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.
Internal Radiation Therapy Use In Breast Cancer
The main type of internal radiation therapy used to treat breast cancer is called High-Dose Rate brachytherapy. HDR brachytherapy can be used for some patients with early-stage breast cancer. After a lumpectomy, a procedure is performed to place an applicator into the breast. This applicator contains a few tubes that hold the radioactive seeds. Over the course of a few days, the seeds will be placed in the applicator to kill any remaining cancer cells left inside the breast. Once treatment is done, the applicator is removed. HDR brachytherapy is a much shorter process than external beam radiation therapy for breast cancer but is not available to every patient based on the size, stage, and type of breast cancer.
Radiation Therapy And The Effects On The Heart
- Heart Muscle Damage: When undergoing radiation treatments, there is a very small risk of damage to the heart muscle or the major blood vessels around the heart. This is a potential problem if you have had cancer in your left breast, since the heart is on the left side of the chest. Ideally, the heart is either not within the radiation area or only a small amount of the heart will receive any radiation, which helps to lower the risk of significant damage.
- Breathlessness/Dizziness: If your heart has been damaged by radiotherapy you may find that you get tired very easily or get breathless on exertion, like climbing stairs. You may also notice that you sometimes feel dizzy or get chest pains. Its important to remember that these symptoms can be caused by many things and they arent always a result of damage to the heart. You will want to immediately consult your doctor if you experience any symptoms that may be heart related.
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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.
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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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.
Coping With Physical Side Effects
There are many things you and your radiation team can do to relieve side effects.
Try these tips for managing skin side effects:
- Wear loose clothing thats soft and comfortable when it touches the treatment area.
- Be gentle when you wash. Choose mild, fragrance-free soap and warm water. When drying, pat gently with a clean towel during the time youre receiving radiation therapy treatments, and in the first few weeks after treatment ends.
- Try to avoid rubbing or scratching the area.
- Avoid using bandages or makeup on the area.
- Your doctor will recommend or prescribe gels, ointments, or lotions to keep your skin moisturized and relieve irritation. Stick to the brands your doctor recommends to make sure youre treating your skin safely.
- Ask your radiation team for sunscreen recommendations to protect sun-sensitive treatment areas. Its also a good idea to keep the area safe from direct sunlight with protective clothing. Clothes that help protect from sun damage usually have UPF on the label.
For help with fatigue, ask your healthcare team about these strategies:
- Physical activity or exercise
- Counseling to help shift your thoughts about fatigue and for help managing sleep issues
- Complementary therapies such as relaxation techniques or music therapy
- Nutrition adjustments
Theres also help for other, long-term radiation side effects:
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Types Of Radiation For Breast Cancer
External-beam radiation therapy is the most common form of radiation treatment for breast cancer. In this approach, a machine called a linear accelerator, or LINAC, produces radiation. The radiation is delivered as precisely targeted x-ray beams.
At MSK, we deliver external-beam radiation therapy in a variety of ways. These approaches are designed to tailor the radiation treatments as much as possible to the exact size and location of your cancer, specifically aiming at tumor cells while avoiding side effects.
We also offer internal radiation therapy in the form of brachytherapy. Brachytherapy is generally reserved for women receiving partial-breast irradiation after lumpectomy.
Learn more about the techniques our breast cancer radiation team frequently recommends.
In this method, patients lie on their stomach . Radiation is directed to the affected breast as it hangs through an opening in the treatment table. This approach may reduce radiation exposure to nearby vital organs, such as the heart and lungs. Prone breast radiation has been shown to reduce radiation burn on the skin. Research has also shown that this therapy is especially useful for women with large breasts.
In this approach, our experienced radiation therapists guide women with cancer in the left breast through a breathing technique called deep inspiration breath hold . It minimizes the risk of injury to the heart.
What Is A Late Effect
A late effect is a side effect that is caused by treatment but happens months to years after the cancer treatment has finished. Some side effects that you develop during treatment can last for months to years after treatment is completed . These are often called long-term side effects.
Late effects can be health issues or psychological, emotional, and practical challenges.
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If You Have Side Effects
Let your doctor or nurse know if you have side effects or are worried about anything.
When treatment ends you usually have regular appointments for about 5 years afterwards. You can talk to your doctor or nurse at these appointments. But you don’t have to wait for your next appointment if you get a new side effect or are worried about anything. You can bring the appointment forward.
National Institute for Health and Care Excellence June 2018
Treatment of primary breast cancerScottish Intercollegiate Guidelines Network, September 2013
Postoperative radiotherapy for Breast Cancer: UK consensus statement
The Royal College of Radiologists, 2016
Early Breast Cancer: ESMO Clinical Practice Guidelines 2019F Cardoso and others
Internal Breast Cancer Radiation
Internal radiation is a form of partial breast radiation. During the treatment, the physician or surgeon inserts a radioactive liquid using needles, wires, or a catheter in order to target the area where the cancer originally began to grow and tissue closest to the tumor site to kill any possible remaining cancer cells.
