Cancer Doctors Usually Treat Cancer With Radiation Therapy Surgery Or Medications Including Chemotherapy Hormonal Therapy And/or Biologic Therapy Either Alone Or In Combination
If your cancer can be treated with radiation, you will be referred to a radiation oncologist a doctor who specializes in treating patients with radiation therapy. Your radiation oncologist will work with your primary doctor and other cancer specialists, such as surgeons and medical oncologists, to oversee your care. He or she will discuss the details of your cancer with you, the role of radiation therapy in your overall treatment plan and what to expect from your treatment.
Being Careful When Showering Or Bathing
A person should use warm rather than hot water, and avoid letting the spray from the showerhead directly hit the treatment area.
The National Cancer Institute notes that a person can shower daily. However, if they prefer bathing, they should do this every other day and avoid soaking for long periods of time.
They should avoid strong or fragranced soaps, and opt for gentle, fragrance-free, moisturizing soaps specifically for sensitive skin.
People should cleanse gently, and avoid scrubbing with loofahs or wash cloths, then, when done, use a soft towel to pat themselves dry..
Are There Options To Prevent Or Treat These Side Effects
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. And during and after treatment, let your health care team know how you are feeling on a regular basis.
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Split Opinions In Practice Perception
U-M researchers mailed a survey to 879 surgeons and 713 radiation oncologists who regularly treat breast cancer. The survey questions evaluated physician attitudes, knowledge, communication and recommendations regarding the omission of radiation therapy in older women with early stage breast cancer.
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In this large national sample, published in the Annals of Surgical Oncology, researchers found that 40 percent of surgeons and 20 percent of radiation oncologists were uncomfortable with omitting radiation after lumpectomy.
A sizable minority in both specialties erroneously associated radiotherapy in this scenario with improvement in survival for early stage patients. They also overestimated the risk of local recurrence if radiation is omitted.
Additionally, clinicians who overestimated the benefits of radiotherapy were more likely to consider radiotherapy omission to be an unreasonable option.
To better assess attitudes, the survey proposed specific patient scenarios. In one scenario, physicians were asked if they would recommend radiation to an unhealthy 81-year-old woman who was a borderline surgical candidate.
One-third said they would a margin that surprised the research team.
What Are Possible Side Effects Of Radiation Therapy
There are usually no immediate side effects from each radiation treatment given to the breast. Patients do not develop nausea or hair loss on the head from radiation therapy to the breast.
Most patients develop mild fatigue that builds up gradually over the course of therapy. This slowly goes away one to two months following the radiation therapy. Most patients develop dull aches or sharp shooting pains in the breast that may last for a few seconds or minutes. It is rare for patients to need any medication for this. The most common side effect needing attention is skin reaction. Most patients develop reddening, dryness anditching of the skin after a few weeks. Some patients develop substantial irritation.
Skin care recommendations include:
- Keeping the skin clean using gentle soap and warm but not hot water
- Avoiding extreme temperatures while bathing
- Avoiding trauma to the skin and sun exposure
- Avoiding shaving the treatment area with a razor blade
- Avoiding use of perfumes, cosmetics, after-shave or deodorants in the treatment area
- Using only recommended unscented creams or lotions after daily treatment
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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.
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.
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How To Manage Skin Side Effects Of Radiation Therapy
There are a number of things you can do to help make your skin less sensitive during radiation treatment and also help your skin heal after radiation treatment is completed.
Here are some steps you can take to help prevent and treat irritation before and after daily radiation treatments:
- Moisturize: At the beginning your radiation treatment, before you have any side effects, moisturize the skin after your daily treatment with an ointment such as A& D, Eucerin, Aquaphor, Miaderm, Biafene, or Radiacare. You also can put it on at night wear an old T-shirt so the ointment doesn’t get on your bed clothes. If your skin becomes dry and flakey during the course of your treatment, moisturize frequently and cleanse skin gently.
- Dress comfortably:
- Wear loose-fitting shirts, preferably made from cotton.
- Avoid wearing underwire bras or any bra that digs into your skin. Dont wear a bra if there are raw areas.
