How Is Radiation Therapy For Breast Cancer Performed
Most people lie on their back during the treatment though some breast treatments are performed while lying on your stomach . You place your arm above your head .
During the treatment, your treatment team:
- Positions and secures your body in the immobilization device. If you had a mastectomy, your provider might place a bolus on top of the treatment area to increase the radiation dose to the surface.
- Lines up the machine with the first treatment field. To protect themselves from radiation exposure, providers leave the room. Your provider can still hear and see you.
- Turns on the machine. You will hear a whirring noise, but you wont see the radiation beams. You must remain still. Depending on the radiation type and dose, treatment can take 30 seconds to several minutes.
- Returns to the room to position the machine to treat a different treatment field. Most people get treatment on two to five fields each day.
- Takes daily/weekly X-rays of the treatment field to make sure the radiation is hitting the correct area.
How Is Radiation Therapy Delivered
- Radiation therapy uses high-energy X-rays or other types of radiation to kill the cancerous cells within the breast tissue. Radiation may be delivered through external radiation, which uses a machine to deliver the rays from outside the body or internal radiation therapy, which utilizes radioactive substances placed in needles, seeds, or thin tubes directly into or near the cancer this method often requires less time.
I Just Found Out I Have Breast Cancer Do I Need A Mastectomy
There are alternative breast cancer treatments to mastectomy . Significant advances have been made in the detection and treatment of breast cancer, which makes “breast conserving therapy” possible. If you have an early-stage breast cancer , you may be a candidate for Breast Conserving Therapy, which is defined as a lumpectomy followed by radiation therapy, which will destroy any cancer cells that may remain behind. The good news is that long-term studies have shown that for early-stage cancers, Breast Conserving Therapy has the same survival outcomes as mastectomy.7, 8
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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:
- Your breast
- 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.
Urinary And Bladder Changes
Radiation therapy to the pelvis can cause urinary and bladder problems by irritating the healthy cells of the bladder wall and urinary tract. These changes may start 35 weeks after radiation therapy begins. Most problems go away 28 weeks after treatment is over. You may experience:
- Burning or pain when you begin to urinate or after you urinate
- Trouble starting to urinate
- Bladder spasms, which are like painful muscle cramps
Ways to manage include:
- Drink lots of fluids. Aim for 68 cups of fluids each day, or enough that your urine is clear to light yellow in color.
- Avoid coffee, black tea, alcohol, spices and all tobacco products.
- Talk with your doctor or nurse if you think you have urinary or bladder problems. You may need to provide a urine sample to check for infection.
- Talk with your doctor or nurse if you have incontinence. He/she may refer you to a physical therapist to assess your problem. The therapist may recommend exercises to help you improve your bladder control.
- Your doctor may prescribe medications to help you urinate, reduce burning or pain, and ease bladder spasms.
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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.
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:
- Nausea
- Diarrhea
- Constipation
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
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Short Term Side Effects
The following list includes some of the most common side effects of radiation therapy for breast cancer. Remember that the treatment can affect each patient differently and you may not experience these problems. Talk with your care team about what you can expect from your specific treatment.
- Skin irritation: Your skin may become red, irritated, dry, or sensitive. This may start to look like a sunburn. The skin may also become darker under the arm and under the breast. In more severe cases, the skin can peel, and moist ulcers can occur. Treat the skin gently to avoid further irritation, and bathe carefully using only warm water and mild soap. Avoid perfumed or scented lotions or soaps, as these may cause further irritation. Avoid spending too much time in the sun, which can worsen the irritation.
- Mild fatigue that generally gets better a month or two after treatment ends.
- Some patients have mild tenderness in the breast or chest wall.
- Some patients have swelling to the ipsilateral arm that may make the movement of that arm more difficult. Any swelling should be brought to the attention of your oncology team.
- Reduced blood counts, including neutropenia , anemia , or thrombocytopenia .
Radiation To The Pelvis
Radiation therapy to the pelvis can cause bowel and bladder problems in some patients, including:
- Urinating more than usual
- Sexual and/or problems getting pregnant or fathering a child
Management of Side Effects during Pelvic Radiation Therapy
- Do not eat raw fruits, vegetables or whole grains
- Eat small, frequent meals
- Do not drink caffeine or alcohol
- Drink lots of fluids
- Drink cranberry juice as part of fluid intake
- Ask your doctor or nurse for medicine if you have painful urination or to lessen frequent loose stools
- Use birth control to prevent pregnancy
- Your doctor may prescribe medicines that decrease the number of bowel movements.
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Why Is Radiation Given
Radiation therapy is used to treat cancer and a few non-cancerous diseases. Radiation treatments can be used to:
- Treat cancer by killing, stopping, or slowing the growth of cancer cells
- Shrink tumors to reduce pain, pressure, or other side effects if a cure is not possible. The term palliative is often used to describe this process.
Radiation therapy is often used with other treatments
Radiation may be used before, during, or after surgery. It is used to shrink the tumor to a smaller size before surgery or to kill any remaining cancer cells after surgery. Sometimes doctors give radiation during surgery so the radiation can be directed right at the cancer cells without having to go through the skin.
