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:
Tiny Radioactive Seed Makes A Big Impact In Breast Cancer Surgery
OKLAHOMA CITY Lakeside Womens Hospital, part of the INTEGRIS network, is the first facility in Oklahoma to offer a new, more patient-friendly approach to pinpointing and removing very small breast cancers.
The innovative procedure is called radioactive seed localization. Using a mammogram or ultrasound for guidance, Charles Groves, M.D., a breast radiologist and medical director of the INTEGRIS Comprehensive Breast Center of Oklahoma, uses a thin needle to place a tiny metal seed into the breast to mark the exact location of the cancer. The implanted seed contains a small amount of radiation that helps the surgeon locate the area of abnormal tissue during surgery when it is too small to be seen or felt by hand.
Until now, patients with such small breast cancers were required to undergo a procedure called breast needle localization, in which we would insert a wire into the breast to map the location of the cancer, says Groves. The wire remained in the breast, projecting out of the skin for several hours until the surgery. The wire was used to guide the surgeon during the operation.
The radioactive seed is strictly used for tumor marking. It does not replace radiation or chemotherapy as a method of treating the cancer.
Laura Takes Charge Of Her High Risk For Breast Cancer
When Laura, mother of two, felt a lump in her breast, she assumed her milk ducts were clogged. She was about to stop breastfeeding her infant son and knew mastitis was often a side effect. But the lump didnt go away. Two months later, she visited her gynecologist, who immediately sent her to Dr. Peter Naruns at El Camino Health for a biopsy.
In January 2017, Laura received a diagnosis of stage 3 invasive ductal carcinoma that involved several lymph nodes. She was also found to be BRCA2 positive at very high risk for breast and ovarian cancer.
I didnt think at all about cancer, recalls Laura. I thought it was just a clogged milk duct. There was no pain so I thought it would go away.
After the jolting diagnosis, things moved really fast. Dr. Naruns referred her to top oncologist, Dr. Shane Dormady, and his renowned team at El Camino Health. Laura and Dr. Dormady agreed on an aggressive treatment based on her age and stage. It would include chemotherapy, a double mastectomy, radiation, menopausal hormone therapy, and eventually, when Laura is ready, she will undergo surgical menopause.
As Laura recalls, Dr. Dormady said, So that we have the best chance of beating this, Im going to throw it all at you, and we started with chemo right away to shrink the tumor.
Prostate Cancer: Radioactive Seed Implants
Radioactive seed implants are a form of radiation therapy for prostate cancer. Brachytherapy, or internal radiation therapy, are also terms used to describe this procedure. There are two types of prostate brachytherapy: permanent and temporary.
Compared to external radiation, which requires five to eight weeks of daily treatments, convenience is a major advantage of brachytherapy.
After Radiotherapy May You Undergo A Mastectomy
After a mastectomy, radiation treatment is not always necessary. Only 5% of women who had mastectomy after a recurrence of breast cancer received radiation treatment following the procedure. Ask your doctor about the findings of this research if you have a recurrence of breast cancer in the same breast following a lumpectomy.
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A Double Mastectomy Radiation And Breast Reconstruction
In August, Dr. Naruns performed a skin and nipple-sparing surgery to remove the affected breast tissue. To prepare for breast reconstruction after radiation, Lauras surgeons inserted temporary expanders to maintain breast shape in the absence of breast tissue.
One year after her diagnosis Laura was done with radiation and had permanent breast implant surgery. I had a pretty quick recovery, says Laura. I only needed two weeks off.
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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New Seed Improves Breast Cancer Care
Posted on in Announcements
Were providing even better care for breast cancer patients thanks to the introduction of a new radioactive seed technique to improve patient experience as well as surgical outcomes following surgery.
Our new procedure aids the surgeons in identifying very small breast cancers prior to surgical removal.
North Tees Breast Screening Unit can identify cancers so small there is no lump or other visible signs. Traditionally, a thin piece of metal wire was inserted into the breast on the day of the operation which the surgeon followed as a guide-line to the location of the tumour.
The new process sees the guide-wire replaced with a tiny, radioactive iodine seed encased in a metal shell.
The seed, which emits a weak radioactive signal, is injected into the tumour by a breast radiologist and can be easily located by the surgeon using a special piece of theatre equipment that can detect the radioactive signal.
Dr Anuradha Anand, consultant radiologist for the Trust, said: This is a real game-changer.
