Vitamins To Avoid During Radiation Therapy
Your radiation oncologist may tell you to avoid taking certain antioxidant vitamin supplements, such as vitamins C, A, D, and E, while you’re having radiation therapy. These vitamins might interfere with radiation’s ability to destroy cancer cells.This is because radiation works in part by creating free radicals highly energized molecules that damage cancer cells. Free radicals in the environment can damage all cells, but in the case of radiation treatment they are focused on the cancer cells. Antioxidants help keep free radicals from forming or neutralize them if they do form.
Because of the potential conflict between the goal of radiation therapy and the goal of antioxidants , it makes sense to stop taking any antioxidant supplements during radiation therapy. When radiation is finished, you can resume taking your supplements.
Throughout your treatment, do your best to eat a well-balanced diet that contains all of the vitamins you need. Vitamins that come naturally from food are unlikely to interfere with treatment.
Side Effects Of Chemotherapy For Breast Cancer
Like any treatment, chemotherapy can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others. These side effects can usually be managed and those described here will not affect everyone.
Your treatment team will give you information about the drugs you are having, details of any side effects they may cause and how these can be controlled or managed.
Before starting chemotherapy you should be given a 24-hour contact number or told who to contact if you feel unwell at any time during your treatment, including at night or at the weekends.
Between each cycle of chemotherapy, youll have an assessment to see how youre feeling and whether youve had any side effects.
If you are concerned about any side effects, regardless of whether they are listed here, talk to your treatment team as soon as possible.
Breast Cancer Support And Resources
There are many resources and support groups for breast cancer survivors. Theres no obligation to stick with a group. You can try it out and move on whenever youre ready. You might be surprised to learn that you have a lot to offer others as well.
The American Cancer Society has a variety of support services and programs. You can call the 24/7 helpline at 800-227-2345, visit the Life After Treatment Guide .
If you like having information at your fingertips, download the free Breast Cancer Healthline app. The app lets you connect with others who have a similar diagnosis and understand what youre going through.
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Radiation Therapy Timing And Breast Reconstruction
The timing of radiation treatment in your overall breast cancer treatment plan depends on your individual situation and the characteristics of the breast cancer.
In many cases, radiation therapy is given after surgery. If chemotherapy is planned after surgery, radiation usually follows chemotherapy.
If youre having mastectomy and have decided to have breast reconstruction, its important to know that radiation can cause a reconstructed breast to lose volume and change color, texture, and appearance.
In particular, radiation therapy is known to cause complications with implant reconstruction. Research also suggests that a reconstructed breast may interfere with radiation therapy reaching the area affected by cancer, though this can vary on a case-by-case basis.
For these reasons, some surgeons advise waiting until after radiation and other treatments, such as chemotherapy, are completed before breast reconstruction surgery is done.
Other surgeons may recommend a more staged approach, which places a tissue expander after mastectomy to preserve the shape of the breast during radiation treatments. Once radiation is completed and the tissues have recovered, the expander that was used to maintain the shape of the breast is removed and replaced with tissue from another part of the body or a breast implant.
Taking Risk Factors For Neuropathy Into Account
The researchers found that several patient characteristics increased the risk of lingering neuropathy 24 months after treatment initiation: the presence of neuropathy before treatment older age being overweight or obese having a mastectomy and a greater number of lymph nodes containing cancer cells.
Because patients treated outside clinical trials are often older and less healthy than patients who enroll in clinical studies, the real-world percentage of women who experience chronic neuropathy after taxane-based chemotherapy is likely higher than reported in this study, Dr. Ganz explained.
Unfortunately, we currently dont have much to offer patients in terms of treating peripheral neuropathy, said Dr. OMara.
Some patients find limited relief with the drug duloxetine, but the best strategy for now remains trying to prevent neuropathy from occurring in the first place, Dr. Ganz added.
A wide range of chemotherapy regimens are currently endorsed by professional groups for women with breast cancer who are at high risk of recurrence, and choosing one of these regimens over another may result in only a small difference in survival, Dr. Ganz noted. And given that most women will live a long time after treatment, its become increasingly important to consider how treatment will impact their future health in initial decisions about therapy, she added.
We need a strategic way in which these get incorporated into treatment decision-making, Dr. Ganz concluded.
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Why Is Chemotherapy Used For Breast Cancer
Not everyone who has breast cancer needs chemotherapy. Depending on the cancer stage, your oncologist may recommend chemotherapy:
- Before surgery : You may have chemotherapy to shrink a tumor. This option could make it possible to have a less-extensive surgery. It may also allow healthcare providers to discover more about the biology of the cancer itself by how it responds to chemotherapy.
