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.
Specific Treatment Plans Might Include:
- External Beam Radiation: The most frequently used treatment for breast cancers, focuses radiation on the treatment area from external machines. Radiation conforms to the shape of the tumor, treating the cancer while liming the exposure to normal tissue. External therapy is usually given over a three to seven-week period. Technologies include:
- Proton Beam Therapy Uses energy from protons instead of photons, allowing high dose radiation with no exit dose, resulting in fewer side effects than traditional radiation.
- Intensity Modulated Radiation Therapy : customizable to different parts of the treatment area
- 3D Conformal Radiation Therapy : beams conform to the tumor, sparing healthy tissue
- Stereotactic Radiosurgery and CyberKnife Stereotactic Body Radiation Therapy – this treatment method delivers large doses of highly focused radiation to the tumor site, sparing as much surrounding healthy tissue as possible. CyberKnife administers this same treatment using a robotic arm, to inoperable tumors anywhere in the body.
- Internal Radiation : Radioactive sources are placed in the breast tissue near the tumor. This option depends on tumor size, location, and other factors and is not appropriate for all patients.
What Should I Expect Before Radiation Therapy For Breast Cancer
Most people who have breast cancer treatment receive external beam radiation therapy. The goal is to destroy any remaining cancerous cells while protecting healthy tissue.
Before your first treatment, you will have a planning session . This simulation helps your provider map out the treatment area while sparing normal tissues . This session may take one hour or longer.
During the simulation, your provider:
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Effects On Pituitary System
Hypopituitarism commonly develops after radiation therapy for sellar and parasellar neoplasms, extrasellar brain tumours, head and neck tumours, and following whole body irradiation for systemic malignancies. Radiation-induced hypopituitarism mainly affects growth hormone and gonadal hormones. In contrast, adrenocorticotrophic hormone and thyroid stimulating hormone deficiencies are the least common among people with radiation-induced hypopituitarism. Changes in prolactin-secretion is usually mild, and vasopressin deficiency appears to be very rare as a consequence of radiation.
When Radiotherapy Is Used
Radiotherapy may be used in the early stages of cancer or after it has started to spread.
It can be used to:
- try to cure the cancer completely
- make other treatments more effective for example, it can be combined with chemotherapy or used before surgery
- reduce the risk of the cancer coming back after surgery
- relieve symptoms if a cure is not possible
Radiotherapy is generally considered the most effective cancer treatment after surgery, but how well it works varies from person to person.
Radiotherapy can be given in several ways. Your doctors will recommend the best type for you.
The most common types are:
- external radiotherapy, where a machine is used to carefully aim beams of radiation at the cancer
- radiotherapy implants , where small pieces of radioactive metal are placed inside your body near the cancer
- radiotherapy injections, capsules or drinks , where you swallow a radioactive liquid, or have it injected into your blood
- intrabeam radiotherapy, where radiation is delivered directly at the tumour during breast cancer surgery
Radiotherapy is usually given in hospital. You can usually go home soon after external radiotherapy, but you may need to stay in hospital for a few days if you have implants or radioisotope therapy.
Most people have several treatment sessions, which are typically spread over the course of a few weeks.
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What Happens Before Radiation Therapy Treatment
Each treatment plan is created to meet a patient’s individual needs, but there are some general steps. You can expect these steps before beginning treatment:
Meeting with your radiation oncologist. The doctor will review your medical records, perform a physical exam, and recommend tests. You will also learn about the potential risks and benefits of radiation therapy. This is a great time to ask any questions or share concerns you may have.
Giving permission for radiation therapy. If you choose to receive radiation therapy, your health care team will ask you to sign an “informed consent” form. Signing the document means:
Your team gave you information about your treatment options.
You choose to have radiation therapy.
You give permission for the health care professionals to deliver the treatment.
You understand the treatment is not guaranteed to give the intended results.
Simulating and planning treatment. Your first radiation therapy session is a simulation. This means it is a practice run without giving radiation therapy. Your team will use imaging scans to identify the tumor location. These may include:
Depending on the area being treated, you may receive a small mark on your skin. This will help your team aim the radiation beam at the tumor.
You may also be fitted for an immobilization device. This could include using:
These items help you stay in the same position throughout treatment.
If Youre Getting Radiation Therapy To The Head Or Neck
People who get radiation to the head and neck might have side effects such as:
- Soreness in the mouth or throat
- Dry mouth
- Jaw stiffness
How to care for your mouth during treatment
If you get radiation therapy to the head or neck, you need to take good care of your teeth, gums, mouth, and throat. Here are some tips that may help you manage mouth problems:
- Avoid spicy and rough foods, such as raw vegetables, dry crackers, and nuts.
- Dont eat or drink very hot or very cold foods or beverages.
- Dont smoke, chew tobacco, or drink alcohol these can make mouth sores worse.
- Stay away from sugary snacks.
- Ask your cancer care team to recommend a good mouthwash. The alcohol in some mouthwashes can dry and irritate mouth tissues.
- Rinse your mouth with warm salt and soda water every 1 to 2 hours as needed.
- Sip cool drinks often throughout the day.
- Eat sugar-free candy or chew gum to help keep your mouth moist.
- Moisten food with gravies and sauces to make it easier to eat.
- Ask your cancer care team about medicines to help treat mouth sores and control pain while eating.
If these measures are not enough, ask your cancer care team for advice. Mouth dryness may be a problem even after treatment is over. If so, talk to your team about what you can do.
How to care for your teeth during treatment
Radiation treatment to your head and neck can increase your chances of getting cavities. This is especially true if you have dry mouth as a result of treatment.
