Radiation Therapy After Mastectomy
A mastectomy is a surgery to remove the entire breast. Rarely is radiation therapy required for these patients. However, your oncologist might recommend it if there are enough risk factors for the cancer returning in the future, such as the number of affected lymph nodes, your BRCA gene status, and the size and location of the cancer.
Types Of Radiation Therapy
The most common type of radiation therapy for breast cancer is called external beam radiation therapy . During EBRT, a machine outside of the body delivers the radiation to the prescribed area of the body.
The exact type that is right for you will be based on many factors, including:
- The exact type of breast cancer
Talking To Your Partner About Sex
Being able to talk openly with your partner about sex is very important. What worked for you both before cancer may not work now. You may need to try different things to find what works for you both. If it has been a while since youve been intimate, start slowly with simple kissing and touching. Here are some basic guidelines for talking to your partner:
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Radioprotective Drugs For Reducing Side Effects
One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.
Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.
Radiation For Breast Cancer
Radiation therapy is treatment with high-energy rays that destroy cancer cells. Some women with breast cancer will need radiation, in addition to other treatments.
Depending on the breast cancer’s stage and other factors, radiation therapy can be used in several situations:
- After breast-conserving surgery, to help lower the chance that the cancer will come back in the same breast or nearby lymph nodes.
- After amastectomy, especially if the cancer was larger than 5 cm , if cancer is found in many lymph nodes, or if certain surgical margins, such as the skin or muscle, have cancer cells.
- If cancer has spread to other parts of the body, such as the bones, spinal cord, or brain.
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Radiation Therapy Uses High Energy X
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.
Side Effects Of Radiation For Breast Cancer
Radiation therapy is a common part of breast cancer treatment. It may be used alone, or in conjunction with other therapies. As with any kind of medical procedure, there can be side effects. Side effects can vary, depending on the kind of radiation therapy you have and your individual response to it.
Knowing what to expect, and potential side effects, can help you prepare for your treatment.
Skin changes are some of the main side effects of external radiation. These changes occur in the area being treated by the radiation. Its similar to a sunburn, and can include:
- redness and itching
- darkening of the skin
These changes happen gradually over the course of treatment, and in some people it can last for years after treatment. Some people also develop spider veins in certain areas months to years after treatment.
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Physical Emotional And Social Effects Of Cancer
In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Supportive care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Supportive care treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies.
Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.
Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.
Meditation and yoga to improve general quality of life.
Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.
Radiation Therapy Timing And Breast Reconstruction
The timing of radiation treatment in your overall breast cancer treatment plan depends on your individual situation and the characteristics of the breast cancer.
In many cases, radiation therapy is given after surgery. If chemotherapy is planned after surgery, radiation usually follows chemotherapy.
If youre having mastectomy and have decided to have breast reconstruction, its important to know that radiation can cause a reconstructed breast to lose volume and change color, texture, and appearance.
In particular, radiation therapy is known to cause complications with implant reconstruction. Research also suggests that a reconstructed breast may interfere with radiation therapy reaching the area affected by cancer, though this can vary on a case-by-case basis.
For these reasons, some surgeons advise waiting until after radiation and other treatments, such as chemotherapy, are completed before breast reconstruction surgery is done.
Other surgeons may recommend a more staged approach, which places a tissue expander after mastectomy to preserve the shape of the breast during radiation treatments. Once radiation is completed and the tissues have recovered, the expander that was used to maintain the shape of the breast is removed and replaced with tissue from another part of the body or a breast implant.
How Long Does It Take To Recover From Radiation
Most side effects generally go away within a few weeks to 2 months of finishing treatment. But some side effects may continue after treatment is over because it takes time for healthy cells to recover from the effects of radiation therapy. Late side effects can happen months or years after treatment.
What To Expect With External Beam Radiation
If you have external beam radiation, youll meet with your radiation oncologist and a nurse before starting treatment. They will walk you through what to expect with external beam radiation, and the risks and benefits of this treatment.
At this time, youll likely have a physical exam and go over your medical history.
Additionally, the radiation oncologist and a radiation therapist will take scans of your treatment area. This will help define the boundaries of the affected area so they know where to aim the radiation beams.
They will put marks on your skin to mark the area. You will need the marks throughout the course of your treatment. The marks will be used to line up your body, so the radiation beams target the exact area that needs to be treated.
Sometimes a body mold will be made to immobilize you during the treatment and to help keep your body still.
Each treatment will only last a few minutes. The session setup will take longer than the actual treatment. You wont feel anything when the machine is turned on for the treatment. Its a painless procedure.
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What Is Radiation Recall
Radiation recall is a rash that looks like a severe sunburn. It is rare but it can happen when certain types of chemotherapy are given during or soon after external-beam radiation therapy.
The rash appears on the part of the body that received radiation therapy. Symptoms may include redness, tenderness, swelling, wet sores, and peeling skin.
Typically, these effects start within days or weeks of starting radiation therapy. But they can also appear months or years later. Doctors treat radiation recall with medications called corticosteroids. Rarely, it may be necessary to wait until the skin heals to continue with chemotherapy.
Will Side Effects Limit My Activities
Not necessarily, says Yale Medicine radiation oncologist Lynn Wilson, MD, who is the chair of Therapeutic Radiology and a professor of therapeutic radiology at Yale School of Medicine. It will depend on what side effects you experienceand how severe they are. Many patients are able to go to work, keep house, and enjoy leisure activities while they are receiving radiation therapy. Others find that they need more rest than usual and therefore cannot do as much. You should try to do the things you enjoy, as long as you don’t become too tired. Your doctor may suggest that you limit activities that might irritate the area being treated. In most cases, you can have sexual relations if you wish. However, your desire for physical intimacy may be lower because radiation therapy may cause you to feel more tired than usual.
