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Radiation Vs Chemo For Breast Cancer

What Are The Side Effects Of Targeted Therapies

TIMING OF CHEMOTHERAPY AND RADIATION FOR BREAST CANCER: How to Know Which Treatment Comes First

Targeted therapies have far fewer side effects than chemotherapy or radiation. While many of the side effects are similar, there are some key differences. One of the most pertinent is that you dont experience hair loss. Additionally, chemotherapy frequently damages the surrounding healthy cells in addition to cancerous cells, while targeted therapy tends to damage only cancerous cells. Some of the most common side effects of targeted therapy may include:

  • Diarrhea or nausea
  • Loss of appetite, weight loss
  • Muscle or joint pain

What Are The Key Differences Between Chemotherapy And Radiation

The major difference between chemo and radiation is the way theyre delivered.

Chemotherapy is a medication given to treat cancer thats designed to kill cancer cells. Its usually taken by mouth or given through an infusion into a vein or medication port.

There are many different types of chemotherapy drugs. Your doctor can prescribe the type thats most effective at treating your specific type of cancer.

Chemotherapy can have many side effects, depending on the type that youre getting.

Radiation therapy involves giving high doses of radiation beams directly into a tumor. The radiation beams change the DNA makeup of the tumor, causing it to shrink or die.

This type of cancer treatment has fewer side effects than chemotherapy since it only targets one area of the body.

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“The amount of exercise was aimed to increase progressively, with the ultimate target of participants meeting the national guideline for recommended exercise levels,” said study leader Georgios Mavropalias, a postdoctoral research fellow in the School of Medical and Health Sciences.

“However, the exercise programs were relative to the participants’ fitness capacity, and we found even much smaller dosages of exercise than those recommended in the national guidelines can have significant effects on cancer-related fatigue and health-related quality of living during and after radiotherapy,” Mavropalias said in a university news release.

The Australian national guidelines for cancer patients call for 30 minutes of moderate intensity aerobic exercise five days a week or 20 minutes of vigorous aerobic exercise three days a week. This is in addition to strength training exercises two to three days a week.

About 1 in 8 women and 1 in 833 men are diagnosed with breast cancer during their lifetimes, according to Living Beyond Breast Cancer, a Pennsylvania-based nonprofit organization.

The study showed a home-based exercise program during radiation therapy is safe, feasible and effective, said study supervisor professor Rob Newton, a professor of exercise medicine.

Study participants who started an exercise program tended to stick with it. They reported significant improvements in mild, moderate and vigorous physical activity up to a year after the program ended.

More information

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Why Choose To Have Your Breast Radiation Therapy At Memorial Sloan Kettering

  • In order to deliver radiation in the best possible way, it takes a dedicated team of doctors, nurses, therapists, physicists, and treatment planners. Our breast cancer team is one of the largest and most experienced in the country.
  • Our radiation oncologists have access to and experience with every single form of radiation therapy available. There is not just one best type of radiation for all of the women we care for. But with our deep experience, we can select the best technique for each individual woman and tailor our approach as needed.
  • Our team of medical physicists ensures that the radiation dose each woman receives is accurately and safely targeted to cancer tissue and spares nearby normal tissue.
  • We consider the details of each unique woman. Our publications have demonstrated that our personalized care leads to superior outcomes.

Starting With Neoadjuvant Therapy

Chemo Vs Radiation Side Effects

Most often, these cancers are treated with neoadjuvant chemotherapy . For HER2-positive tumors, the targeted drug trastuzumab is given as well, sometimes 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 done, it is usually delayed until after radiation is complete. In some cases, 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, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses. For people with hormone receptor-positive cancer in the lymph nodes who have completed a year of trastuzumab, the doctor might also recommend additional treatment with an oral drug called neratinib for a year.

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How Is Radiation Therapy For Breast Cancer Performed

Most people lie on their back during the treatment though some breast treatments are performed while lying on your stomach . You place your arm above your head .

During the treatment, your treatment team:

  • Positions and secures your body in the immobilization device. If you had a mastectomy, your provider might place a bolus on top of the treatment area to increase the radiation dose to the surface.
  • Lines up the machine with the first treatment field. To protect themselves from radiation exposure, providers leave the room. Your provider can still hear and see you.
  • Turns on the machine. You will hear a whirring noise, but you wont see the radiation beams. You must remain still. Depending on the radiation type and dose, treatment can take 30 seconds to several minutes.
  • Returns to the room to position the machine to treat a different treatment field. Most people get treatment on two to five fields each day.
  • Takes daily/weekly X-rays of the treatment field to make sure the radiation is hitting the correct area.

What Are The Cosmetic Results Of Breast Conservation Therapy

Eighty percent to 90 percent of women treated with modern surgery and radiotherapy techniques have excellent or good cosmetic results that is, little or no change in the treated breast in size, shape, texture or appearance compared with what it was like before treatment.

Patients with large breasts seem to have greater shrinkage of the breast after radiation therapy than do patients with smaller breasts. However, this problem usually can be overcome with the use of higher x-ray energies or with IMRT. Partial breast radiation using brachytherapy can also be considered if the patient has a small early-stage tumor. This treatment is still undergoing clinical investigation. Certain single institution studies on brachytherapy and intraoperative radiation have shown some promising results. You would need to discuss this with your doctor before or shortly after surgery to determine if you qualify for partial breast radiation.

