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Chest Pain After Radiation For Breast Cancer

Side Effects Of Radiation Therapy

What Can Cause Breast Pain?

External beam radiation therapy is a non-invasive treatment with some short term and some longer-term side effects. Patients undergoing some weeks of treatment usually experience fatigue caused by the healthy tissue repairing itself and aside from this there can be no side effects at all. However many breast cancer patients develop a suntan-like change in skin color in the exact area being treated. As with a suntan, this darkening of the skin usually returns to normal in the one to two months after treatment. In some cases permanent changes in color and texture of the skin is experienced. Other side effects sometimes experienced with radiation can include:

  • muscle stiffness
  • tenderness in the area

After surgery, radiation and other treatments have been completed, many patients notice the affected breast seems smaller or seems to have shrunk. This is basically due to the removal of tissue during the lumpectomy operation.

The use of adjuvant radiation has significant potential effects if the patient has to later undergo breast reconstruction surgery. Fibrosis of chest wall skin from radiation negatively affects skin elasticity and makes tissue expansion techniques difficult. Traditionally most patients are advised to defer immediate breast reconstruction when adjuvant radiation is planned and are most often recommended surgery involving autologous tissue reconstruction rather than breast implants.

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Why Does Radiation Therapy Cause Side Effects

In this type of treatment, high doses of radiation therapy are used to destroy cancer cells. Side effects come from damage to healthy cells and tissues near the treatment area.

There have been major research advances in radiation therapy over recent years that have made it more precise. This has reduced this treatment’s side effects compared to radiation therapy techniques used in the past.

Some people experience few or no side effects from radiation therapy. Other people experience more severe side effects. Reactions to radiation therapy often start during the second or third week of treatment. Or, they may last for several weeks after the final treatment. Some side effects may be long term. Talk with your treatment team about what you can expect.

When To Call Your Radiation Oncologist Or Nurse

  • You have a fever of 100.4 °F or higher.
  • You have chills.
  • Your skin is painful, peeling, blistering, moist, or weepy.
  • You have discomfort in the treatment area.
  • Your breast, underarm , or arm is getting more swollen.
  • You have any new or unusual symptoms.

Many people find that counseling helps them. Our counseling center offers counseling for individuals, couples, families, and groups. We can also prescribe medications to help if you feel anxious or depressed. To make an appointment, ask your healthcare provider for a referral or call the number above.

Integrative Medicine Servicewww.mskcc.org/integrativemedicineOur Integrative Medicine Service offers many services to complement traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy. To schedule an appointment for these services, call .

You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They will work with you to come up with a plan for creating a healthy lifestyle and managing side effects. To make an appointment, call .

Nutrition ServicesOur Nutrition Service offers nutritional counseling with one of our clinical dietitian nutritionists. Your clinical dietitian nutritionist will talk with you about your eating habits. They can also give advice on what to eat during and after treatment. To make an appointment, ask a member of your care team for a referral or call the number above.

Tobacco Treatment Program

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How Long Do Side Effects Last

Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.

Side effects might limit your ability to do some things. What you can do will depend on how you feel. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and cant do as much. If you have side effects that are bothersome and affecting your daily activities or health, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment youre getting. Tell your cancer care team about any side affects you notice so they can help you with them.

Surveillance And Monitoring For Signs And Symptoms Of Recurrence

Pin on Radiation Induced Fibrosis

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Treatment for early-stage or locally advanced breast cancer is given to get rid of as many cancer cells in the body as possible. However, cancer recurs because small areas of cancer cells that don’t respond to treatment may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.

Many survivors feel worried or anxious that the cancer will come back after treatment. While it often does not, its important to talk with your doctor about the possibility of the cancer returning. Most breast cancer recurrences are found by patients between doctor visits. The American Society of Clinical Oncology does not recommend routine screening for cancer at distant sites.

During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return and will help you make decisions about your treatment. Learn more about coping with the fear of recurrence.

Your doctor will ask specific questions about your health at your follow-up care appointments. Regular follow-up care recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given.

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Causes And Risk Factors

Radiation therapy works by damaging DNA in cells. This damage isnt isolated to cancer cells, though normal cells can be damaged as well. While radiation therapy has improved significantly such that less damage occurs to healthy cells than in the past, some healthy tissues are inevitably exposed.

Several variables can increase or decrease your risk of developing long-term side effects of radiotherapy. Some of these are:

  • Your age at the time of radiation
  • The dose of radiation you receive
  • The number of treatment sessions
  • The type of cancer treated
  • The area of the body that receives radiation
  • Other cancer treatments, such as chemotherapy
  • Other health conditions, such as heart disease or diabetes

Cardiovascular Risk Factors And Fitness Assessment

At baseline, all subjects performed a maximal graded exercise stress test on a treadmill to determine their level of fitness. During the test, measurements were taken for heart rate, heart rhythm, blood pressure, and maximal metabolic equivalent capacity using the ramp/Bruce protocol 16. Blood samples taken immediately after completion of the questionnaires for assessment of cardiovascular risk factors were analyzed for B-type natriuretic peptide, C-reactive protein, total cholesterol, high-density lipoprotein , low-density lipoprotein , triglycerides, and ratio of total cholesterol to hdl.