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How Long Is A Course Of Treatment
Your treatment will depend on what sort of cancer you have, where it is, its size, your general health and other cancer treatments you may have had. Some people need only one treatment, while others need radiation therapy five days a week for several weeks. If you have internal radiation therapy the implants may be left in place for a few minutes, one to six days or permanently.
Radiation Therapy Uses High Energy X
Its a localised treatment affecting only the area which is specifically targeted. Although some healthy tissue may be in the treatment area, it generally has the ability to repair itself, unlike cancer cells.
In early breast cancer, radiation therapy is used with the aim of getting rid of any malignant or pre-cancerous cells remaining in the breast following partial mastectomy or lumpectomy. This reduces the risk of developing a local recurrence of cancer in the breast in the future. Radiation therapy is also used to treat the chest wall after mastectomy if the cancer has high-risk features.
The regional lymph nodes in the axilla , supraclavicular fossa or internal mammary chain may also be treated in some cases.
In these settings, large international trials have demonstrated that radiation therapy reduces the incidence of local breast cancer recurrence.
Radiation therapy is usually given after surgery, once the wounds have healed. For people needing chemotherapy, radiation is given after that treatment has been completed.
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Types Of Radiation Therapy
- External beam radiation is most commonly used to treat breast cancer. A machine outside your body aims a beam of radiation on the area affected by the disease.
- Brachytherapy delivers radiation to the cancer through something implanted in your body.
- Proton therapy sends highly targeted radiation just to your breast tissue and not into your heart or lungs.
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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What Is Radiation Therapy And How Does It Work
Radiation therapy uses high-energy rays to kill cancer cells. It affects cells only in the part of the body that is treated with the radiation. Breast cancer radiation therapy may be used to destroy any remaining mutated cells that remain in the breast or armpit area after surgery.
Note: There are special situations in which radiation is used for women with metastatic breast cancer experiencing painful bone metastasis. This section however focused on the use of radiation for adjuvant therapy .
Who should expect to be prescribed radiation therapy and what is involved?Some people with Stage 0 and most people with Stage 1 invasive cancer and higher, who have had a lumpectomy, can expect radiation therapy to be a part of their treatment regimen.
What Are Potential Side Effects Of Hypofractionation
As with any form of radiation therapy, a common side effect of hypofractionation is some degree of skin irritation, much like a sunburn. Usually, skin irritation flares up during treatment sometimes, it arises after. Some patients also get an itchy, bumpy rash in the area where the radiation hit the skin, which usually starts near the end of treatment.
Another common side effect is fatigue, which usually builds as treatment progresses.
Scar tissue may also potentially form in the breast after radiation treatment, particularly in and around the surgical site. The breast may feel a little firmer or bumpier there. In a minority of women, scar-tissue formation from the combination of surgery and radiation can distort the shape of the breast. But something on the order of 85 percent of women are happy with their cosmetic outcome, says Suzanne Buckley Evans, MD, MPH, a radiation oncologist in the Department of Therapeutic Radiology.
There is also a small risk of developing a second cancer from the radiation. This is a possibility with any form of radiation, whether its from the sun, a chest X-ray, a mammogram, a CT scan or a radiation treatment, says Dr. Evans. Its a very, very small risk, and the benefits of radiation far outweigh the small association with second cancer.
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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.
What Are The Findings From Experiments In Laboratory Animals
Early studies involving laboratory animals showed no evidence that radiofrequency radiation increased cancer risk or enhanced the cancer-causing effects of known chemical carcinogens .
Because of inconsistent findings from epidemiologic studies in humans and the lack of clear data from previous experimental studies in animals, in 1999 the Food and Drug Administration nominated radiofrequency radiation exposure associated with cell phone exposures for study in animal models by the US National Toxicology Program . NTP is an interagency program that coordinates toxicology research and testing across the US Department of Health and Human Services and is headquartered at the National Institute of Environmental Health Sciences, part of NIH.
The NTP studied radiofrequency radiation in rats and mice . This large project was conducted in highly specialized labs. The rodents experienced whole-body exposures of 3, 6, or 9 watts per kilogram of body weight for 5 or 7 days per week for 18 hours per day in cycles of 10 minutes on, 10 minutes off. A research overview of the rodent studies, with links to the peer-review summary, is available on the NTP website. The primary outcomes observed were a small number of cancers of Schwann cells in the heart and non-cancerous changes in the same tissues for male rats, but not female rats, nor in mice overall.
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Is The Radiation From Cell Phones Harmful
Cell phones emit radiation in the radiofrequency region of the electromagnetic spectrum. Second-, third-, and fourth-generation cell phones emit radiofrequency in the frequency range of 0.72.7 GHz. Fifth-generation cell phones are anticipated to use the frequency spectrum up to 80 GHz.
These frequencies all fall in the nonionizing range of the spectrum, which is low frequency and low energy. The energy is too low to damage DNA. By contrast, ionizing radiation, which includes x-rays, radon, and cosmic rays, is high frequency and high energy. Energy from ionizing radiation can damage DNA. DNA damage can cause changes to genes that may increase the risk of cancer.
The human body does absorb energy from devices that emit radiofrequency radiation. The only consistently recognized biological effect of radiofrequency radiation absorption in humans that the general public might encounter is heating to the area of the body where a cell phone is held . However, that heating is not sufficient to measurably increase body temperature. There are no other clearly established dangerous health effects on the human body from radiofrequency radiation.
What Are The Types Of Radiation Therapy For Breast Cancer
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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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.