Written by: Jamie DePolo, senior editor
Doses A Delay In Radiation Increases Risk Of Breast Cancer Recurrence
Some but not all research suggests that for women who choose to undergo breast-conserving surgery for treatment of early stage breast cancer, a longer interval between surgery and the start of radiation therapy may increases the risk of local cancer recurrence.
Among women who undergo breast-conserving therapy, prompt treatment with radiation therapy after surgery may result in better outcomes than delayed radiation therapy. To explore this issue, researchers evaluated information from a large U.S. database that links cancer registry data with Medicare claims data. Information was available for more than 18,000 women over the age of 65 who had undergone breast-conserving therapy for Stage 0-II breast cancer and did not receive chemotherapy.
The average time from surgery to start of radiation therapy was 34 days and 30% of women started radiation therapy more than six weeks after surgery.
Longer intervals between surgery and the start of radiation therapy were linked with an increased risk of local cancer recurrence. For example, women who started radiation therapy more than six weeks after surgery were 19% more likely to experience local cancer recurrence than women who had a shorter interval between surgery and radiation.
These results suggest that starting radiation therapy as soon as possible after lumpectomy may reduce the risk of local cancer recurrence.
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Modern Cancer Treatment Has Revolutionized Treatment Experience Minimizing Associated Side
Bhubaneswar: Treating cancer is challenging as it is essential to zero down to the most suitable treatment that ensures total eradication of cancer. Today, cancer treatment has become simpler and less morbid patients experience fewer after-effects. Immense and valuable changes in treating cancer have eased the lives of cancer patients to a great extent and motivated them towards healthier and meaningful living.
Dr. Sandeep Nayak, leading surgical oncologist in India, shares valuable insights on how modern cancer treatments effectively treat cancer with minimal side effects for two of the most common cancers we see.
Treatment of Breast Cancer
Breast-conserving surgeries are also referred to lumpectomy, partial mastectomy, segmental mastectomy, or quadrantectomy, depending upon the extent of tissue removed. The main advantage of breast-conserving surgeries is that much of the breast is preserved in appearance. The patient does not lose her self-esteem as most of the breast is conserved. Moreover, it is a less invasive surgery implying early recovery and less pain than a mastectomy and yet has an equal or better cure rate.
A positive sentinel lymph node biopsy report indicates the need for removing more lymph nodes. In contrast, a negative biopsy suggests less risk of the spread of cancer, which reduces the extent of complications associated with removing lymph nodes.
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Possible Side Effects Of External Beam Radiation
The main short-term side effects of external beam radiation therapy to the breast are:
- Swelling in the breast
- Skin changes in the treated area similar to a sunburn
- Fatigue
Your health care team may advise you to avoid exposing the treated skin to the sun because it could make the skin changes worse. Most skin changes get better within a few months. Changes to the breast tissue usually go away in 6 to 12 months, but it can take longer.
External beam radiation therapy can also cause side effects later on:
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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.
The Pressure Of Patient Expectations
A majority of surveyed physicians reported that patients want the most aggressive treatment, even if the benefit is small, and that it takes more effort to tell patients that they do not need radiation than it does to recommend it.
Its important to recognize that this is a controversial area, says Shumway. You cant say that offering radiation to older women is wrong. It really is a patient-driven decision, and it depends on the patients own values and preferences, in addition to her risk of recurrence and overall health.
As the point of first contact for breast cancer patients, surgeons have a tremendous influence on how patients choose treatment options.
Which is why Shumway thinks they could play a crucial role in counseling older women about options for less aggressive therapy.
The population is aging, and this is going to be an issue that affects more women, says Shumway. There is increasing attention given to considerations that are unique to older patients and in this case, their vulnerability for overtreatment.
Shumways future work will focus on developing interventions to help patients make fully informed decisions and understand the concept of competing causes of mortality.
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More Things To Avoid During Your Radiation Therapy Foods
Its important to note before diving into this section Only your doctor should advise/prescribe a specific diet for each patient based on their individual situation. Consult your doctor for any and all dietary questions.
This is a common topic and a familiar question asked by those undergoing radiation therapy:
What foods should I avoid during radiation?
Food can go a long way towards easing side effects of radiation therapy, as well as aiding in the fight against cancer itself. And while there are plenty of foods that WILL help your body throughout your treatment, there a plenty you should steer clear of as well.
