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:
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:
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Wear clothing or a bathing suit with a high neckline, or wear a rash guard top.
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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.
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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.
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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:
What Happens Before Your First External Beam Radiation Therapy Treatment
You will have a 1- to 2-hour meeting with your doctor or nurse before you begin radiation therapy. At this time, you will have a physical exam, talk about your medical history, and maybe have imaging tests. Your doctor or nurse will discuss external beam radiation therapy, its benefits and side effects, and ways you can care for yourself during and after treatment. You can then choose whether to have external beam radiation therapy.
If you decide to have external beam radiation therapy, you will be scheduled for a treatment planning session called a simulation. At this time:
A mask fitted to your face helps make sure that you are in exactly the same position for each treatment.
- If you are getting radiation to the head and neck area you may be fitted for a mask. The mask has many air holes. It attaches to the table where you will lie for your treatments. The mask helps keep your head from moving so that you are in exactly the same position for each treatment.
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What Is Lumpectomy Combined With Radiation
Lumpectomy combined with radiation therapy is often referred to as breast conservation therapy . This type of treatment is as effective as having all the breast tissue removed . In special situations where the risk of recurrence is very low, your doctor may also discuss the option of avoiding radiation after a lumpectomy.
How To Contact Komen About Breast Cancer
If you or a loved one needs more information about breast health or breast cancer, call the Komen Breast Care Helpline at 1-877 GO KOMEN . All calls are answered by a trained specialist or oncology social worker in English and Spanish, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. You can also email the helpline at helpline@komen.org.
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After Breast Cancer Twice In One Year Early Detection And New Radiation Therapy Made All The Difference
Mammograms were never something Karin Diamond tried to avoid. She got one every year without fail and scheduled her annual wellness appointments to fall six months in between. The way she puts it, somebody was squeezing my breasts every six months.
Karin has large breasts, theyre dense, and her great aunt died of breast cancer fairly young. She has other high-risk markers too: Shes light-skinned, Ashkenazi Jewish, and got her period at age 11. All my life I assumed it was going to happen at some point in the future, she explains.
The future showed up earlier than expected. On Feb. 1, 2018, a routine mammogram returned with an abnormality. I was kind of like, really? Im 50! Dont I get a couple more years? says Karin. But it is what it is, I was not shocked or hysterical or any of those things.
How Radiation Is Used With Other Cancer Treatments
For some people, radiation may be the only treatment you need. But, most often, you will have radiation therapy with other cancer treatments, such as surgery, chemotherapy, and immunotherapy. Radiation therapy may be given before, during, or after these other treatments to improve the chances that treatment will work. The timing of when radiation therapy is given depends on the type of cancer being treated and whether the goal of radiation therapy is to treat the cancer or ease symptoms.
When radiation is combined with surgery, it can be given:
- Before surgery, to shrink the size of the cancer so it can be removed by surgery and be less likely to return.
- During surgery, so that it goes straight to the cancer without passing through the skin. Radiation therapy used this way is called intraoperative radiation. With this technique, doctors can more easily protect nearby normal tissues from radiation.
- After surgery to kill any cancer cells that remain.
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Facts About Breast Cancer
- 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime
- 30% of all newly diagnosed cancers in women, will be breast cancers.
- Good news is that Breast Cancer Is VERY CURABLE
- And the decades-long DROP in breast cancer death rate continues.
- In the most recent 5-year period , the breast cancer death rate declined by 2.1% per year in Hispanics/Latinas, 1.5% per year in blacks, 1.0% per year in whites, and 0.8% per year in Asians/Pacific Islanders, and was stable in American Indians/Alaska Natives.
Accelerated Partial Breast Irradiation
After whole breast radiation or even after surgery alone, most breast cancers tend to come back very close to the area where the tumor was removed . For this reason, some doctors are using accelerated partial breast irradiation in selected women to give larger doses over a shorter time to only one part of the breast compared to the entire breast . Since more research is needed to know if these newer methods will have the same long-term results as standard radiation, not all doctors use them. There are several different types of accelerated partial breast irradiation:
- Intraoperative radiation therapy : In this approach, a single large dose of radiation is given to the area where the tumor was removed in the operating room right after BCS . IORT requires special equipment and is not widely available.
- 3D-conformal radiotherapy : In this technique, the radiation is given with special machines so that it is better aimed at the tumor bed. This spares more of the surrounding normal breast tissue. Treatments are given twice a day for 5 days or daily for 2 weeks.
- Intensity-modulated radiotherapy : IMRT is like 3D-CRT, but it also changes the strength of some of the beams in certain areas. This gets stronger doses to certain parts of the tumor bed and helps lessen damage to nearby normal body tissues.
- Brachytherapy: See brachytherapy below.
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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.
Talk With Others Who Understand
MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 58,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.
Have you gone through radiation therapy for breast cancer? What type were you given? Share your experiences in the comments below, or start a conversation by posting on your Activities page.
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What Should I Expect After Radiation Therapy For Breast Cancer
You may notice fatigue as well as skin changes while undergoing radiation therapy. Your skin may become irritated, tender and swollen . People with fair skin may develop a red sunburn appearance. People with dark skin may notice darkening of the skin. This condition can also cause dry, itchy, flaky skin. Your skin may peel as you get close to finishing treatments . This skin irritation is temporary. Your provider can prescribe creams or medications to ease discomfort, if needed.