You may have read the news that a âtest means fewer women will need chemotherapyâ.

The news reports follow a study, called TAILORx, of a test widely used on the NHS.

The test Oncotype DX predicts whether someone would benefit from chemotherapy.

The test is suitable for women whose breast cancer:

This means that several thousand women a year could avoid having chemotherapy, which can cause a range of often unpleasant side effects.

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Radiation Therapy Clinical Trials For Breast Cancer

Clinical trials are research studies that test new treatments to see how well they work and confirm that they are safe. Women who choose to participate in a trial at MSK receive the most advanced cancer treatments available, sometimes years before they are available anywhere else.

We offer a number of clinical trial options for women with breast cancer who are receiving radiation therapy. For example, MSK investigators are leading a national trial on the use of proton therapy to limit radiation-induced heart disease. Our team is also testing radiation in combination with new drugs, such as immunotherapy for recurrent breast cancer.

Radiotherapy To Part Of The Breast

Surgery, chemotherapy and radiation increase chances of survival when treating breast cancer

Less commonly, some women are given radiotherapy to part of the breast instead of the whole breast. There are different ways of doing this.

Your cancer doctor or specialist nurse will explain if any of the following treatments are options for you. They will tell you what the possible side effects are and any risks involved.

It is important to have information about all your treatment options. They can explain how these treatments compare with external radiotherapy.

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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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Timing Of Chemotherapy And Radiotherapy Following Breast

  • Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Purpose: To investigate the effect of chemotherapy and radiotherapy timing after breast conserving surgery on recurrence and survival of women with early-stage breast cancer.

Patients and Methods: We retrospectively analyzed 900 patients who underwent BCS followed by both adjuvant chemotherapy and radiotherapy. Of these, 488 women received chemotherapy first while the other 412 received radiotherapy first . Locoregional recurrence , distant metastasis , disease-free survival , and overall survival rates were calculated using the Kaplan-Meier method and further confirmed with propensity-score matching and the Cox proportional hazards model. The optimal cut-off value of interval time from surgery to the start of chemotherapy was calculated by Maxstat.

Results: The median follow-up was 7.1 years. In pre-match analysis, the CT-first group had a significantly higher 8-year DFS than the RT-first group . PSM analysis of 528 patients indicated that the 8-year DFS and DM were significantly better in the CT-first group, but that the OS and LRR were similar. We found the optimal cut-off value of interval from surgery to chemotherapy was 12 weeks. Patients starting chemotherapy later than 12 weeks after surgery had significantly inferior survival outcomes.

Benefits And Risks Of Chemotherapy

Adjuvant Therapy

Chemotherapy is an essential treatment option for many cancers. The drugs used in chemotherapy are often given so that they can reach and kill cancer cells system-wide, outside of the primary tumor your doctor may have discovered.

When cancer spreads, it can be challenging to treat. So chemotherapy is an important treatment option to help kill cancer cells that may have escaped the primary tumor and spread to other parts of the body but are too small to see these are called micrometastases.

Chemotherapy can also help treat any tumor pieces or cells left over after other treatment approaches, like surgery or radiation therapy.

But because the drugs used in chemotherapy can be nonspecific to cancers and impact other healthy tissues of the body, they cause some side effects. These side effects are typically limited to when youre actively being treated with chemotherapy and will rapidly improve after treatment is discontinued.

Youll also likely feel exhausted by the treatments and need to take time off work the day of and the day after your treatments.

Chemotherapy is often given in cycles. For example, you may receive one week of treatment and then have a few weeks off to allow your body to heal before the next treatment.

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What Should I Expect Before Radiation Therapy For Breast Cancer

Most people who have breast cancer treatment receive external beam radiation therapy. The goal is to destroy any remaining cancerous cells while protecting healthy tissue.

Before your first treatment, you will have a planning session . This simulation helps your provider map out the treatment area while sparing normal tissues . This session may take one hour or longer.

During the simulation, your provider:

  • Carefully positions your body in an immobilization device on the treatment table. This device helps you stay in the correct position for all treatments.
  • Uses techniques to reduce the dose to the heart and lungs
  • Uses a tattoo device to mark the corners of the treatment areas . The freckle-sized tattoos are permanent. These markings help your provider align the radiation treatment in the same manner each time.
  • About Upmc Hillman Cancer Center

    When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.

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    When To Use Radiation

    Similar to chemotherapy, radiation can also be applied as a standalone treatment. It can also be used in conjunction with chemotherapy before surgery to shrink the tumor , or after surgery to destroy any remaining cancer cells .

    Typically, doctors prefer radiation therapy prior to surgery to shrink the size of the tumor so that it can be removed more easily.

    In some cases, palliative radiation is used to ease symptoms and improve quality of life in terminal cancer patients.

    Coping With The Side Effects

    Radiation Treatment vs. Chemotherapy

    The side effects of chemo and radiation depend on many factors. You will need support during your cancer journey. Many oncology facilities have support services that include a dietician, masseuse, yoga instructor, social worker, financial advocate, and nurse navigator who help find ways to relieve the physical and emotional side effects of chemo and radiation.

    When cancer treatment has been completed, you will need ongoing support, as some side effects can be lifelong. Participation in a survivorship program is vital for your continuing health and wellness after cancer treatment.

    Also Check: How To Prevent Breast Cancer Naturally

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