How Sex Might Be Affected
With some types of radiation therapy involving the pelvis and/or sex organs, men and women may notice changes in their ability to enjoy sex or a decrease in their level of desire.
For women: During radiation treatment to the pelvis, some women are told not to have sex. Some women may find sex painful. Treatment can also cause vaginal itching, burning, and dryness. You most likely will be able to have sex within a few weeks after treatment ends, but check with your doctor first. Some types of treatment can have long-term effects, such as scar tissue that could affect the ability of the vagina to stretch during sex. Again, your cancer care team can offer ways to help if this happens to you. You can also get more information in Sex and Women With Cancer.
For men: Radiation may affect the nerves that allow a man to have erections. If erection problems do occur, they are usually gradual, over the course of many months or years. Talk with your doctor about treatment options if this is a concern for you. You can get more information in Sex and Men With Cancer.
If you get internal radiation therapy with seed implants, check with your cancer care team about safety precautions during sex
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How To Stay Vigilant About Your Safety
As the pandemic stretches on into the fall and winter, some states have lifted stay-at-home orders and have started to allow businesses to re-open. As things become a bit more normal, you may find yourself being more casual about washing your hands, keeping your distance from other people in public, and wearing a mask. Psychologists call this reaction caution fatigue.
We can become desensitized to stress and repeated warnings, said Jackie Gollan, Ph.D., associate professor of psychiatry and behavioral science and a clinical psychologist at Northwestern Universitys Feinberg School of Medicine in Chicago. Our brains adjust to the alarms to reduce our stress, and then we can take longer to respond to warnings or start to ignore them.
Still, the pandemic is far from over. On Oct. 22, 2020, the FDA approved remdesivir to treat people hospitalized with COVID-19. But this medicine is only for people with symptoms serious enough to require hospitalization.
In December 2020, the FDA authorized the first COVID-19 vaccines for emergency use: the Pfizer-BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine. Other COVID-19 vaccines are being developed and may eventually be authorized, as well. Learn more about COVID-19 vaccination for people with breast cancer.
If youre experiencing any change in your condition or symptoms or want to talk about your COVID-19 concerns, he added, dont hesitate to reach out to your medical team.
To Elect Or Forgo Radiation Therapy: An Informed Decision For Patients With Breast Cancer
12/3/2021 1:13:46 PM
Advances in treating breast cancer increasingly create opportunities to consider where radiation therapy might safely be omitted, Reshma Jagsi, MD, DPhil, told participants at the 2021 Lynn Sage Breast Cancer Symposium.1 But, I would encourage us, she continued, not to assume that women who dont omit radiation therapy are making unreasonable choices. Advances in radiation therapy techniques developed over the past couple of decades may be creating situations in which patients are reasonably electing radiation, even for a relatively small disease control benefit, especially if this might allow them to forgo other toxic or burdensome treatment. That is a question that is actively being investigated.
Dr. Jagsi called on oncologists to work together as a field to generate and provide information about all options, so our patients themselves can make informed decisions concordant with their own values and preferences. Dr. Jagsi is Newman Family Professor, Deputy Chair of the Department of Radiation Oncology, and Director of the Center for Bioethics and Social Sciences in Medicine University of Michigan in Ann Arbor. The symposium was sponsored by Northwestern Medicine/Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago.
Standard Option
Advances in treating breast cancer increasingly create opportunities to consider where radiation therapy might safely be omitted. Reshma Jagsi, MD, DPhilTweet this quote
Tumor Biology
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What Are The Side Effects Of Radiation
Radiation therapy can have side effects, and these vary from person to person.
The most common side-effects are:
- Sunburn-type skin irritation of the targeted area
- Red, dry, tender, or itchy skin
- Breast heaviness
- Discoloration, redness, or a bruised appearance
- General fatigue
What should I do about side effects from breast cancer radiation?If you experience difficulty from side effects, you should discuss them with your doctor, who may be able to suggest ways you can treat side effects and help yourself feel more comfortable. These problems usually go away over a short period of time, but there may be a lasting change in the color of your skin.Here are some good general tips for dealing with the most common side effects of radiation: