Questions To Ask Your Radiation Oncologist
Before your appointment, its helpful to write down the questions you want to ask your radiation therapy care team. Examples of questions you can ask are listed below. Write down the answers during your appointment so you can review them later.
What kind of radiation therapy will I get?
How many radiation treatments will I get?
What side effects should I expect during my radiation therapy?
Will these side effects go away after I finish my radiation therapy?
What kind of late side effects should I expect after my radiation therapy?
Breast Discomfort Or Swelling
You may have some tenderness in your breast on your affected side, especially at your nipple. You may also develop extra fluid in your breast that may cause sharp, stabbing sensations. Your breast or chest may feel heavy or swollen. Your shoulder on your affected side may also feel stiff.
These sensations can start within the first few days of your radiation therapy. They can go on for many months after you finish radiation therapy. Below are suggestions to help you reduce this discomfort.
- If you wear bras, you may want to choose soft, loose bras without an underwire. Sports bras or cotton bras are good choices. You may even find it more comfortable to not wear a bra at all.
- Take pain medications such as nonsteroidal anti-inflammatory drugs as needed. Some examples of NSAIDs are ibuprofen and naproxen . If you cant take an NSAID, you can take acetaminophen instead.
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.
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Why Radiation Is Used
One of the upsides of using radiation is that it can be used to treat breast cancer at almost every stage. Its most often used in conjunction with surgery, chemotherapy, and other medicines to prevent breast cancer from coming back. And for incurable cases such as when the cancer has spread to other parts of the body its commonly used to ease symptoms.
But, unlike other forms of treatment, radiation is generally localized, meaning its usually aimed at only the part of the body thats needing therapy. In many cases, patients might just need radiation to a part of the breast or partial-breast irradiation where internal or external radiation is directed toward the area around where the cancer was removed.
Change In Breast Shape Size And Colour
If youve had radiotherapy after breast-conserving surgery, the breast tissue on the treated side may feel firmer than before, or the breast may be smaller and look different.
Although this is normal, you may be concerned about differences in the size of your breasts, or worry that the difference is noticeable when youre dressed.
You can discuss this with your breast surgeon to see if anything can be done to make the difference less noticeable.
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When Should I Call The Doctor
You should call your healthcare provider if you experience:
- Severe skin or breast inflammation.
- Signs of infection, such as fever, chills or weeping skin wounds.
A note from Cleveland Clinic
Radiation therapy can lower the risk of cancer recurrence and cancer spread. The treatment affects everyone differently. Most side effects go away in a few months after treatments end. Some problems last longer. You should tell your healthcare provider about any problems you have while getting treatment. Your provider may change the therapy slightly to minimize issues while still effectively treating the cancer.
Last reviewed by a Cleveland Clinic medical professional on 03/19/2021.
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Mouth And Throat Changes
Radiation therapy to the head and neck can cause mouth changes. Radiation not only kills cancer cells but can also harm healthy cells in the glands that make saliva and the moist lining of your mouth. You may have:
- Loss/change in taste
- Thickened saliva
Some problems, like mouth sores, may go away after treatment ends. Others, such as taste changes, may last for months or even years. Some problems, such as dry mouth, may get better but never go away.
Mouth Care After Radiation
Radiation therapy to the neck or chest can cause the lining of your throat to become swollen and sore. Your risk for throat changes depends on how much radiation you are getting, whether you are also having chemotherapy, and whether you use tobacco and alcohol while getting radiation therapy. You may notice throat changes in 23 weeks after starting radiation. These will likely get better 46 weeks after you have finished treatment.
Nutrition During Head, Neck or Chest Radiation
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Rapid Radiation Therapy For Prostate Cancer
Treatment times: Standard treatment is a course of 44 treatments given over nine weeks, says Dr. Yu. With hypofractionated radiotherapy, patients are given five treatments over two weeks.
New advances: Radiotherapy is a common treatment for advanced prostate cancers. However, radiation can damage the rectum, which is close to the prostate. Protecting the rectum is important if damaged, a man may experience incontinence.
New technologies have opened the door to safe, rapid treatment of prostate cancers, says Dr. Yu. One of them, SpaceOAR, is essentially a gel spacer that helps keep the rectum away from the prostate during radiation treatment. It gives us one more level of safetywe are able to place fluid between the prostate and rectum, effectively protecting the rectum from very high doses of radiation, says Dr. Yu.
