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:
Skin And Hair Reactions
Your skin and hair in the treatment area will change during your radiation therapy. This is normal.
- Your skin may turn pink, red, tanned, or look like it has sunburn. The skin in the folds under your arm and breast, over your collar bone, and in other parts of the treatment area that have been in the sun may blister and peel.
- Your skin may become very sensitive and itchy.
- You may get a rash, especially in any area where your skin has been in the sun. Tell a member of your radiation therapy team if you get a rash at any time during your radiation therapy. Rashes are sometimes a sign of an infection.
- You may lose some or all of your hair under your arm on the treated side. It usually grows back in 2 to 4 months after you finish radiation therapy.
If your skin becomes open, wet, and oozing, contact your radiation team. They may prescribe a cream called Silvadene® . Your radiation oncologist may also stop your radiation therapy until your skin heals, although this is rarely needed.
Skin reactions from radiation therapy are usually strongest 1 or 2 weeks after you finish radiation therapy and then start to heal. It often takes 3 to 4 weeks for skin reactions to heal. If you have any questions or concerns, dont hesitate to contact your radiation oncologist or nurse.
Skin care guidelines
Follow these guidelines care for your skin during treatment. Keep following them until your skin gets better. These guidelines refer only to the skin in the treatment area.
Neoadjuvant And Adjuvant Systemic Therapy
For women who have a hormone receptor-positive breast cancer, most doctors will recommend hormone therapy as an adjuvant treatment, no matter how small the tumor is. Women with tumors larger than 0.5 cm across may be more likely to benefit from it. Hormone therapy is typically given for at least 5 years.
If the tumor is larger than 1 cm across, chemo after surgery is sometimes recommended. A womanâs age when she is diagnosed may help in deciding if chemo should be offered or not. Some doctors may suggest chemo for smaller tumors as well, especially if they have any unfavorable features .
After surgery, some women with HER2-positive cancers will be treated with trastuzumab for up to 1 year.
Many women with HER2-positive cancers will be treated with trastuzumab followed by surgery and more trastuzumab for up to 1 year. If after neoadjuvant therapy, residual cancer is found during surgery, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses. If hormone receptor-positive cancer is found in the lymph nodes, your doctor might recommend one year of trastuzumab followed by additional treatment with an oral drug called neratinib for 1 year.
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Radiation Therapy After Breast
Radiation therapy is most often used to prevent cancer from returning after breast-conserving surgery, also called a lumpectomy.
Our doctors most frequently use external beam radiation therapy to manage breast cancer. This type of radiation therapy is delivered by a machine called a linear accelerator. The machine rotates around you during therapy to treat the entire breast.
Clinical Trials
Our doctors may recommend whole breast irradiationa type of radiation therapy that is targeted to the entire breastor partial breast irradiation, which is delivered only to the part of the breast affected by cancer.
Whole breast irradiation is typically delivered over the course of three weeks. Some people receiving whole breast irradiation also require an additional week of radiation therapy specifically targeted to the location of the tumor. This may be given at the same time as whole breast irradiation.
Accelerated partial breast irradiation is typically offered to women who have an early breast cancer diagnosis and are postmenopausal. Partial breast irradiation is typically delivered in one week.
If cancer has also spread to the lymph nodes, doctors may recommend radiation therapy targeted to the breast and lymph nodes, which is given over five to six weeks.
What Are The Implications
There may be various reasons why a woman is not ready to start chemotherapy within four weeks. This study suggests there are compelling reasons to avoid non-essential delays.
However, absolute risk will vary depending on cancer stage and characteristics. For example, if a womans 10-year risk of death is 20%, with prompt chemotherapy this could increase to 21% with four-week delay. A 60% risk could increase to 65%. Therefore risks need to be balanced for the individual and electronic tools, such as Predict, are available to help with this.
The key message for hospitals and commissioners is to manage waiting lists and clinics in a way that minimises unnecessary delays in starting chemotherapy after surgery.
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Starting With Neoadjuvant Therapy
Most often, these cancers are treated with neoadjuvant chemotherapy. For HER2-positive tumors, the targeted drug trastuzumab is given as well, often along with pertuzumab . This may shrink the tumor enough for a woman to have breast-conserving surgery . If the tumor doesnt shrink enough, a mastectomy is done. Nearby lymph nodes will also need to be checked. A sentinel lymph node biopsy is often not an option for stage III cancers, so an axillary lymph node dissection is usually done.
Often, radiation therapy is needed after surgery. If breast reconstruction is planned, it is usually delayed until after radiation therapy is done. For some, additional chemo is given after surgery as well.
After surgery, some women with HER2-positive cancers will be treated with trastuzumab for up to a year. Many women with HER2-positive cancers will be treated first with trastuzumab followed by surgery and then more trastuzumab for up to a year. If after neoadjuvant therapy, any residual cancer is found at the time of surgery, ado-trastuzumab emtansine may be used instead of trastuzumab. It is given every 3 weeks for 14 doses. For women with hormone receptor-positive cancer that is in the lymph nodes, who have completed a year of trastuzumab, the doctor might also recommend additional treatment with an oral targeted drug called neratinib for a year.
How To Get Rid Of Fatigue From Breast Cancer
Get Good Nutrition. Get Exercise. Take Charge of Your Stress. When to Call Your Doctor. More. Youre likely to have some fatigue while youre being treated for breast cancer or any other kind of cancer. Its one of the most common side effects of the disease and of the treatments for it. Fatigue isnt the same as being tired.
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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.
