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Side Effects Of Radiation For Breast Cancer

What Time Of Day Is Best For Radiation Therapy

Side Effects of Radiation Therapy for Breast Cancer?

New research from Roswell Park Comprehensive Cancer Center, to be presented at the American Association for Cancer Research Annual Meeting 2019 in Atlanta, reports that administering radiation treatments in the morning as opposed to later in the day can significantly reduce severity of mucositis and its related

Staying On Track With Radiation Treatments

The benefits of radiation therapy strongly depend on getting the full recommended dose without significant breaks, because:

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    The full dose of radiation is needed to get rid of any cancer cells remaining after surgery.

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    Radiation therapy is most effective when given continuously on schedule. In the past, it was given every day, 5 days a week, for 5 to 7 weeks. Accelerated, also called hypofractionated, radiation therapy schedules deliver about the same total dose of radiation over a shorter schedule usually 3 to 4 weeks, which can be more convenient. Partial breast radiation can be completed in 1 to 3 weeks. Also, by seeing your doctor regularly during and after treatment, you can best deal with any side effects.

Why you might have problems sticking to your radiation therapy plan:

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    The treatment schedule may conflict with job demands, family needs, or the distance you live from the treatment facility. This may cause you to miss or postpone appointments, even if youre on an accelerated schedule.

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    Skin irritation from radiation can cause soreness, peeling, and sometimes blisters. If you’ve also had lymph-node surgery, radiation treatment may worsen breast or underarm pain or discomfort. If you have these side effects, you might feel like stopping radiation.

Ways to overcome problems and stay on track with radiation treatment:

Having Radiotherapy For Breast Cancer

You will have radiotherapy as an outpatient. It is usually given using equipment that looks like a large x-ray machine. You might hear it called external beam radiotherapy .

You usually have radiotherapy as a series of short, daily treatments. These are called sessions. The treatments are given from Monday to Friday, with a rest at the weekend. The person who operates the machine is called a radiographer. They will give you information and support during your treatment.

You usually have radiotherapy for 3 weeks. Women who had breast-conserving surgery may have an extra dose to the area where the cancer was. Sometimes the booster dose is given at the same time as radiotherapy to the rest of the breast. Or it may be given at the end of the 3 weeks. This means you will need a few more treatments. Your doctor will tell you how many treatments you will need.

If you have radiotherapy to your left breast, you may be asked to take a deep breath and hold it briefly. This is called deep inspiration breath hold . You do this at each of your planning and treatment sessions. It keeps you still and also moves your heart away from the treatment area. DIBH helps protect your heart during your treatment and reduces the risk of late effects.

External radiotherapy does not make you radioactive. It is safe for you to be with other people, including children, after your treatment.

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What Can I Expect From My Treatment

When you arrive, please check in at the desk. Each treatment should only last 10 to 15 minutes. You can change your clothes in the dressing room and then wait in the lounge to be called.

During each treatment session, you will lay on a table while the technician uses the marks on your skin to locate and treat the field. It is important to be still while getting the radiation, although you should continue to breathe normally.

Higher Risk Of Infections

Side effects of radiation for breast cancer: What to know

All breast cancer therapies can weaken your immune response and raise your risk of infection. Common areas for infection include:

Chemotherapy and radiation therapy for breast cancer can stop your body from making white blood cells, which fight infections. Try to stay out of large crowds and away from sick adults and children for 7 to 10 days after you have chemotherapy. Thats when you usually have the fewest white blood cells.

Contact your doctor right away if you get sick. You might notice:

  • Colored mucus in saliva or nasal drainage
  • Fever of 100.5 degrees F or higher
  • Sore or burning throat
  • Swelling, redness, warmth, or pus at injury site
  • Cough or shortness of breath

Your doctor might recommend antibiotics as a precaution. Or they may suggest you get a flu shot before you start chemotherapy.

If your white blood cell counts are too low, your doctor may give you a treatment called G-CSF or GM-CSF .

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Heart Or Lung Problems

Some women experience lung inflammation years after radiation therapy. This is especially true if they have also had chemotherapy. If there is significant heart exposure because of left breast radiation, in some cases injury to the heart can occur, causing heart conditions or heart disease. This is not as common these days, thanks to greater understanding of this potential link.

Oral Devices Need Special Care During High

The following can help in the care and use of dentures, braces, and other oral devices during high-dose chemotherapy or stem cell transplant:

  • Have brackets, wires, and retainers removed before high-dose chemotherapy begins.
  • Wear dentures only when eating during the first 3 to 4 weeks after the transplant.
  • Brush dentures twice a day and rinsing them well.
  • Soak dentures in an antibacterial solution when they are not being worn.
  • Clean denture soaking cups and changing denture soaking solution every day.
  • Remove dentures or other oral devices when cleaning your mouth.
  • Continue your regular oral care 3 or 4 times a day with dentures or other devices out of the mouth.
  • If you have mouth sores, avoid using removable oral devices until the sores have healed.