Doctors at Yale Medicine also use advanced technology to track the natural movement of the prostate during radiation treatment. Its a 4D tracking system that uses micro-sized transponders, which are implanted into the prostate by a urologist during a quick outpatient procedure. If the prostate moves during treatment, the transponders set off an alarm that alerts the radiation oncology team. Treatment is automatically stopped until the technicians make necessary adjustments in order to protect the areas surrounding the prostate, especially the rectum and bladder.
Changes In The Shape Size And Feel Of The Breast
In time radiotherapy can cause the breast tissue to change shape or shrink in size a little. This can happen to your natural breast tissue or a reconstructed breast.
After radiotherapy, the breast might feel hard and less stretchy. This is due to a side effect called radiation fibrosis. This side effect is usually mild.
Sometimes the breast can shrink a little over time. This is because radiotherapy can make the breast tissue contract so that the breast gradually gets smaller.
An implant in a reconstructed breast can become hard and may need replacing.
Let your surgeon know of any changes, they may be able to do some minor surgical adjustments to improve the look.
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Pain And Skin Changes
During and just after treatment, your treated breast may be sore. Talk with your health care provider about using mild pain relievers such as ibuprofen, naproxen or acetaminophen to ease breast tenderness.
The treated breast may also be rough to the touch, red , swollen and itchy. Sometimes the skin may peel, as if sunburned. Your health care provider may suggest special creams to ease this discomfort.
Sometimes the skin peels further and the area becomes tender and sensitive. Its most common in the skin folds and the underside of the breast. If this occurs, let your radiation team know. They can give you creams and pads to make the area more comfortable until it heals.
Fatigue is common during radiation therapy and may last for several weeks after treatment ends.
Fatigue is mainly a short-term problem, but for some, it can persist .
You may feel like you dont have any energy and may feel tired all of the time. Resting may not help.
Regular exercise, even just walking for 20 minutes every day, may help reduce fatigue . Getting a good nights sleep is also important.
Talk with your health care provider if you are fatigued or have insomnia .
Learn more about fatigue and insomnia.
Hair Loss In The Armpit
Radiotherapy to the armpit will make the underarm hair fall out on that side.
Men having radiotherapy will lose the hair on the area of the chest thats being treated.
Hair usually starts to fall out two to three weeks after treatment has started and it may take several months to grow back. For some people, hair lost from radiotherapy may never grow back.
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Breast Cancer: A New 5
Delivering radiotherapy in 5 days instead of 3 to 5 weeks – this is the new challenge taken up by Gustave Roussy. The Institute now offers women over 60, with localised breast cancer, fewer but equally effective radiotherapy sessions after surgery. This constitutes a first in terms of care and organisation, and was introduced following recommendations from learned radiotherapy societies on how to tackle cancer more effectively in the light of the Covid-19 pandemic.This care pathway is based on new technologies which reduce session preparation time on the one hand and the number of sessions required on the other hand, using hypofractionated and personalised radiotherapy.Post-surgical radiotherapy is one of the treatment pillars for localised breast cancer following lumpectomy – a conservative surgical technique. It complements surgery by destroying any remaining cancer cells in an attempt to minimise the risk of local recurrence and to boost recovery rates. It is beneficial in the event of disease recurrence and also in terms of survival.
Swelling Of The Breast
Radiotherapy can make it more difficult for fluid to drain from the breast tissue. This can cause swelling of the breast or chest area. Doctors call this lymphoedema.
The swelling usually goes down a few weeks after the treatment ends. But tell your doctor or radiographers if it doesnt. They can arrange for you to see a lymphoedema specialist. You might have a type of massage called manual lymphatic drainage.
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Types Of Radiation Therapy
The most common type of radiation therapy for breast cancer is called external beam radiation therapy . During EBRT, a machine outside of the body delivers the radiation to the prescribed area of the body.
The exact type that is right for you will be based on many factors, including:
- The exact type of breast cancer
Questions To Ask The Health Care Team
Consider asking the health care team these questions if radiation therapy is a part of your recommended treatment plan:
What physical side effects are likely based on my specific radiation therapy treatment plan? When will they likely begin?
How can these side effects be prevented or managed?
How can I take care of the affected skin during my treatment period?
Who should I tell when a side effect appears or gets worse?
Are there specific side effects I should tell the doctor about right away?
Who can I talk with if I’m feeling anxious or upset about having this treatment?