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What You Should Know About Radiation Therapy For Breast Cancer Treatment
Radiation therapy is a treatment that can be used for many different types of cancer to target cancer cells and minimize tumor growth. Radiation therapy works by using high-energy beams or particles to damage the DNA of cancer cells, which prevents them from dividing, and results in the death of the cell.
Radiation therapy is often used for breast cancer patients to make sure any remaining cancer cells are killed after surgery or if cancer has spread to other areas of the body. Read on to learn more about the types of radiation therapy, when radiation therapy is used to treat breast cancer, what to expect at a radiation oncology appointment, and the side effects of radiation therapy.
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Managing The Side Effects Of Radiation Therapy For Cancer Treatment
Side effects of radiation therapy depend on the type of radiation treatment you receive. Radiation treatments rarely cause pain, but some patients experience both short- and long-term problems. Always let your oncologist know if you have any of these side effects because there are treatment options.
Short-term side effects may include:
- Discomfort or swelling in the target area
- Changes in skin sensitivity
- Fluid collecting in your breast
Long-term effects are less common but can include heart or lung problems, damage to the breasts fatty tissues, or multiple spider veins .
Why The Procedure Is Performed
After surgery, cancer cells may remain in the breast tissue or lymph nodes. Radiation can help kill the remaining cancer cells. When radiation is delivered after surgery is performed, it is called adjuvant treatment.
Adding radiation therapy can kill the remaining cancer cells and lower the risk of the cancer growing back.
Wholebreast radiation therapy may be given for several different cancer types:
- For ductal carcinoma in situ
- For stage I or II breast cancer, after lumpectomy or partial mastectomy
- For more advanced breast cancer, sometimes even after full mastectomy
- For cancer that has spread to local lymph nodes
- For widespread breast cancer, as a palliative treatment to relieve symptoms
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Expectations And What To Avoid
Radiation therapy should not cause pain or discomfort during the procedure. However, minor side effects are common in the days or weeks afterward. Before beginning radiation therapy, an individual should schedule a consultation with their doctor to work out the details.
People should also take some precautions while they are receiving radiation therapy. For example, they should avoid direct sun exposure by using sunscreen and covering up areas of bare skin when outside.
Also, taking antioxidant supplements, such as vitamins A, C, D, and E, can interfere with radiation therapys effectiveness. People should, therefore, focus on eating a well-balanced diet so that their body can absorb the nutrients and vitamins it needs from food.
A Lower Risk For Breast Cancer Recurrence
Landmark 2004 research, augmented by later studies, helped cancer experts develop guidelines defining which women with early-stage breast cancer could safely omit radiation after lumpectomy.
Generally, this option is offered to women 65 or older who have small tumors with nonaggressive cells that havent spread to the lymph nodes. Medically, this is described as a T1N0, grade 1-2 tumor. The tumors must be estrogen receptor-positive, meaning that the hormone estrogen helps fuel their growth. They also must have an adequate margin of normal tissue surrounding the tumor cut away to ensure all the cancer has been removed. Women who decide to omit radiation instead receive medication known as endocrine therapy for five years. This stops cancer cells from using hormones like estrogen to grow and spread.
“This has been the standard of care for a long time in women 65 or older. Now the debate is whether we can also omit radiation for a larger group of patients with breast cancer. For example, can we take this approach in patients younger than age 65, if patients are chosen carefully?” says Dr. Nadine Tung, director of the Cancer Risk and Prevention Program and Breast Medical Oncology at Beth Israel Deaconess Medical Center.
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What Emotional Responses Might I Expect
You may or may not experience anxiety or fear when you begin your treatment. Most people tell us that their concerns lessen as they adapt to the new environment and treatment.
Please speak to the staff if you feel that you need either emotional or practical support. There is a social worker on staff in the Radiation Oncology department. This may be a time when you think again about support groups or one-to-one consultation for the feelings that arise or to support your coping. For information about support services, please call the Breast Care Center at 353-7070.
How Long Does Radiation Stay In Your Body After Cancer Treatment
For most people, the cancer experience doesnt end on the last day of radiation therapy. Radiation therapy usually does not have an immediate effect, and it could take days, weeks or months to see any change in the cancer. The cancer cells may keep dying for weeks or months after the end of treatment.
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How Should I Care For Myself During Radiation Therapy
How Long Does It Take For Radiation To Cause Side Effects
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.
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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
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:
Radioprotective Drugs For Reducing Side Effects
One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.
Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.
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Other Ways Of Giving Radiotherapy
The following types of radiotherapy are less commonly used and are not widely available, but may be discussed with you.
Intraoperative radiotherapy
Intraoperative radiotherapy uses low-energy x-rays given from a machine in the operating theatre during breast-conserving surgery.
Radiotherapy is given directly to the area inside the body where the cancer was after it has been removed. Usually a single dose of radiation is given in one treatment. Sometimes you may also need a short course of to the rest of the breast.
Intraoperative radiotherapy is not suitable for everyone and is not standard treatment.
Brachytherapy
Brachytherapy involves placing a radiation source inside the body in the area to be treated.
Narrow, hollow tubes or a small balloon are put in the body where the breast tissue has been removed. Radioactive wires are inserted through the tubes or into the balloon. The radioactive wires may be left in place for a few days or inserted for a short time each day. The tubes or balloon are removed after your radiotherapy treatment is finished.
Depending on the type of brachytherapy you have, you may need to have your treatment as an inpatient and be kept in a single room for a short time due to the radiation.
Brachytherapy is currently only given as part of a clinical trial. If brachytherapy is an option your specialist will discuss it with you.