020 study. However, experts in Germany reportedly said that they found both had a “low level” of toxicity.
We do know that tattoos, in some cases, can cause bacterial infections, and experts also say that tattoos can potentially affect doctor’s findings with an MRI scan, making it harder to diagnose cancer and other conditions.
Dr. Swierk also noted that they have concerns about laser tattoo removal and cancer risk, “since we don’t understand how the laser is transforming the pigments.”
Reflecting After Your Cancer Journey Through Artwork
Contributing: SurvivorNet Staff
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