What Kind Of Skin Problems Can Radiation Therapy Cause
The way external radiation therapy affects your skin is similar to what happens when you spend time in the sun. It may look red, sunburned, or tanned. It may also get swollen or blistered. Your skin may also become dry, flaky, or itchy. Or it may start to peel.
Be gentle with your skin:
- Donât wear tight clothing over the area thatâs being treated.
- Donât scrub or rub your skin. To clean it, use a mild soap and let lukewarm water run over it.
- Avoid putting anything hot or cold on the area unless the doctor tells you to.
- Ask your doctor before you use any type of ointment, oil, lotion, or powder on your skin.
- Ask about using corn starch to help relieve itching.
- Stay out of the sun as much as possible. Cover the area getting radiation with clothing or hats to protect it. Ask the doctor about using sunscreen if you must be outdoors.
- If youÃ¢re having radiation therapy for breast cancer, try not to wear a bra. If that isnât possible, wear a soft, cotton one without underwire.
- Donât use any tape, gauze, or bandages on your skin unless the doctor tells you to.
Your skin should start to feel better a few weeks after therapy ends. But when it heals, it may be a darker color. And youÃ¢ll still need to protect yourself from the sun even after radiation therapy has ended.
What Happens At A First Radiation Therapy Appointment
You will be positioned on the treatment bed in the same position as your CT scan. The treatment machine delivers your radiation treatment from several different angles. The skin markings and individual treatment plan are used to deliver the prescribed treatment.
Radiation therapy is usually delivered in small daily doses called fractions over five consecutive days in a 36week period. Each individual session takes about 1020 minutes to complete. When the dose is being delivered, the radiation therapists will monitor you from another room, but you will always be able to communicate with the therapists through an intercom during your treatment and they can pause the treatment if required.
While youre receiving treatment, listening to music can help you relax, and it is possible to bring your own music to listen to, or organise a playlist with your radiation therapist.
After a treatment session most people can continue to carry out their usual daily activities including work. However, if you are unable to carry on your normal activities, please discuss this with your treatment team. The nursing team are always available and will provide you with information on how best to manage any side effects that you may experience, such as skin changes around your breast and managing fatigue.
How Sex Might Be Affected
With some types of radiation therapy involving the pelvis and/or sex organs, men and women may notice changes in their ability to enjoy sex or a decrease in their level of desire.
For women: During radiation treatment to the pelvis, some women are told not to have sex. Some women may find sex painful. Treatment can also cause vaginal itching, burning, and dryness. You most likely will be able to have sex within a few weeks after treatment ends, but check with your doctor first. Some types of treatment can have long-term effects, such as scar tissue that could affect the ability of the vagina to stretch during sex. Again, your cancer care team can offer ways to help if this happens to you. You can also get more information in Sex and Women With Cancer.
For men: Radiation may affect the nerves that allow a man to have erections. If erection problems do occur, they are usually gradual, over the course of many months or years. Talk with your doctor about treatment options if this is a concern for you. You can get more information in Sex and Men With Cancer.
If you get internal radiation therapy with seed implants, check with your cancer care team about safety precautions during sex
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What Is Radiation Therapy
Radiation therapy is the use of high-energy rays or particles to treat disease. It works by killing tumor cells or inhibiting their growth and division.
Through years of clinical trials, radiation oncologists have studied the use of radiation therapy to treat breast cancer. These studies have led to the widespread use of effective and tolerable doses of radiation therapy. It is used to treat early stage breast cancer along with surgery for local control of disease. It may be used in more advanced breast cancer to control the disease or to treat symptoms, such as pain.
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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What Type Of Radiation Therapy Is Used For Breast Cancer
The most common type of radiation therapy for breast cancer is external beam radiation. This uses high-energy radiation beams delivered by a linear accelerator machine to deliver radiation from outside your body to destroy cancer cells in the breast. Advanced techniques are used to deliver the radiation therapy at a precise dose to the targeted treatment area.
What Is Radiation Therapy And How Does It Work
Radiation therapy uses high-energy rays to kill cancer cells. It affects cells only in the part of the body that is treated with the radiation. Breast cancer radiation therapy may be used to destroy any remaining mutated cells that remain in the breast or armpit area after surgery.
Note: There are special situations in which radiation is used for women with metastatic breast cancer experiencing painful bone metastasis. This section however focused on the use of radiation for adjuvant therapy .
Who should expect to be prescribed radiation therapy and what is involved?Some people with Stage 0 and most people with Stage 1 invasive cancer and higher, who have had a lumpectomy, can expect radiation therapy to be a part of their treatment regimen.
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If Youre Getting Radiation Therapy To The Head Or Neck
People who get radiation to the head and neck might have side effects such as:
- Soreness in the mouth or throat
- Dry mouth
- Jaw stiffness
How to care for your mouth during treatment
If you get radiation therapy to the head or neck, you need to take good care of your teeth, gums, mouth, and throat. Here are some tips that may help you manage mouth problems:
- Avoid spicy and rough foods, such as raw vegetables, dry crackers, and nuts.