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Preventing Heart And Lung Damage

After my breasts were a decent size, one of the radiation therapists made my . I laid on my back on the big radiation machine. I had to reach both hands above my head and hold on to handlebar type things.

Since my cancer was in my left breast, my doctors were concerned about my heart being radiated. They had me do deep breathing exercises where I held my breath for different lengths of time.

The longest I ever had to hold it was during this CT scan appointment. The actual radiation sessions went much faster.

The therapist used a sharpie marker to make crosses on my chest and abdomen. I was not supposed to wash these off for the entire five weeks.

Some of them did fade, but the therapists would freshen them up at my appointments. During these five weeks, I made sure to wear shirts that had high collars. Otherwise, you could see a big green x near my collarbone.

Why Radiation Is Used

Side Effects of Radiation Therapy After Breast Cancer

One of the upsides of using radiation is that it can be used to treat breast cancer at almost every stage. Its most often used in conjunction with surgery, chemotherapy, and other medicines to prevent breast cancer from coming back. And for incurable cases such as when the cancer has spread to other parts of the body its commonly used to ease symptoms.

But, unlike other forms of treatment, radiation is generally localized, meaning its usually aimed at only the part of the body thats needing therapy. In many cases, patients might just need radiation to a part of the breast or partial-breast irradiation where internal or external radiation is directed toward the area around where the cancer was removed.

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Are There Options To Prevent Or Treat Side Effects Caused By Radiation Therapy

Yes. Your health care team can help you prevent or relieve many side effects. Preventing and treating side effects is an important part of your overall cancer treatment. This is called palliative care or supportive care.

Before treatment begins, ask what side effects are likely from the specific type of treatment you are receiving and when they may happen. During and after treatment, let your health care team know how you are feeling on a regular basis. This includes if you are experiencing a new side effect, or a problem persists or has gotten worse.

Prone Position External Beam Radiation Therapy

Perlmutter Cancer Center radiation oncologists helped pioneer prone external beam radiation therapy, which allows for better distribution of the treatment dose. During this approach, you lie in a prone position, or face down, rather than on your back, called the supine position.

Our doctors helped pioneer prone external beam radiation therapy, which allows for better targeting of the treatment dose while avoiding nearby organs, such as the heart or lungs.

This positioning lets gravity displace the breast tissue away from the body, allowing radiation oncologists to better target the breast tissue while avoiding the heart and lungs.

Another advantage of the prone position is that it decreases the incidence of skin irritation. Radiation beams are evenly distributed throughout the breast and are less concentrated in the skin folds, as compared to radiation therapy given to women when they lie on their backs during treatment.

Whole breast radiation and partial breast radiation are typically delivered while you are in the prone position. After mastectomy, the supine, or back-lying position, is used for better targeting of the lymph nodes surrounding a tumor.

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If Youre Getting Radiation Therapy To The Chest

Radiation treatment to the chest may cause side effects such as:

Radiation can also cause other problems in the heart or lungs.

Heart complications

Getting radiation to the middle portion of the chest can raise your risk of heart disease. This risk increases with higher radiation doses and larger treatment areas in this part of your body. Radiation can also cause hardening of the arteries , heart valve damage, or irregular heartbeats.

Radiation pneumonitis

Radiation pneumonitis is inflammation of the lungs that can be caused by radiation treatment to the chest . It may occur about 3 to 6 months after getting radiation therapy. Its more likely if you have other lung diseases, like emphysema . Common symptoms of radiation pneumonitis include:

  • Shortness of breath that usually gets worse with exercise
  • Chest pain, which is often worse when taking in a deep breath

Sometimes there are no symptoms, and radiation pneumonitis is found on a chest x-ray.

Symptoms often go away on their own, but if treatment is needed, it is based on trying to decrease the inflammation. Steroids, like prednisone, are usually used. With treatment, most people recover without any lasting effects. But if it persists, it can lead to pulmonary fibrosis . When this happens, the lungs can no longer fully inflate and take in air.

Be sure you understand what to look for, and tell your cancer care team if you notice any of these side effects.

What Are The Types Of Radiation Therapy For Breast Cancer

Breast Cancer Radiation Therapy Burns

There are different ways to receive radiation therapy. Your healthcare provider will choose the best method based on the cancer location, type and other factors.

