Why It Is Done
Standard radiation therapy is given to most people with early-stage breast cancer who choose breast-conserving surgery such as lumpectomy. It may also be given after a mastectomy if there’s cancer in the lymph nodes.
If you’ve had breast-conserving surgery, you may choose to get hypofractionated radiation. This is a shorter course of treatment. But the doses of radiation are higher.
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.
When Does Someone With Breast Cancer Get Radiation Therapy
The timing for radiation therapy depends on several factors. The treatment may take place:
- After a lumpectomy: A lumpectomy removes the cancerous tumor, leaving most of the breast. Radiation therapy lowers your risk of cancer coming back in the remaining breast tissue or nearby lymph nodes as well as reduces your chance of passing away of breast cancer.
- After a mastectomy: Most people dont get radiation therapy after a mastectomy . Your provider may recommend radiation if the tumor was larger than 5 cm if theres cancer in surrounding lymph nodes, skin tissue or muscle or if all the cancer cant be removed .
- Before surgery: Rarely, healthcare providers use radiation to shrink a tumor before surgery.
- Instead of surgery: Sometimes, providers use radiation therapy to shrink a tumor that they cant surgically remove . A tumor may be unresectable due to its size or location. Or you may not be a candidate for surgery because of concerns about your health.
- To treat cancer spread: Stage 4 breast cancer is cancer that spreads to other parts of the body. Your provider may use radiation therapy to treat cancer that spreads to other parts of the body.
If you had surgery, radiation therapy typically starts about one month after the incision heals if chemotherapy is not received. Some individuals receive chemotherapy after surgery, followed by radiation therapy. You may get the two treatments at the same time.
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Coping With Emotional Side Effects
Daily radiation therapy treatments can trigger many different emotions. Fear, anger, or sadness can come up at any point in treatment. Coming to the treatment center every day can be a regular reminder of your diagnosis, fears about cancer coming back, and for many people, the entire cancer experience. In other words, it can feel overwhelming.
Fortunately, there are ways to get the treatment you need and still have some balance in your life. Katharine Winner, MSW, LSW, who works closely with radiation oncologists to provide emotional support to people receiving radiation therapy, says, âItâs important to find a balance between treatment and everyday life, when possible, to help maintain a sense of normalcy. We can help arrange your schedule to accommodate the important things outside of treatment: work, time with family, self-care.
We want to help find the best way to realign your schedule to accommodate radiation. Thereâs a reason why youâre doing radiation: to treat the cancer and prolong your life. Our goal is that treatment doesnât stall your life and that you can still do the things you love and enjoy doing. See how you can reschedule yourself to get a good balance for getting through treatment.
How Long The Treatment Takes
Radiation therapy for early-stage breast cancer can be given in two different schedules.
- Standard radiation therapy. This is usually given 5 days a week. Treatment takes 5 to 6 weeks.
- Hypofractionated radiation therapy. This is given in slightly higher doses. It’s done 5 days a week. Treatment takes about 3 to 4 weeks.
The doctor will look at the stage of the tumor and other things. This is to help decide which course may be right for you. Ask your doctor to go over both of these options with you.
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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.
Why Do I Need Radiation Therapy If The Cancer Has Been Removed
After the cancerous tissue is removed, radiation therapy is used to kill any cancer cells that may remain after the lumpectomy. Radiation therapy uses high-energy beams of radiation focused on the breast where the cancer occurred. This energy disrupts the growth of the cells. Cancer cells are especially vulnerable to radiation, because unlike normal, healthy cells, cancer cells cant repair themselves.
To learn more about radiation therapy, .
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About External Beam Radiation Therapy
With external beam radiation therapy, a treatment machine will aim a beam of radiation directly to the tumor from outside your body. The radiation will pass through your body and destroy the cancer cells in its path. You wont see or feel it.
You may be having external beam radiation therapy to 1 or more of the following areas:
- The lymph nodes near your collarbone
- The lymph nodes under your arm
- The lymph nodes near your sternum
Your radiation oncologist and nurse will talk with you about your treatment plan.
Day Radiotherapy For Breast Dcis
Hi I have been diagnosed with intermediate dcis and given the option of 5 day radiotherapy – it used to be 15 days apparently but is now all in one week. has anyone skipped radio as I have that option to do that ? is it needed if I have the option to skip RT altogether? or has anyone had the 5 day treatment plan only? are the side effect less/more etc? I am so anxious and indecisive 🙁
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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.
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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Changes To The Look And Feel Of The Breast
Radiation therapy may cause the breast to feel firmer and to be slightly smaller in volume. There may be some permanent discolouration of the skin in the treatment area and visible small red blood vessels may develop.
Your radiation oncologist will discuss with you the very small risks of long-term damage to normal tissue in the treatment area, such as changes in the lungs underlying the chest wall, rib fracture, heart problems if you have a left-sided breast cancer, nerve damage causing weakness in the arm, or lymphoedema of the arm or breast. There is an extremely small risk of inducing a second cancer in the treatment area many years after your breast cancer radiotherapy.
It is felt that the benefit of radiation therapy using modern radiation techniques outweighs the potential risks of treatment and your radiation oncologist will discuss this with you.
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 it’s hitting, which causes the cell’s 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.
Effects On The Lung Or Heart
Sometimes after treatment to the breast or chest wall area, part of the lung behind the treatment area can become inflamed, causing a dry cough or shortness of breath. This usually heals by itself over time.