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Why Is Radiation Often Needed After Surgery

Quite simply, radiation reduces the chance of cancer growing back in the area where the tumor was surgically removed. When a lumpectomy is performed, the surgeon removes a normal layer of breast tissue around the cancer, called margins. Even if the margins are clear and uninvolved with cancer, there is still a small chance cancer cells can be left behind in that area of the breast. In the future, these cells can grow to become a local recurrence of cancer in the same area of the surgery. Without radiation, the chance of local recurrence after a lumpectomy is about 15 to 25% over a period of 10 years. Radiation reduces this risk to about 5 to 8%.

Hair Loss In The Armpit

How to Reduce Pain After Breast Surgery: Lumpectomy or Mastectomy Recovery Tips

Radiotherapy to the armpit will make the underarm hair fall out on that side. You will also lose any hair on the area of the chest thats being treated.

Hair in the treatment area usually starts to fall out two to three weeks after treatment has started and it may take several months to grow back. For some people, hair lost from radiotherapy may never grow back.

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During Your Radiation Therapy

On the day of your first radiation treatment, youll start putting triamcinolone 0.1% ointment on your skin in the treatment area. This is a prescription ointment that will help protect your skin. Youll use it every day, once in the morning and once in the evening. This includes the days you dont have treatment. Your radiation nurse will give you more information about it before your first treatment.

Your radiation oncologist may also recommend using Mepitel® Film to protect your skin in the treatment area. If they do, put it on your skin in the treatment area before your first treatment. Keep it on until the edges start to peel up.

Youll stay in one position for about 10 to 20 minutes during each of your radiation treatments, depending on your treatment plan. If you think youll be uncomfortable lying still, you can take acetaminophen or your usual pain medication 1 hour before your appointments.

Persistent Pain After Breast Cancer Hormonal Therapy

Previous studies suggested that hormonal disturbance contribute to breast cancer, thus hormonal therapies are recommend. Arthralgias, a common side effect of aromatase inhibitors, can produce painful mobility limitations and impaired daily activities . Compared with tamoxifen, aromatase inhibitors such as anastrozole, letrozole, and exemestane show increased disease-free survival benefits they have therefore become the standard of care for adjuvant endocrine treatment of postmenopausal women with hormone receptor – positive early breast cancer .

Din et al. reviewed the incidence of musculoskeletal symptoms in phase III clinical trials of anastrozole, letrozole, and exemestane , and women on those AIs have shown significantly higher rates of arthralgia than with tamoxifen. In a specific study investigating arthralgia in 200 patients on AIs, 47% of patients reported AI-related joint pain, and 44% reported stiffness . Typically, patients on AIs experience stiffness, aches, or pain that is frequently symmetric, occurring in the hands, arms, knees, feet, and pelvic and hip bones . In addition, patients on AIs may develop tenosynovial changes, including fluid in the tendon sheath, increased tendon thickness, trigger finger, and carpal tunnel syndrome .

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How Much Radiation Did The Women Get After Breast Cancer Surgery

All the women had lumpectomy to remove the breast cancer. After surgery, the women were randomly assigned to one of three radiation regimens: 674 women had the standard full dose of 40 Gy of radiation to the whole breast. 673 women had 40 Gy of radiation to the tumor bed and 36 Gy to the rest of the breast. 669 women had 40 Gy to the tumor bed only.

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Persistent Pain After Breast Cancer Treatment

Did Breast Cancer Radiation Cause This Weird Lung Problem ...

Howard S. Smith1, Sheng-Xi Wu2

1Department of Anesthesiology, Albany Medical College, New York, USA 2Department of Anatomy, Histology and Embryology, K.K. Leung Brain Research Centre, the Fourth Military Medical University, Xian, China

Corresponding to:

Submitted Oct 06, 2012. Accepted for publication Oct 28, 2012.

Ann Palliat Med 2012 1. DOI:10.3978/j.issn.2224-5820.2012.10.13

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Fight The Cancer Spare The Heart

When treating cancer with radiation therapy, our goal is to deliver radiation to your breast area while protecting surrounding healthy tissue from exposure and potential damage.

If you have left-breast cancer, we take extra precautions to make sure that your heart receives minimal radiation exposure during your treatment.

Weekly Visits During Treatment

Your radiation oncologist and radiation nurse will see you each week to talk with you about any concerns, ask about any side effects you may be having, and answer your questions. This visit will be before or after your treatments each ________________. You should plan on being at your appointment about 1 extra hour on those days.

If you need to speak with your radiation oncologist or radiation nurse any time between your weekly visits, call your radiation oncologists office or ask the support staff or your radiation therapists to contact them when you come in for treatment.

