Radiation Therapy Side Effects Breast Cancer

Breast Radiation Side Effects

• Medical Review: Neil K. Taunk MD, MSCTS

Radiation therapy, also called radiotherapy, is a very effective treatment for lowering the risk of recurrence in early-stage breast cancer and for managing pain or complications of metastatic breast cancer. While radiation therapy itself isnât painful, there are side effects that can feel uncomfortable. This is because while radiation destroys cancer cells, it also damages healthy cells near the area being treated.

Itâs completely normal to be concerned about potential side effects of radiation therapy. Your healthcare team is there to support you and help you manage side effects. Weâre here for you too, with information about what you might experience and things you can do to feel better.

As you prepare for radiation treatment, consider what you may want to ask your team, such as:

• What kinds of side effects can I expect? When are they most likely to start?
• Are there side effects I should let you know about immediately?
• Can you recommend ways I can take care of my skin during treatment?

The type and intensity of radiation therapy side effects you may experience depend on a number of factors, such as:

You can learn more about the different types of radiation and why they are recommended on the Radiation therapy for breast cancer page.

• Sensitivity to sunlight
• Skin color changes

You can hear more of Dr. Garyâs recommendations for skin care during radiation therapy in our full video interview.

When Might Radiation Therapy Be Used

Not all men with breast cancer need radiation therapy, but it may be used in several situations:

• After breast-conserving surgery , to help lower the chance that the cancer will come back in the remaining breast tissue or nearby lymph nodes. Radiation is needed less often for men with breast cancer than it is for women, mainly because breast-conserving surgery isn’t done as much.
• After a mastectomy, especially if the cancer is larger than 5 cm , attached to the skin, or if cancer is found in the lymph nodes.
• If cancer has spread to other parts of the body, such as the bones or brain.

Which areas need radiation depends on whether you had a mastectomy or breast-conserving surgery and whether or not the cancer has reached nearby lymph nodes.

What Is The Best Treatment For Radiation

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.

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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:

Staying On Track With Radiation Treatments

The benefits of radiation therapy strongly depend on getting the full recommended dose without significant breaks, because:

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  The full dose of radiation is needed to get rid of any cancer cells remaining after surgery.

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  Radiation therapy is most effective when given continuously on schedule. In the past, it was given every day, 5 days a week, for 5 to 7 weeks. Accelerated, also called hypofractionated, radiation therapy schedules deliver about the same total dose of radiation over a shorter schedule usually 3 to 4 weeks, which can be more convenient. Partial breast radiation can be completed in 1 to 3 weeks. Also, by seeing your doctor regularly during and after treatment, you can best deal with any side effects.

Why you might have problems sticking to your radiation therapy plan:

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  The treatment schedule may conflict with job demands, family needs, or the distance you live from the treatment facility. This may cause you to miss or postpone appointments, even if youre on an accelerated schedule.

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  Skin irritation from radiation can cause soreness, peeling, and sometimes blisters. If you’ve also had lymph-node surgery, radiation treatment may worsen breast or underarm pain or discomfort. If you have these side effects, you might feel like stopping radiation.

Ways to overcome problems and stay on track with radiation treatment:

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When Is Radiation Therapy Used For Breast Cancer

Radiation therapy may be recommended as a treatment option following a lumpectomy or to treat more advanced stages of cancer. It may also be suggested to use other treatments, such as chemotherapy combined with radiation therapy. This is called neoadjuvant therapy and is largely dependent on each patients individualized treatment plan.

Fighting Breast Cancer With Fewer Treatments At Upmc In Central Pa

Many breast cancer patients receive radiation therapy following surgery. The goal of radiation is to kill breast cancer cells that may remain even after successful surgery. This helps prevent a recurrence.

At the UPMC Breast Care Center at UPMC in Central Pa., we are striving to make radiation treatment easier for our patients. We provide eligible patients a four-week course of radiation, which has been found to be as effective as the traditional six-week course, with the same or milder side effects.