- After surgery : Sometimes, cancerous cells remain in your body but dont show up on imaging tests. Your healthcare provider may recommend chemotherapy after surgery to kill any remaining cancer cells. This treatment can also reduce the risk of the cancer from returning .
- For advanced cancer: If breast cancer has spread to other parts of your body , chemotherapy may be the main treatment.
- For IBC: Inflammatory breast cancer doesnt have a lump that a surgeon can remove easily. Chemotherapy often is the first treatment for IBC.
Is Early Menopause A Risk Of Chemotherapy For Breast Cancer
Yes. If you have not gone through menopause, chemotherapy may stop your ovaries from producing estrogen. You may go into early menopause. If you want to have children in the future, discuss the risks of infertility with your healthcare provider.
Some womens ovaries begin working again after chemotherapy treatment. Women who want to bear children in the future may also choose fertility preservation before starting chemotherapy.
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Treatment For Stage 1 Breast Cancer
Doctors can offer a variety of for stage 1 breast cancer, although surgery is the primary treatment.
Surgery
A lumpectomy or mastectomy are both viable surgical options for people with stage 1 breast cancer. A doctor will decide what surgery is most appropriate depending on the location of the primary tumor, how large it is, the size of the breast, family history, genetics, and the persons preference.
The doctor may also carry out a biopsy on one or more lymph nodes.
After removing the tissue, they will send it to a laboratory for further tests. The results will help inform decisions on the next stage of treatment.
Radiation therapy
Radiation therapy is a standard treatment for stage 1 breast cancer. However, the decision will depend on factors such the age of the person, the type of cancer, the size of the tumor, and whether there are cancer cells in the lymph nodes.
Hormone therapy
If the breast cancer is ER+ or PR+, hormone therapy may be effective. Hormone therapy works by preventing the growth of estrogen, which helps cancer grow, by blocking estrogen from attaching to tissue and fuelling cancer growth, or both.
Hormone therapy can reach cancer cells in the breast, as well as other areas of the body, and it can reduce the risk of cancer returning.
Chemotherapy
However, the
also has subcategories known as 2A and 2B.
Stage 2A breast cancer is invasive cancer:
How Chemotherapy Is Given
Many chemotherapy drugs for breast cancer are given in liquid form, as intravenous infusions or injections , but some are available as pills or tablets.
Some drugs may be given alone, and other drugs are combined to work together. When chemo drugs are given in combination, the treatment is called a regimen.
Some of the common regimens are:
- AC: Adriamycin and Cytoxan
- ACT: Adriamycin and Cytoxan followed by a Taxol or Taxotere
- ECT: Epirubicin and Cytoxan followed by a Taxol or Taxotere
- CAF: Cytoxan, Adriamycin, and 5-FU
- CEF: Cytoxan, Ellence, and 5-FU
- CMF: Cytoxan, Trexall , and 5-FU
- TC: Taxotere and Cytoxan
- TAC: Taxotere, Adriamycin, and Cytoxan
Several types of targeted therapies have been approved for many cancer types, including breast cancer. For example, a therapy that targets the HER2 receptor is an antibody treatment called trastuzumab.
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Chemotherapy For Metastatic Breast Cancer
Advances in treatment are making it possible for women with metastatic breast cancer to live for many years. New drug therapies can not only slow down or stop a tumors growth but also keep symptoms at bay.
Which treatment your doctor recommends will vary based on your medical history, age, and breast cancer type, among other factors. Combinations of drugs are commonly prescribed for women with early-stage disease. Most women with advanced breast cancer generally receive only one drug at a time.
Chemotherapy drugs that MSK doctors commonly prescribe for advanced breast cancer include:
Women with advanced disease can also benefit from genomic testing. This is also called tumor sequencing or molecular profiling. It is offered to all MSK patients with metastatic breast cancer. Genomic testing involves looking at the cancer cells to see if there are any genetic mutations that could be linked to the specific type of breast cancer you have.
Our experts use a highly sophisticated testing approach developed by MSK researchers called MSK-IMPACT. The information gained from MSK-IMPACT can help us personalize your care. We can rule out drug therapies that may not work for you or sometimes recommend cutting-edge clinical trials designed to target the specific mutations in your tumor.
What Happens During Chemotherapy For Breast Cancer
Most people receive chemotherapy for breast cancer through one of their veins . You may receive chemotherapy as one short injection or as an infusion. Infusions last longer and usually take place in a hospital or specialized infusion center.
When you get to the infusion center, your nurse administers your chemotherapy drugs and any additional medications you need. For example, you may also receive an anti-nausea medication before the chemotherapy drugs.