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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.
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.
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.
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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Treatment Areas And Possible Side Effects
|Part of the body being treated
|Possible side effects
Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is over. But sometimes people may have side effects that do not improve. Other side effects may show up months or years after radiation therapy is over. These are called late effects. Whether you might have late effects, and what they might be, depends on the part of your body that was treated, other cancer treatments you’ve had, genetics, and other factors, such as smoking.Ask your doctor or nurse which late effects you should watch for. See the section on Late Effects to learn more.
- Reviewed:January 11, 2022
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Why Choose To Have Your Breast Radiation Therapy At Memorial Sloan Kettering
- In order to deliver radiation in the best possible way, it takes a dedicated team of doctors, nurses, therapists, physicists, and treatment planners. Our breast cancer team is one of the largest and most experienced in the country.
- Our radiation oncologists have access to and experience with every single form of radiation therapy available. There is not just one best type of radiation for all of the women we care for. But with our deep experience, we can select the best technique for each individual woman and tailor our approach as needed.
- Our team of medical physicists ensures that the radiation dose each woman receives is accurately and safely targeted to cancer tissue and spares nearby normal tissue.
- We consider the details of each unique woman. Our publications have demonstrated that our personalized care leads to superior outcomes.
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Fighting Breast Cancer With Fewer Treatments At Upmc In Central Pa
Many breast cancer patients receive radiation therapy following surgery. The goal of radiation is to kill breast cancer cells that may remain even after successful surgery. This helps prevent a recurrence.
At the UPMC Breast Care Center at UPMC in Central Pa., we are striving to make radiation treatment easier for our patients. We provide eligible patients a four-week course of radiation, which has been found to be as effective as the traditional six-week course, with the same or milder side effects.
Will My Appetite Be Affected
Many side effects can cause problems with eating and digesting food, but you always should try to eat enough to help damaged tissues rebuild themselves. It’s very important not to lose weight during radiation therapy so that your body can heal. Try to eat small meals often and eat a variety of different foods. Your doctor or nurse can tell you whether your treatment calls for a special diet and a dietitian will have a lot of ideas to help you maintain your weight.
If you have pain when you chew and swallow, your doctor may advise you to use a powdered or liquid diet supplement. Many of these products, available at the drugstore without prescription, are made in a variety of flavors. They are tasty when used alone, or they can be combined with other foods, such as pureed fruit, or added to milkshakes. Some of the companies that make diet supplements have produced recipe booklets to help you increase your nutrient intake. Ask your dietitian or pharmacist for further information.
What side effects occur with radiation therapy to the head and neck area? Some people who are having radiation to the head and neck have redness and irritation in the mouth, a dry mouth, difficulty in swallowing, changes in taste or nausea. Try not to let these symptoms keep you from eating.
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What Are The Different Kinds Of Radiation Therapy
Most radiation therapy is administered by a radiation oncologist at a radiation center and usually begins three to four weeks after surgery. The radiation is used to destroy undetectable cancer cells and reduce the risk of cancer recurring in the affected breast.
There are two main kinds of radiation therapy that may be considered, and some people have both.
- External Beam Breast Cancer Radiation
- Internal Breast Cancer Radiation
Keep in mind that the course of treatment you decide is something you should discuss with your radiation oncologist in order to ensure that it is as effective as possible.
What Side Effects Occur With Radiation Therapy To The Breast And Chest
Radiation treatment to the chest may cause several changes. You will notice some of these changes yourself, and your treatment team will keep an eye on these and others. For example, you may find swallowing to be difficult or painful. You may develop a cough. Or you may develop a fever, notice a change in the color or amount of mucus when you cough, or feel short of breath. It is important to let your treatment team know right away if you have any of these symptoms. Your doctor also may check your blood counts regularly, especially if the radiation treatment area on your body is large. Just keep in mind that your doctor and nurse will be alert for these changes and will help you deal with them.
Your radiation therapy plan may include implants of radioactive material a week or two after external treatment is completed. You may have some breast tenderness or a feeling of tightness while the implants are in your breast. After they are removed, you are likely to notice some of the same effects that occur with external treatment. If so, follow the advice given above and let your doctor know about any problems that persist.
After 10 to 12 months, no further changes are likely to be caused by the radiation therapy. If you see new changes in breast size, shape, appearance, or texture after this time, report them to your doctor at once.
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What Side Effects Occur With Radiation Therapy To The Pelvis
If you are having radiation therapy to any part of the pelvis , you might have one or more of the digestive problems already described. You also may have some irritation to your bladder. This can cause discomfort or frequent urination. Drinking fluids can help relieve some of your discomfort. Your doctor can prescribe medication to deal with these problems.
There are also certain side effects that occur only in the reproductive organs. The effects of radiation therapy on sexual and reproductive functions depend on which organs are treated. Some of the more common side effects for both men and women do not last long after treatment. Others may be long-term or permanent. Before your treatment begins, ask your doctor about possible side effects and how long they might last.