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What Are The Side Effects Of Radiation For Breast Cancer

From Comments from Jennifer Gerson, MD, radiation oncologist with OHC. Article by Nicole Galan, Medical News Today

Image credit: Stephen Kelly, 2018

Common short-term side effects include:

  • Pain: Some people experience mild discomfort or pain around the breast, or stiffness in the shoulder area. Over time, treatments should become less uncomfortable.
  • Skin changes: Skin damage is a common side effect of radiation therapy, and having a good skin care routine is essential during treatment. Changes to the skin can include color changes, peeling or flaking, skin that feels tender, dry, itchy or sore, blisters, and excess moisture and weeping.
  • Swelling: The breast or surrounding tissue may become swollen or inflamed. Swelling should reduce within a few weeks of the end of treatment.
  • Hair loss in the armpit or chest: When a doctor applies radiation to the lymph nodes in the armpit and chest, it can cause hair loss in these areas.
  • A sore throat: Applying radiation to the lymph nodes around the collarbone can cause a sore throat or difficulty swallowing. These symptoms should improve once the treatment is complete.
  • Fatigue: Radiation can cause someone to feel very tired or fatigued. Its important to sleep and rest as much as possible during treatment.

Long-term side effects can include:

Rare side effects of radiation can include:

Radiation Therapy Uses High Energy X

Postmastectomy radiation therapy in breast cancer patients who had immediate reconstruction

Its a localised treatment affecting only the area which is specifically targeted. Although some healthy tissue may be in the treatment area, it generally has the ability to repair itself, unlike cancer cells.

In early breast cancer, radiation therapy is used with the aim of getting rid of any malignant or pre-cancerous cells remaining in the breast following partial mastectomy or lumpectomy. This reduces the risk of developing a local recurrence of cancer in the breast in the future. Radiation therapy is also used to treat the chest wall after mastectomy if the cancer has high-risk features.

The regional lymph nodes in the axilla , supraclavicular fossa or internal mammary chain may also be treated in some cases.

In these settings, large international trials have demonstrated that radiation therapy reduces the incidence of local breast cancer recurrence.

Radiation therapy is usually given after surgery, once the wounds have healed. For people needing chemotherapy, radiation is given after that treatment has been completed.

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What Is Radiation Therapy

Radiation therapy is a commonly used therapy for many types of cancer. For breast cancer, radiation is typically used after surgery to help reduce the risk of cancer returning. It can also help treat a symptom, such as pain, in someone with cancer that has spread outside the breast.

During treatment, a dose of ionizing radiation is targeted at the tumor. It is often given each day, Monday through Friday, for one to six weeks. Each dose of radiation is referred to as a fraction.

Radiation damages the DNA inside the cells its hitting, which causes the cells death. Unfortunately, radiation can also damage healthy cells, leading to side effects. Some body tissues can handle radiation better than others, so side effects may occur quickly or appear later, even after radiation is done.

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Biologic And Targeted Therapies

Patients with HER2 positive breast cancer are given HER2 targeted therapy in combination with a chemotherapy backbone. The availability of HER2 targeted agents has dramatically changed the prognosis of patients with HER2 positive breast cancers. Initial trials randomizing patients to chemotherapy alone or chemotherapy plus trastuzumab, a monoclonal antibody directed against the HER2 receptor, demonstrated nearly 50% reduction in rate of recurrence.â At present, patients with stage I HER2 positive breast cancer often receive a regimen of paclitaxel with trastuzumab . Until United States Food and Drug Administration approval of pertuzumab in 2013, patients with stage II-III HER2 positive breast cancer received regimens with trastuzumab added to AC-T or to docetaxel and carboplatin . Recent data have shown an improvement in pathologic complete response rate when pertuzumab, an HER2 dimerization inhibitor, is added to trastuzumab in the neoadjuvant setting. Administration of dual-HER2 agents in the neoadjuvant setting is now standard for patients with stage II-III HER2 positive breast cancer., The National Comprehensive Cancer Network has also endorsed the addition of HP to chemotherapy for patients with the same burden of disease in the adjuvant setting if these therapies were not received neoadjuvantly. Recently the APHINITY trial demonstrated a small but statistically significant benefit of adjuvant HP-based over H-based therapy for one year.

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Your Role On Your Radiation Therapy Team

You will have a team of healthcare providers working together to provide the right care for you. You are a part of that team, and your role includes:

  • Arriving on time for all your radiation therapy sessions.
  • Asking questions and talking about your concerns. We have included a list of possible questions at the end of this resource.
  • Letting someone on your radiation therapy team know when you have side effects.
  • Telling your doctor or nurse if you are in pain.
  • Caring for yourself at home:
  • Quitting smoking, if you smoke. If you want to quit, call our Tobacco Treatment Program at .
  • Following your radiation therapy teams instructions to care for your skin.
  • Drinking liquids as instructed by your healthcare team.
  • Eating the foods suggested by your radiation therapy team.
  • Maintaining your weight.

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