Skin discoloration can persist after treatment ends. Some people with fair skin have a slight pink or tan appearance for several years. You may also see tiny blood vessels in the radiated area. These vessels look like thin red lines or threads. These are not cause for concern.
How Much Radiation Therapy Costs
Radiation therapy can be expensive. It uses complex machines and involves the services of many health care providers. The exact cost of your radiation therapy depends on the cost of health care where you live, what type of radiation therapy you get, and how many treatments you need.
Talk with your health insurance company about what services it will pay for. Most insurance plans pay for radiation therapy. To learn more, talk with the business office at the clinic or hospital where you go for treatment. If you need financial assistance, there are organizations that may be able to help. To find such organizations, go to the National Cancer Institute database, Organizations that Offer Support Services and search for “financial assistance.” Or call toll-free 1-800-4-CANCER to ask for information on organizations that may help.
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Internal Radiation Therapy Use In Breast Cancer
The main type of internal radiation therapy used to treat breast cancer is called High-Dose Rate brachytherapy. HDR brachytherapy can be used for some patients with early-stage breast cancer. After a lumpectomy, a procedure is performed to place an applicator into the breast. This applicator contains a few tubes that hold the radioactive seeds. Over the course of a few days, the seeds will be placed in the applicator to kill any remaining cancer cells left inside the breast. Once treatment is done, the applicator is removed. HDR brachytherapy is a much shorter process than external beam radiation therapy for breast cancer but is not available to every patient based on the size, stage, and type of breast cancer.
Side Effects Of Radiation For Breast Cancer
Radiation treatments today are very precise, resulting in little harm to surrounding skin or healthy tissues. Many women tolerate radiation therapy to the breast very well and report few lasting side effects.
That said, after a few weeks of radiation, patients may experience:
- a sunburn-like condition on the skin
- changes in the color of the skin
- swelling and heaviness in the breast
Our radiation oncologists will explain in detail what to expect and when side effects are likely to appear. They can also prescribe a topical cream to minimize any changes in the skin. The fatigue women experience during treatment varies greatly, but in general women can remain active in all of their normal daily activities. Most women are able to continue working throughout the course of their care.
Other side effects can appear months or years after treatment has ended. These are called late effects.
Late effects of breast cancer radiation are not common but may include:
- inflammation in the lung, especially for women who have also received chemotherapy
- injury to the heart when there is significant heart exposure
- lymphedema in the arm, especially when radiation therapy is given after lymph node dissection
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What Happens During A Treatment Session
- You may be asked to change into a hospital gown or robe.
- You will go to the treatment room where you will receive radiation. The temperature in this room will be very cool.
- Depending on where your cancer is, you will either lie down on a treatment table or sit in a special chair. The radiation therapist will use the dots on your skin and body mold or face mask, if you have one, to help place you in the right position.
- You may see colored lights pointed at your skin marks. These lights are harmless and help the therapist position you for treatment.
- You will need to stay very still so the radiation goes to the exact same place each time. You will get radiation for 1 to 5 minutes. During this time, you can breathe normally.
The radiation therapist will leave the room just before your treatment begins. He or she will go to a nearby room to control the radiation machine. The therapist watches you on a TV screen or through a window and talks with you through a speaker in the treatment room. Make sure to tell the therapist if you feel sick or are uncomfortable. He or she can stop the radiation machine at any time. You will hear the radiation machine and see it moving around, but you won’t be able to feel, hear, see, or smell the radiation.
Most visits last from 30 minutes to an hour, with most of that time spent placing you in the correct position.
What You Can Expect
- Radiation therapy usually begins three to eight weeks after surgery unless chemotherapy is planned. When chemotherapy is planned, radiation usually starts three to four weeks after chemotherapy is finished. You will likely have radiation therapy as an outpatient at a hospital or other treatment facility. A common treatment schedule histori
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Why People With Cancer Receive Radiation Therapy
Radiation therapy is used to treat cancer and ease cancer symptoms.
When used to treat cancer, radiation therapy can cure cancer, prevent it from returning, or stop or slow its growth.
When treatments are used to ease symptoms, they are known as palliative treatments. External beam radiation may shrink tumors to treat pain and other problems caused by the tumor, such as trouble breathing or loss of bowel and bladder control. Pain from cancer that has spread to the bone can be treated with systemic radiation therapy drugs called radiopharmaceuticals.
How Radiation Can Affect Breast Implants
Due to its damaging effects on tissues, radiation can make cosmetic procedures more challenging. For instance, radiation can cause asymmetry . Thats because radiation can cause the skin over an implant or tissue flap to become firmer and more rigid, which can also lead to infection and cause the breast that underwent surgery to leak fluids. But, dont worry, there is a fix a plastic surgeon may do a fat injection to help soften and improve the affected breast.
Still, these post-reconstruction risks can be mitigated with the right amount of radiation. Radiation is typically administered in small doses over several weeks, but Dr. Mutter says some studies show the benefits of giving bigger rounds each day and finishing over a shorter time. The thought behind this approach is that it reduces the risk of complications down the line.
Theres a lot for us to still learn about why some patients might develop side effects where others may not, Dr. Mutter says. But both doctors acknowledge that theres still room for improvements to be made for breast cancer survivors.
Were not only worried about cancer recurrence and survival but we also have to prioritize their quality of life and cosmetic outcome, because we dont want women to look at their breasts and always be reminded of this diagnosis and be upset by it, Dr. Kim says. Id rather her forget about it: Thats a success in my book.
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