During the infusion:
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How Many Chemo Treatments For Breast Cancer
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What Happens Before Chemotherapy For Breast Cancer
A few days before your chemotherapy treatment, youll have blood tests. The blood tests tell your oncologist and pharmacist how to tailor your treatment based on your laboratory values and body mass index .
You may receive chemotherapy through a large, sturdy tube called a central venous catheter . If your healthcare provider recommends a CVC, it will be surgically implanted before treatment. It stays in place until you finish chemotherapy. Types of CVCs include:
- Central line: Long, plastic tube inserted near your heart or in a neck vein.
- Peripherally inserted central catheter : A central line that goes in through an arm vein.
- Port-a-cath : A small, implantable chamber where your nurse gives drug injections.
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Are There Ways To Prevent Hair Loss With Chemotherapy
Not everyone loses hair when receiving chemotherapy, but many people do. Some peoples hair only thins. Others lose the majority or all of their hair.
Using a cold cap can reduce hair loss. Cold caps cool your scalp before, during and after chemotherapy treatment. Cooling tightens the blood vessels in your scalp, potentially reducing how much chemotherapy goes to your hair follicles.
People may choose to wear a wig as a result of hair loss. Some private insurance companies may help cover wig costs if your doctor prescribes a cranial prosthesis or hair prosthesis. Medicare Parts A and B do not cover wigs, but the costs may be tax-deductible.
The Impact Of Breast Cancer Treatment On Your Long
The late effects associated with breast cancer treatments. Antonio Wolff, M.D., medical oncologist at the Johns Hopkins Sydney Kimmel Comprehensive Cancer Center, encourages a relationship with a primary care doctor who is knowledgeable about these effects on breast cancer survivors and their long-term health care.
These long-term and late side effects may include:
- Fatigue
- Pain and numbness
- Dental issues
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For Family And Friends
Caring for a loved one with stage 4 breast cancer has special challenges as well. Fortunately, organizations such as CancerCare now offer support groups design for loved ones who are caring for someone with cancer. In addition to caring for yourself , it’s helpful to learn about metastatic breast cancer.
Common things that people learn about cancer usually refer to an early-stage disease, and myths about metastatic breast cancer can be painful for those living with advanced disease. For example, one of the things not to say to someone with metastatic breast cancer is, “When will you be done with treatment?”
For the most part, people with metastatic breast cancer will require some type of treatment for the rest of their lives.
Radiation Therapy And Sun Exposure
During radiation treatment, its best to keep the treated area completely out of the sun. This can be especially difficult if youre having radiation therapy in areas or seasons with warmer weather. To help avoid sun exposure:
- Wear clothing or a bathing suit with a high neckline, or wear a rash guard top.
- Try to keep the area covered whenever you go outside. An oversized cotton shirt works well and allows air to circulate around the treated area.
- Avoid chlorine, which is very drying and can make any skin reactions youre having worse. Chlorine is used to disinfect most pools and hot tubs.
- If you do want to swim in a pool, you might want to spread petroleum jelly on the treated area to keep the chlorine away from your skin.
After your radiation treatment is completed, the treated skin may be more sensitive to the sun than it was in the past, so you might need to take extra protective steps when you go out in the sun:
- Use a sunblock rated 30 SPF or higher on the area that was treated.
- Apply the sunblock 30 minutes before you go out in the sun.
- Reapply the sunblock every few hours, as well as when you get out of the water.
Written by: Jamie DePolo, senior editor
This content was developed with contributions from the following experts:
Chirag Shah, M.D., breast radiation oncologist, director of breast radiation oncology and clinical research in radiation oncology at the Cleveland Clinic in Cleveland, Ohio
References
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Where You Have Chemotherapy
You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so its a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.
You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.
For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.
Clare Disney : Hello, my name is Clare and this is a cancer day unit.
So when you arrive and youve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.
Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. Were going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?
Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
The Bottom Line: Timely Treatment Is Better Than Delay
I realize that these two studies are about as close to Well, duh! studies as there are. Of course, delaying surgery for breast cancer is not a good thing. Of course, delaying chemotherapy when its indicated is also not a good thing. These are results that are not unexpected. However, these studies are still very important because they give us estimates of how much of a delay is safe and at what point delaying care starts to have a measurable impact on patient outcomes. Putting the results of these studies together suggests that its best to do surgery within about 60 days in patients not needing chemotherapy first, and that for patients with disease lacking the estrogen and progesterone receptor its best to start chemotherapy within 90 days of surgery.
We can thus reassure anxious patients who want their surgery tomorrow while at the same time tell patients balking at surgery or chemotherapy how long they can safely wait before the delay starts adversely affecting their chances of survival. Unfortunately, in my practice, due to the socioeconomic status of a lot of patients, by the time some of my patient see me its already been more than 30 days since their biopsy and diagnosis.
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