The old metal guide-line procedure was uncomfortable and had to be fitted on the day of the operation when the patient is understandably stressed and nervous.
But our new seed can be fitted up to two weeks before the operation with a simple injection. Its painless, the radiation levels are extremely low and it allows more precise removal of the tumour.
The whole team has undergone extensive training and learned about the safe handling of the seeds.
What Are The Side Effects
Urinary symptoms are the most common. These include frequent urination and a need to get to the bathroom quickly. Some men have a burning with urination and, in a few cases, an inability to empty the bladder completely.
These symptoms can usually be managed with medicine, and they improve over time. Temporary self-catheterization may be necessary to help drain the bladder.
Urinary incontinence from brachytherapy is rare. The risk may be somewhat increased in patients who have undergone a previous surgical procedure to remove a part of the prostate called a TURP . A doctor can minimize this risk by doing a careful prostate ultrasound before the procedure to determine how much prostate tissue is still present to implant the seeds.
The impotence rate at five years after the procedure is about 25% using brachytherapy alone. If hormone therapy is added, the impotence rate rises depending on the duration of the hormonal treatment.
Bowel problems can sometimes happen and include rectal pain, burning pain and diarrhea.
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What Happens Before The Procedure
A transrectal ultrasound is done to provide the radiation oncologist with specific details about your case. Newer techniques using a CAT scan or MRI may be used to guide the proper placement of the implants. This information is used to custom-design the treatment plan for you. Another option is for the ultrasound and treatment plan to be done at the same time as the radioactive seeds are implanted.
Setting Expectations For Proton Therapy Treatment
From the moment you walk into The University of Kansas Cancer Centers Proton Therapy Center, you will be surrounded by support, compassion and leading-edge expert care providers.
Our disease-dedicated cancer specialists work with you to develop a comprehensive treatment plan tailored to meet your individual needs, because we understand that no 2 people experience cancer the same. Your personal care team may include physician specialists, nurses, psychologists, social workers, dietitians and navigation experts. These individuals work closely together to ensure you receive exceptional treatment every step of the way.
Here, cancer experts who are nationally and internationally recognized bring a wealth of knowledge and experience to help patients prevail over cancer. These highly skilled specialists from one of the countrys leading National Cancer Institute-designated cancer centers work in tandem to offer exceptional treatment for adult and pediatric cancers.
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Radioactive Seed Localization During Surgery
Surgery was guided by audible and visual feedback of a hand-held -detector probe . The three-dimensional extent of tumour to be resected was determined using a combination of preoperative imaging modalities , and knowledge and expertise of the surgeon. For patients who underwent surgery after NST, tumour extent was determined on CE-MRI acquired shortly before surgery. For BCS, the surgeon aimed to resect a spherical volume of tissue including the tumour, the seed and a resection margin of 10 mm beyond the identified tumour border. Resections were typically performed from the skin to the underlying fascia. In patients with a clinical complete response, the aim was to resect a margin of only 10 mm around the 125I-labelled seed during BCS, independent of the original tumour extent. When multiple seeds were used for bracketing, a segmental block of tissue around the seeds was resected, ensuring removal of all seeds with an adequate margin. After surgery, the excision cavity was examined with the probe to ensure that all seeds had been removed. The excised specimen containing the seed was stored in a lead container for transport to the pathology department. Additionally, a planar X-ray of the specimen was acquired to confirm the presence of the seed in the specimen and/or lymph node.
A Specialized Procedure Used For Short
SAVI brachytherapy uses an implanted device that delivers radiation internally. “SAVI” stands for “strut-adjusted volume implant.” Brachytherapy is also known as internal radiation therapy.
SAVI is often used after a lumpectomy in those diagnosed with early-stage breast cancer. This type of brachytherapy is different from external beam radiation, which applies radiation from outside the body and can cause damage to underlying tissues of the breast, lung, and ribcage.
SAVI reduces the length of therapy from up to seven weeks for traditional whole-breast irradiation to just one week or less. This short-course approach is known as accelerated partial breast irradiation .
In studies, ABPI was shown to improve cosmetic outcomes while remaining an effective treatment method and being generally well-tolerated by patients. People undergoing ABPI typically report fewer side effects than those who receive whole breast irradiation.
This article will explain when SAVI is used, how it works, and what to expect from the procedure.
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Brachytherapy Will Make You Give Off Radiation
With brachytherapy, the radiation source in your body will give off radiation for a while. If the radiation you receive is a very high dose, you may need to follow some safety measures.