If I’m having side effects that affect my nutrition, can you recommend an oncology dietitian?
What are other ways I can take care of myself during the treatment period?
Are there any restrictions on exercising or other physical activity during this treatment?
Could this treatment affect my sex life? If so, how and for how long?
Could this treatment affect my ability to become pregnant or have a child? If so, should I talk with a fertility specialist before cancer treatment begins?
What are the potential long-term effects of this type of radiation therapy?
If I’m worried about managing the financial costs of cancer care, who can help me?
Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?
After radiation therapy is completed, what will my follow-up care plan be?
Why is follow-up care important for managing side effects of treatment?
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Radiations Link To Secondary Diseases And Cancers
Radiation therapy may increase a persons risk of developing a different type of cancer years or may even decades after the fact. Though rare, some women may just be genetically predisposed to radiation-induced cancers. That said, Dr. Mutter says the risk of radiation-induced cancers for most breast cancer patients over their lifetime is only a fraction of a percent.
Unfortunately, due to its proximity to the heart, secondary cancers arent the only thing breast cancer survivors have to worry about radiation also makes them more likely to develop cardiovascular-related diseases that can lead to cardiac arrest and heart failure. Thanks to advancements in technology and more awareness of the potentially toxic side effects of radiation, Dr. Kim tells us that these deaths can largely be avoided nowadays.
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:
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How Do I Know If 5
Your doctors will carefully evaluate your cancer to determine if you are a candidate for 5-Day Radiation Therapy. The American Society of Breast Surgeons, American Brachytherapy Society, American Society for Radiation Oncology and the American College of Radiation Oncology recommend this treatment for early-stage breast cancers that are 3 cm or smaller, with limited or no spread of cancer to the lymph nodes 9,10,11,12. To see the full Society Guidelines on Patient Selection,
What Time Of Day Is Best For Radiation Therapy
New research from Roswell Park Comprehensive Cancer Center, to be presented at the American Association for Cancer Research Annual Meeting 2019 in Atlanta, reports that administering radiation treatments in the morning as opposed to later in the day can significantly reduce severity of mucositis and its related
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If Youre Getting Radiation Therapy To The Chest
Radiation treatment to the chest may cause side effects such as:
Radiation can also cause other problems in the heart or lungs.
Getting radiation to the middle portion of the chest can raise your risk of heart disease. This risk increases with higher radiation doses and larger treatment areas in this part of your body. Radiation can also cause hardening of the arteries , heart valve damage, or irregular heartbeats.
Radiation pneumonitis is inflammation of the lungs that can be caused by radiation treatment to the chest . It may occur about 3 to 6 months after getting radiation therapy. Its more likely if you have other lung diseases, like emphysema . Common symptoms of radiation pneumonitis include:
- Shortness of breath that usually gets worse with exercise
- Chest pain, which is often worse when taking in a deep breath
Sometimes there are no symptoms, and radiation pneumonitis is found on a chest x-ray.
Symptoms often go away on their own, but if treatment is needed, it is based on trying to decrease the inflammation. Steroids, like prednisone, are usually used. With treatment, most people recover without any lasting effects. But if it persists, it can lead to pulmonary fibrosis . When this happens, the lungs can no longer fully inflate and take in air.
Be sure you understand what to look for, and tell your cancer care team if you notice any of these side effects.
Will My Family Be Exposed To Radiation During My Treatment
No. There is no radiation source in your body between treatments. During 10 treatments over 5 days, a tiny source of radiation, called a “seed” is placed in the balloon catheter and therapeutic radiation is delivered to the area surrounding the lumpectomy cavity. After each radiation treatment, the “seed” is removed. The balloon catheter itself has no radioactive material.26
Coping With The Side Effects Of Radiation Therapy
Everyone’s experience with radiation therapy is different. Side effects vary from person to person, even when given the same type of treatment. Before your treatment, ask your health care team which physical side effects are possible and what to watch for. You may also experience emotional side effects. Seeking out mental health support to help with anxiety and stress is important.
Ask your health care team about ways to take care of yourself during the treatment period, including getting enough rest, eating well, and staying hydrated. Ask whether there are any restrictions on your regular exercise schedule or other physical activities. If so, talk with them about another way to get regular exercise.
Continue to talk to your health care team throughout your treatment. Tell them when side effects first appear, worsen, or continue despite treatment. That will help your health care team provide ways to help you feel better during and after treatment.