More rarely, fibrosis of the upper lung can occur, causing similar side effects.
Although particular care is taken to avoid unnecessary radiotherapy to the tissues of the heart, if radiotherapy is given on the left side you may be at risk of heart problems in future.
Breath hold technique is thought to reduce the risk of any possible damage to the heart and lungs.
Coping With Side Effects Of Radiation Therapy
Everyoneâs experience with radiation therapy is different. Side effects vary from person to person, even when given the same type of treatment. Before your treatment, ask your health care team which physical side effects are possible and what to watch for. There can also be emotional side effects, and seeking out mental health support to help with anxiety or stress is important. Ask your health care team about ways to take care of yourself during the treatment period, including getting enough rest, eating well, and staying hydrated. Ask whether there are any restrictions on your regular exercise schedule or other physical activities.
And, continue talking with the team throughout your treatment. Always tell your health care team when side effects first appear, worsen, or continue despite treatment. That will allow your health care team to provide ways to help you feel better during and after treatment.
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Early And Late Effects Of Radiation Therapy
- Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. Theyre usually gone within a few weeks after treatment ends. The most common early side effects are fatigue and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.
- Late side effects can take months or even years to develop. They can occur in any normal tissue in the body that has received radiation. The risk of late side effects depends on the area treated as well as the radiation dose that was used. Careful treatment planning can help avoid serious long-term side effects. Its always best to talk to your radiation oncologist about the risk of long-term side effects.
Planning Your Radiotherapy Treatment
You will have a hospital appointment to plan your treatment. You will usually have a CT scan of the area to be treated. During the scan, you need to lie in the position that you will be in for your radiotherapy treatment.
Your radiotherapy team use information from this scan to plan:
- the dose of radiotherapy
- the area to be treated.
You may have some small, permanent markings made on your skin. The marks are about the size of a pinpoint. They help the radiographer make sure you are in the correct position for each session of radiotherapy.
These marks will only be made with your permission. If you are worried about them, talk to your radiographer.
Accelerated Partial Breast Irradiation
After whole breast radiation or even after surgery alone, most breast cancers tend to come back very close to the area where the tumor was removed . For this reason, some doctors are using accelerated partial breast irradiation in selected women to give larger doses over a shorter time to only one part of the breast compared to the entire breast . Since more research is needed to know if these newer methods will have the same long-term results as standard radiation, not all doctors use them. There are several different types of accelerated partial breast irradiation:
- Intraoperative radiation therapy : In this approach, a single large dose of radiation is given to the area where the tumor was removed in the operating room right after BCS . IORT requires special equipment and is not widely available.
- 3D-conformal radiotherapy : In this technique, the radiation is given with special machines so that it is better aimed at the tumor bed. This spares more of the surrounding normal breast tissue. Treatments are given twice a day for 5 days or daily for 2 weeks.
- Intensity-modulated radiotherapy : IMRT is like 3D-CRT, but it also changes the strength of some of the beams in certain areas. This gets stronger doses to certain parts of the tumor bed and helps lessen damage to nearby normal body tissues.
- Brachytherapy: See brachytherapy below.
Side Effects Of Radiotherapy For Breast Cancer
Radiotherapy can cause side effects in the area of your body that is being treated. You may also have some general side effects, such as feeling tired.
After treatment finishes, it may be 1 to 2 weeks before side effects start getting better. After this, most side effects usually slowly go away.
Your cancer doctor, specialist nurse or radiographer will tell you what to expect. They will give you advice on what you can do to manage side effects. If you have any new side effects or if side effects get worse, tell them straight away.
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Radiation Therapy For Breast Cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is often used to treat breast cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.
Radiation therapy is given for different reasons. You may have radiation therapy to:
- lower the risk of the cancer coming back, or recurring, after surgery
- shrink a tumour before surgery
- treat breast cancer that comes back, or recurs, in the area of a mastectomy
- relieve pain or control the symptoms of advanced breast cancer
Doctors use external beam radiation therapy to treat breast cancer. During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it.
Some women may not be able to have radiation therapy because they already had radiation therapy to the chest or breast. Doctors may not offer radiation therapy to women with lung problems, damaged heart muscles and certain connective tissue diseases.
What Are The Common Side Effects Of Radiation Therapy
Radiation therapy is called a local treatment. This means that it only affects the specific area of the body that is targeted. For example, radiation therapy to the scalp may cause hair loss. But people who have radiation therapy to other parts of their body do not usually lose the hair on their head.
Common physical side effects of radiation therapy include:
Skin changes. Some people who receive radiation therapy experience dryness, itching, blistering, or peeling on the skin in the area being treated. Skin changes from radiation therapy usually go away a few weeks after treatment ends. If skin damage becomes a serious problem, your doctor may change your treatment plan. Lotion may help with skin changes, but be sure to check with your health care team about which cream they recommend and when to apply it. It is also best to protect affected skin from the sun. Learn more about skin-related treatment side effects.
Fatigue. Fatigue is a term used to describe feeling physical, emotional, and mental exhaustion even if you are getting enough rest and sleep. Many patients experience fatigue. Your level of fatigue may increase if you are receiving more than 1 type of treatment, such as radiation therapy combined with chemotherapy. Learn how to cope with fatigue.
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