- Staying in a private hospital room to protect others from radiation coming from your body.
- Being treated quickly by nurses and other hospital staff. They will provide all the care you need but may stand at a distance, talk with you from the doorway of your room, and wear protective clothing.
Your visitors will also need to follow safety measures, which may include
- not being allowed to visit when the radiation is first put in
- needing to check with the hospital staff before they go to your room
- standing by the doorway rather than going into your hospital room
- keeping visits short, about 30 minutes or less each day
- not having visits from pregnant women and children younger than a year old
You may also need to follow safety measures once you leave the hospital, such as not spending much time with other people. Your doctor or nurse will talk with you about any safety measures you should follow when you go home.
How Effective Is Radiation Therapy
If early-stage breast cancer hasnt spread, radiation therapy after a lumpectomy significantly reduces the risk of cancer coming back by approximately 50%. Studies show that a lumpectomy followed by radiation therapy is as effective as a mastectomy without radiation therapy.
People who undergo a lumpectomy have a 20% to 40% chance of the cancer coming back at 10 to 20 years. With the addition of postsurgical radiation therapy, that risk drops to 5% to 10%. However, there are some patients who derive less benefit from radiation including patients 65 years or older with small cancers.
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Radiation For Breast Cancer
Radiation therapy is treatment with high-energy rays that destroy cancer cells. Some women with breast cancer will need radiation, in addition to other treatments.
Depending on the breast cancer’s stage and other factors, radiation therapy can be used in several situations:
- After breast-conserving surgery, to help lower the chance that the cancer will come back in the same breast or nearby lymph nodes.
- After amastectomy, especially if the cancer was larger than 5 cm , if cancer is found in many lymph nodes, or if certain surgical margins, such as the skin or muscle, have cancer cells.
- If cancer has spread to other parts of the body, such as the bones, spinal cord, or brain.
Brachytherapy Via Implantable Device
There are two common types of internal radiation treatment: interstitial brachytherapy and intracavitary brachytherapy.
During interstitial brachytherapy, a doctor will insert several small tubes into your breast where the cancer was removed. The tubes deliver radioactive pellets to that area a few times each day over several days. This procedure is not commonly used today.
Intracavitary brachytherapy is the most common type of internal breast cancer radiation. Your doctor will place a tube-like device into your breast to send radiation to the location of the cancer. The end of the device expands in the breast to keep it in place, while the other end sticks out of the breast. Outpatient treatment sessions happen twice a day for five days.
Side effects of intracavitary brachytherapy may include:
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Treatment Continues But Life Doesnt Slow Down
Fast forward to present, Laura marvels that its been four years since her original diagnosis. Her son is now 5 and her daughter 9. Life continues on as it must with children, school, marriage and my research work.
Now at age 44, Laura has been put into menopause and is learning how to deal with that. I have the body of an older lady now. Chemotherapy and the hormone therapy have impacted my bone density. Im not as strong physically as I was before and need to start working out again regularly to build my muscles and bones back up, says Laura.
After four years, however, her cancer journey isnt over. Lauras treatment plan includes menopausal hormone therapy for a total of 10 years and regular check-ins with Dr. Dormady and his team. Laura is choosing to undergo a total hysterectomy with a bilateral salpingo-oophorectomy to further reduce her genetic cancer risk.
For the next few years, she will be relying on the support and the awesome experience she continues to have with El Camino Health.
Are Some Therapies More Effective Based On Stage
The type of radiation treatment you get depends on the stage of breast cancer. People with early to stage 3 breast cancer will benefit most from radiation treatment. Radiation can also help ease side effects in people with advanced breast cancer.
External whole breast radiation works best:
- for early stage to stage 3 breast cancer
- for tumors that are an inch or smaller
- if the cancer is in one spot
- if you had breast-saving surgery or a mastectomy
External beam radiation can also help treat side effects of advanced breast cancer.
Internal radiation works best:
- for early stage breast cancer
- if the cancer is in one spot
- if you had breast-saving surgery or a mastectomy
Sometimes, a person with advanced breast cancer will have internal radiation.
Intraoperative radiation works best:
- during early stage breast cancer
- when the tumor is too close to healthy tissue for external radiation to be possible
Not everyone can have intraoperative radiation or internal beam radiation. Whether you can have these procedures depends on:
- size and location of the tumor
- size of your breast
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