Types of radiation therapy for breast cancer include:

  • External beam whole-breast irradiation: During external beam whole-breast radiation therapy, a machine called a linear accelerator sends beams of high-energy radiation to the involved breast. Most people get whole-breast radiation five days a week for one to six weeks. The time frame depends on factors including lymph node involvement. In some cases, intensity-modulated radiation therapy may be used.
  • External beam partial-breast: This treatment directs radiation to the tumor site only, not the entire breast over 1 to 3 weeks with 3-dimensional conformal radiation or IMRT.
  • Brachytherapy: Some people get internal radiation therapy or brachytherapy. Your provider places an applicator or catheter. A radioactive seed is moved into the tumor site. The seeds give off radiation for several minutes before your provider removes them. You receive two treatments every day for five days.
  • Intraoperative:Intraoperative radiation therapy takes place in the operating room before your provider closes the surgical site. Your provider delivers a high dose of radiation to the tumor area of the exposed breast tissue.

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Immune And Excretory Systems

In the later stages of breast cancer, the tumors have spread to other lymph nodes. The underarms are some of the first affected areas. This is because of how close they are to the breasts. You may feel tenderness and swelling under your arms.

Other lymph nodes can become affected because of the lymphatic system. While this system is usually responsible for transmitting healthy lymph throughout the body, it can also spread cancer tumors.

Tumors may spread through the lymphatic system to the lungs and liver. If the lungs are affected, you might experience:

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.

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The Effects Of Breast Cancer On The Body

At first, breast cancer affects the breast area only. You may notice changes in your breasts themselves. Other symptoms arent so obvious until you detect them during a self-exam.

Sometimes your doctor may also see breast cancer tumors on a mammogram or other imaging machine before you notice symptoms.

Like other cancers, breast cancer is broken down into stages. Stage 0 is the earliest stage with the fewest noticeable symptoms. Stage 4 indicates the cancer has spread to other parts of the body.

If breast cancer spreads to other parts of the body, it may cause symptoms in those particular areas, too. Affected areas may include the:

American Cancer Society , the most common sign of breast cancer is a newly formed mass or lump in your breast.

The mass or lump is usually irregularly shaped and painless. However, some cancerous masses can be painful and round in shape. This is why any lump or mass ought to be screened for cancer.

Invasive ductal carcinoma causes lumps and bumps in the breasts. This is a type of breast cancer that forms inside the milk ducts.

According to the Cleveland Clinic, invasive ductal carcinoma is the most common type of breast cancer. It makes up about 80 percent of all diagnoses. Its also more likely to spread to other areas of the body.

With breast cancer, your nipples may also undergo some noticeable changes.

Pain In The Breast Or Chest Area

Radiation Side Effects Common In Breast Cancer Treatment

You may have aches, twinges or sharp pains in the breast or chest area.

Although these are usually mild, they can continue for months or even years, but they usually become milder and less frequent over time.

You may also have stiffness and discomfort around the shoulder and breast or chest area during and after treatment.

Continuing to do arm and shoulder exercises during radiotherapy and for several months afterwards may help minimise or prevent stiffness or discomfort.

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Swelling Of The Breast

Radiotherapy can make it more difficult for fluid to drain from the breast tissue. This can cause swelling of the breast or chest area. Doctors call this lymphoedema.

The swelling usually goes down a few weeks after the treatment ends. But tell your doctor or radiographers if it doesnt. They can arrange for you to see a lymphoedema specialist. You might have a type of massage called manual lymphatic drainage.

If Youre Getting Radiation Therapy To The Abdomen

If you are getting radiation to your stomach or some part of the abdomen , you may have side effects such as:

Eating or avoiding certain foods can help with some of these problems, so diet planning is an important part of radiation treatment of the stomach or abdomen. Ask your cancer care team about what you can expect, and what medicines you should take to help relieve these problems. Check with your cancer care team about any home remedies or over-the-counter drugs youre thinking about using.

These problems should get better when treatment is over.

Managing nausea

Some people feel queasy for a few hours right after radiation therapy. If you have this problem, try not eating for a couple of hours before and after your treatment. You may handle the treatment better on an empty stomach. If the problem doesnt go away, ask your cancer care team about medicines to help prevent and treat nausea. Be sure to take the medicine exactly as you are told to do.

If you notice nausea before your treatment, try eating a bland snack, like toast or crackers, and try to relax as much as possible. See Nausea and Vomiting to get tips to help an upset stomach and learn more about how to manage these side effects.

Managing diarrhea

Many people have diarrhea at some point after starting radiation therapy to the abdomen. Your cancer care team may prescribe medicines or give you special instructions to help with the problem. Diet changes may also be recommended, such as:

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