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What Are The Common Side Effects Of Radiation Therapy

Radiation therapy is called a local treatment. This means that it only affects the specific area of the body that is targeted. For example, radiation therapy to the scalp may cause hair loss. But people who have radiation therapy to other parts of their body do not usually lose the hair on their head.

Common physical side effects of radiation therapy include:

Skin changes. Some people who receive radiation therapy experience dryness, itching, blistering, or peeling on the skin in the area being treated. Skin changes from radiation therapy usually go away a few weeks after treatment ends. If skin damage becomes a serious problem, your doctor may change your treatment plan. Lotion may help with skin changes, but be sure to check with your health care team about which cream they recommend and when to apply it. It is also best to protect affected skin from the sun. Learn more about skin-related treatment side effects.

Fatigue. Fatigue is a term used to describe feeling physical, emotional, and mental exhaustion even if you are getting enough rest and sleep. Many patients experience fatigue. Your level of fatigue may increase if you are receiving more than 1 type of treatment, such as radiation therapy combined with chemotherapy. Learn how to cope with fatigue.

Side Effects Of Breast Cancer Radiation

The side effects of short-course radiation have been found in studies to be the same or milder than traditional longer courses of radiation treatment.

Side effects are caused by receiving multiple doses of radiation on the cells. As a result, many people dont experience side effects until they are a few weeks into their treatment. These are usually in the area of the body that is being treated. Most are temporary.

Skin irritation, swelling in the breast, and fatigue are common short-term side effects. Long-term side effects may develop months or years after radiation therapy. They can include darkening or tanning of the skin, rib fracture, heart complications and swelling of the breast or arm . Another side effect can be radiation pneumonitis. This is a rare pneumonia-like condition caused by radiation-induced lung damage.

One way we are reducing radiation dose to the heart is by using a technique called deep inspiration breath hold. This involves having the patient take a deep breath and holding it for 15 to 20 seconds while they receive their radiation treatment. Taking a deep breath creates a gap between the breast radiation fields and the heart, thereby significantly reducing radiation dose to the heart.

Most patients tolerate radiation therapy well. Many people stay active during their treatment. UPMC Breast Care Center offers many support services to help you manage treatment side effects.

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Take Hormone Therapies As Prescribed:

If you have been prescribed endocrine therapy its very important to take it exactly as prescribed. Research has shown that many women dont take their medication every day, either because they forget or because of the side effects. Endocrine therapy reduces the chance of breast cancer recurrence and when not taken as prescribed, the drugs are less effective.

How To Prepare For Radiation Therapy

Talk with your doctor. Before starting radiation therapy, talk with your doctor about what to expect before, during, and after each therapy session. Ask them about possible side effects, how to reduce your risk of them, and best treatments. Knowing what to expect can reduce anxiety and help you be prepared. During and after radiation therapy, tell

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If Youre Having Radiation Therapy To The Pelvis

Radiation therapy to the pelvis can cause side effects such as:

• Bladder problems
• Fertility problems
• Changes in your sex life

You might also have some of the same problems people get from radiation to the abdomen, such as nausea, vomiting, diarrhea, or constipation.

Bladder problems

Radiation to the pelvis can cause problems with urination, including:

• Pain or burning sensations
• Blood in the urine
• An urge to urinate often

Most of these problems get better over time, but radiation therapy can cause longer-term side effects as well:

• Radiation cystitis. If the radiation damages the lining of the bladder, radiation cystitis can be a long-term problem that causes blood in the urine or pain when passing urine.
• Urinary incontinence. Radiation treatments for certain cancers, such as prostate and bladder cancer, may make you unable to control your urine or have leakage or dribbling. There are different types and degrees of incontinence, but it can be treated. Even if incontinence cant be corrected completely, it can still be helped. See Bladder and Bowel Incontinence to learn more. This side effect is most often a problem for men being treated for prostate cancer, but some of the information might also be helpful for women dealing with treatment-related incontinence.