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Deep Inspiration Breath Hold
Various techniques are used to minimise the exposure of the heart to radiation. One technique is to voluntarily hold a deep breath for 20-30 seconds while the radiation is delivered, as this expands the lungs and moves the heart away from the radiation field. Pre-treatment assessment of lung capacity and breathing patterns is carried out and the patient is given instruction on breath-holding for the required time.
To accurately maintain a deep inspiration breath hold, some centres use an active breathing co-ordinator device. Using this, patients are taught to take and hold a measured deep breath while the radiation dose is delivered. Using this method, patients can monitor their own breathing and the machine links to the linear accelerator ensuring that the radiation dose is only delivered when optimal breath hold is reached and maintained.
Both methods have been shown to reduce the exposure of the heart to radiation.
Radiation Therapy For Breast Cancer In Men
Some men with breast cancer will need radiation, often in addition to other treatments. The recommendations for radiation therapy in men with breast cancer is largely taken from those for female breast cancer because not enough studies have been done in men. The need for radiation depends on what type of surgery you had or whether your cancer has spread to the lymph nodes or somewhere else in your body. Tumors that are large or involve the skin might also need radiation. You could have just one type of radiation, or a combination of different types.
Radiation therapy is treatment with high-energy rays or particles that destroy cancer cells. The most common type of radiation therapy for men with breast cancer is called external beam radiation. A machine focuses the radiation on the area affected by the cancer.
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Breast Cancer: Types Of Treatment
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will learn about the different types of treatments doctors use for people with breast cancer. Use the menu to see other pages.
This section explains the types of treatments, also known as therapies, that are the standard of care for early-stage and locally advanced breast cancer. Standard of care means the best treatments known. When making treatment plan decisions, you are encouraged to discuss with your doctor whether clinical trials are an option. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug and how often it should be given, a new combination of standard treatments, or new doses of standard drugs or other treatments. Some clinical trials also test giving less drug or radiation treatment or doing less extensive surgery than what is usually done as the standard of care. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.
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When Radiotherapy Is Used
Radiotherapy may be used in the early stages of cancer or after it has started to spread.
It can be used to:
- try to cure the cancer completely
- make other treatments more effective for example, it can be combined with chemotherapy or used before surgery
- reduce the risk of the cancer coming back after surgery
- relieve symptoms if a cure is not possible
Radiotherapy is generally considered the most effective cancer treatment after surgery, but how well it works varies from person to person.
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What Should I Avoid After Radiation
Avoid raw vegetables and fruits, and other hard, dry foods such as chips or pretzels. Its also best to avoid salty, spicy or acidic foods if you are experiencing these symptoms. Your care team can recommend nutrient-based oral care solutions if you are experiencing mucositis or mouth sores caused by cancer treatment.
Where Do I Start
You first will meet with a radiation oncologist to decide if radiation therapy is a recommended treatment option for your particular situation. If you and your doctors decide to proceed, then you will have an extended consultation in which you discuss the details of your treatment. This includes the exact area to treat, the amount of radiation you will receive, the length of treatment time and potential treatment side effects. The radiation oncologist will also answer any questions you may have. These issues vary for each person, so it is important to make an individual treatment plan.
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Does Radiation Affect The Emotions
Nearly all patients who receive treatment for cancer feel some degree of emotional upset. “It’s not unusual to feel depressed, afraid, angry, frustrated, alone or helpless,” says Dr. Wilson. “Radiation therapy may affect the emotions indirectly through fatigue or changes in hormone balance, but the treatment itself is not a direct cause of mental distress.”
Many patients help themselves by talking about their feelings with a close friend, family member, chaplain, nurse, social worker or psychologist with whom they feel at ease. You may want to ask your doctor or nurse about meditation or relaxation exercises that could help you unwind and feel better. American Cancer Society programs can provide support. Groups such as the United Ostomy Association and the Lost Chord Club offer opportunities to meet with others who share the same problems and concerns. Some medical centers have formed peer support groups so that patients can meet to discuss their feelings and inspire each other.
Radiation Therapy After Lumpectomy
A lumpectomy is a breast-conserving surgery that only removes the cancer and surrounding tissue to keep as much of the breast as possible. Patients often receive external beam radiation therapy or HDR brachytherapy following their surgery to ensure that any potential cancer cells are gone. This makes the cancer less likely to return, although its not a guarantee.
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Side Effects Of Radiation Therapy For Breast Cancer
Radiation therapy is often used to treat breast cancer after surgery. The doses of radiation used to destroy cancer cells can also hurt normal cells. The damage to these normal cells is the cause of the common side effects of radiation treatment. The possible side effects of radiation therapy are directly related to the area of the body being treated. Side effects are caused by the cumulative effect of radiation on the cells, which is why most patients do not experience any side effects until a few weeks into their treatments. While side effects may be unpleasant, there are treatments to help deal with them. Most side effects are temporary, disappearing slowly over time after therapy is complete.
Most radiation oncologists see their patients at least once a week while the patient is receiving treatment. This visit with the healthcare team is a chance for the patient to ask questions, discuss any side effects, and find ways to help relieve side effects. However, you can report concerning symptoms anytime to the treatment team.
How Effective Is Radiation Therapy
If early-stage breast cancer hasnt spread, radiation therapy after a lumpectomy significantly reduces the risk of cancer coming back by approximately 50%. Studies show that a lumpectomy followed by radiation therapy is as effective as a mastectomy without radiation therapy.
People who undergo a lumpectomy have a 20% to 40% chance of the cancer coming back at 10 to 20 years. With the addition of postsurgical radiation therapy, that risk drops to 5% to 10%. However, there are some patients who derive less benefit from radiation including patients 65 years or older with small cancers.
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