Radiation can also be used with chemotherapy. Sometimes radiation is given to shrink the tumor before or during chemotherapy so the medicines will work better. Other times the chemotherapy helps the radiation treatment work better than chemotherapy alone.
When Should I Call The Doctor
You should call your healthcare provider if you experience:
- Severe skin or breast inflammation.
- Signs of infection, such as fever, chills or weeping skin wounds.
A note from Cleveland Clinic
Radiation therapy can lower the risk of cancer recurrence and cancer spread. The treatment affects everyone differently. Most side effects go away in a few months after treatments end. Some problems last longer. You should tell your healthcare provider about any problems you have while getting treatment. Your provider may change the therapy slightly to minimize issues while still effectively treating the cancer.
Last reviewed by a Cleveland Clinic medical professional on 03/19/2021.
References
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Side Effects Of Radiation Therapy To Your Breast Or Chest Wall
You may have side effects from radiation therapy. The type and how strong they are depends on many things. These include the dose of radiation, the number of treatments, and your overall health. The side effects may be worse if youre also getting chemotherapy.
You may start to notice side effects about 2 weeks after you start radiation therapy. They may get worse during your radiation therapy, but theyll slowly get better over 6 to 8 weeks after your last treatment. Some side effects may take longer to go away. Follow the guidelines in this section to help manage your side effects during and after your radiation therapy.
Pain In The Breast Or Chest Area
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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Pain And Skin Changes
During and just after treatment, your treated breast may be sore. Talk with your health care provider about using mild pain relievers such as ibuprofen, naproxen or acetaminophen to ease breast tenderness.
The treated breast may also be rough to the touch, red , swollen and itchy. Sometimes the skin may peel, as if sunburned. Your health care provider may suggest special creams to ease this discomfort.
Sometimes the skin peels further and the area becomes tender and sensitive. Its most common in the skin folds and the underside of the breast. If this occurs, let your radiation team know. They can give you creams and pads to make the area more comfortable until it heals.
Fatigue is common during radiation therapy and may last for several weeks after treatment ends.
Fatigue is mainly a short-term problem, but for some, it can persist .
You may feel like you dont have any energy and may feel tired all of the time. Resting may not help.
Regular exercise, even just walking for 20 minutes every day, may help reduce fatigue . Getting a good nights sleep is also important.
Talk with your health care provider if you are fatigued or have insomnia .
Learn more about fatigue and insomnia.
Radiation Reduces Mortality At 15 Years In Early Breast Cancer
Researchers affiliated with the Early Breast Cancer Trialistsâ Collaborative Group evaluated breast-conserving therapy with or without radiation therapy to mastectomy with or without radiation therapy in a large analyses and found that radiation resulted in a significant difference in local regional recurrences and 15-year mortality.
- Radiation in patients treated with breast-conserving therapy reduced local regional recurrences by 19%.
- 15-year mortality from breast cancer was reduced from nearly 36% to 30% in patients treated with radiation therapy following breast-conserving therapy compared to those not treated with radiation therapy.
- 15-year mortality from breast cancer was reduced from 60% to 54% in patients who received radiation therapy following a mastectomy compared to those treated with a mastectomy alone.
The researchers concluded that a reduction in the risk of local regional recurrences with the use of radiation therapy significantly reduces the long-term risk of death caused by early breast cancer.
Radiation therapy is associated with side effects such as fatigue, skin burns, and cosmetic changes. Additionally, patients often need to take time off from work in order to attend radiation treatment sessions. Therefore, clinical studies have been performed to evaluate shorter radiation treatment schedules with the goal of maintaining the highest survival benefit for patients.
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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.
Your Role On Your Radiation Therapy Team
Your radiation therapy care team will work together to care for you. Youre a part of that team, and your role includes:
- Getting to your appointments on time.
- Asking questions and talking about your concerns.
- Telling someone on your care team when you have symptoms related to your treatment.
- Telling someone on your care team if youre in pain.
- Caring for yourself at home by:
- Quitting smoking if you smoke. If you want to quit, call our Tobacco Treatment Program at .
- Caring for your skin based on your care teams instructions
- Drinking liquids based on your care teams instructions.
- Eating the foods your care team suggests.
- Staying around the same weight.
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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 can’t 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.
Late Effects Of Radiotherapy For Breast Cancer
Radiotherapy to the breast may cause side effects that happen months or years after radiotherapy. They are called late effects.
Newer ways of giving radiotherapy are helping reduce the risk of these late effects happening. If you are worried about late effects, talk to your cancer doctor or specialist nurse.
The most common late effect is a change in how the breast looks and feels.
Radiotherapy can damage small blood vessels in the skin. This can cause red, spidery marks to show.
After radiotherapy, your breast may feel firmer and shrink slightly in size. If your breast is noticeably smaller, you can have surgery to reduce the size of your other breast.
If you had breast reconstruction, using an implant before radiotherapy, you may need to have the implant replaced.
It is rare for radiotherapy to cause heart or lung problems, or problems with the ribs in the treated area. This usually only happens if you had treatment to your left side.
Tell your cancer doctor if you notice any problems with your breathing, or have any pain in the chest area.
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