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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How Can I Manage Skin Problems

You may notice that your skin in the treatment area begins to look reddened, irritated, sunburned or tanned. After a few weeks your skin may become very dry. Ask your doctor or nurse for advice on relieving itching or discomfort.

With some kinds of radiation therapy, treated skin may develop a “moist reaction,” especially in areas where there are skin folds. When this happens, the skin is wet and it may become very sore. It’s important to notify your doctor or nurse if your skin develops a moist reaction. You might find it helpful to seek care from an onco-dermatologist, a doctor who specializes in caring for skin problems cancer patients encounter.

Be very gentle with the skin in the treatment area. Avoid irritating treated skin, which can compromise the stratum corneum . When you wash, use only lukewarm water and mild soap. Don’t wear tight clothing over the treatment area. It’s important not to rub, scrub or scratch any sensitive spots. Also avoid putting anything that is very hot or very coldsuch as heating pads or ice packson your treated skin. Don’t use any powders, creams, perfumes, deodorants, body oils, ointments, lotions, or home remedies in the treatment area while you’re being treated or for several weeks afterward . Thats because many skin products can leave a coating on the skin that can interfere with radiation therapy or healing.

Who Is Eligible For Hypo

• Standard external beam radiation, which usually entails approximately 6 weeks of daily radiation.
• Hypo-fractionated radiation using 3 to 4 weeks of daily radiation.
• Balloon breast brachytherapy using 1 week of twice-daily radiation.

If you need radiation treatment, talk to your doctor about short-course radiation treatment. Make sure you understand all your options.

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Treatment Areas And Possible Side Effects

Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is over. But sometimes people may have side effects that do not improve. Other side effects may show up months or years after radiation therapy is over. These are called late effects. Whether you might have late effects, and what they might be, depends on the part of your body that was treated, other cancer treatments you’ve had, genetics, and other factors, such as smoking.Ask your doctor or nurse which late effects you should watch for. See the section on Late Effects to learn more.

• Reviewed:January 11, 2022

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How Can I Prevent Hair Loss

Radiation therapy can cause hair lossalso known as alopeciabut only in the area being treated. For example, if you are receiving treatment to your hip, you will not lose the hair from your head. However, radiation to your head may cause you to lose some or all of the hair on your scalp. Many patients find that their hair grows back again after the treatments are finished, but accepting the loss of hairwhether from scalp, face, or bodycan be a hard adjustment. The amount of hair that grows back will depend on how much radiation you receive and the type of radiation treatment your doctor recommends. Other types of treatment, such as chemotherapy, also can affect how your hair grows back. For example, if your radiation therapy is for palliative care, your hair probably will grow back slowly. However, if the goal of your radiation therapy is to cure rather than to relieve the symptoms of your cancer, then your hair may not grow back, and if it does, it probably will have a very fine texture.

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What Can I Expect During Radiation Treatment

I went to radiation therapy every day for five weeks. It was a really simple and fast process.

I arrived each day around 9:00 in the morning and went straight back to the changing rooms. I had to wear a gown from the waist up.

They also made me take off my wig and hat during my sessions. Since I was just in the beginning stages of hair growing out after chemo, my head was still pretty bald.

I was a bit overcome with emotion during my first treatment. You lay on the machine in a room by yourself. I felt really exposed with my arms above my head, my breasts out in the open, and my head coverings removed.

My mind couldnt help but wander since there was nothing else I could really do. They played music into the room, so I eventually tried to just focus on that.

During the treatments, I laid perfectly still and held my breath or breathed whenever the therapists asked over the intercom. The machine moved to different spots over my body. I didnt feel any pain or anything during this process.

My left arm did get pretty numb a few times. This is the arm where four lymph nodes had been removed. My circulation wasnt the greatest in this arm so it fell asleep really easily. I cant imagine what it must be like for people who have way more than four nodes removed!

The numbness got a bit worse with radiation treatment, but it is normal now that its over. So, if you are dealing with a tight arm, know that there is an end in sight!