- Dont eat or drink very hot or very cold foods or beverages.
- Dont smoke, chew tobacco, or drink alcohol these can make mouth sores worse.
- Stay away from sugary snacks.
- Ask your cancer care team to recommend a good mouthwash. The alcohol in some mouthwashes can dry and irritate mouth tissues.
- Rinse your mouth with warm salt and soda water every 1 to 2 hours as needed.
- Sip cool drinks often throughout the day.
- Eat sugar-free candy or chew gum to help keep your mouth moist.
- Moisten food with gravies and sauces to make it easier to eat.
- Ask your cancer care team about medicines to help treat mouth sores and control pain while eating.
If these measures are not enough, ask your cancer care team for advice. Mouth dryness may be a problem even after treatment is over. If so, talk to your team about what you can do.
How to care for your teeth during treatment
Radiation treatment to your head and neck can increase your chances of getting cavities. This is especially true if you have dry mouth as a result of treatment.
How Fertility Might Be Affected
For women: Talk to your cancer care team about how radiation might affect your fertility . Its best to do this before starting treatment so you are aware of possible risks to your fertility.
Depending on the radiation dose, women getting radiation therapy in the pelvic area sometimes stop having menstrual periods and have other symptoms of menopause. Report these symptoms to your cancer care and ask them how to relieve these side effects.Sometimes menstrual periods will return when radiation therapy is over, but sometimes they do not.
See Fertility and Women With Cancer to learn more.
For men: Radiation therapy to an area that includes the testicles can reduce both the number of sperm and their ability to function. If you want to father a child in the future and are concerned about reduced fertility, talk to your cancer care team before starting treatment. One option may be to bank your sperm ahead of time.
See Fertility and Men With Cancer to learn more.
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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.
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.
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How Can I Make A Decision Between Mastectomy And Breast Conservation Therapy
Breast conservation therapy is often used for patients with early-stage invasive breast cancers . It is also used for patients with DCIS . Some of the reasons to not have breast conservation therapy include: personal preference increased risk of complications from radiation therapy in individuals with certain rare medical conditions such as certain autoimmune disorders surgery that would require removing a large amount of diseased breast tissue that would lead to a poor cosmetic result and tumors that are more likely than average to have a relapse in the breast with breast conservation therapy.
Most patients may choose a treatment based on other factors, such as convenience or personal preference . Most women prefer to keep their breast if this is possible to do safely, but there is no right answer that is best for everyone. This decision is one that is ideally made in partnership between a patient and her physician. In some cases a pre-surgical consultation with a radiation oncologist may be helpful in answering questions about breast-conserving therapy.
Nearly all physicians will recommend patients be treated with mastectomy instead of breast conservation therapy when the risk of recurrence in the breast is more than 20 percent. This is the case if the tumor is large or multifocal . This situation occurs for only a small number of women, however.
Radiation Therapy For Breast Cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is often used to treat breast cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.
Radiation therapy is given for different reasons. You may have radiation therapy to:
- lower the risk of the cancer coming back, or recurring, after surgery
- shrink a tumour before surgery
- treat breast cancer that comes back, or recurs, in the area of a mastectomy
- relieve pain or control the symptoms of advanced breast cancer
Doctors use external beam radiation therapy to treat breast cancer. During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it.
Some women may not be able to have radiation therapy because they already had radiation therapy to the chest or breast. Doctors may not offer radiation therapy to women with lung problems, damaged heart muscles and certain connective tissue diseases.
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External Radiation Therapy Side Effects
One of the main side effects of external radiation therapy is skin changes in the treated area.
The reaction is much like a sunburn, with redness and possible itching, burning, soreness, peeling, blisters, or darkening of the skin. These skin changes happen gradually over the course of treatment and may happen only in certain areas.
Places where skin touches skin, such as the armpit and the area under the breasts, and places where you may have had a lot of sun exposure, such as the upper chest, are more likely to be affected. Some people have a change in skin color that lasts for years after treatment.
Some people may have telangiectasias develop months to years after radiation to the breast. A telangiectasia is a small patch of tiny blood vessels on the skin of the treated area that looks like a tangle of thin red lines. Telangiectasias are not a sign of cancer recurrence, but they can sometimes cause bothersome symptoms such as itching or pain. If you develop telangiectasia after radiation therapy and wish to treat it, you can talk to a dermatologist about laser therapy or other treatments.
You may be more likely to have significant skin side effects if you have fair skin, larger breasts, certain health conditions that affect skin healing , or had mastectomy or chemotherapy before radiation.
Other common side effects of external radiation therapy are:
- swelling in the breast
Other, less common side effects that external radiation may cause are:
How Long Can You Wait For Radiation After Lumpectomy
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 get radiation therapy as an outpatient at a hospital or other treatment facility.
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The Pressure Of Patient Expectations
A majority of surveyed physicians reported that patients want the most aggressive treatment, even if the benefit is small, and that it takes more effort to tell patients that they do not need radiation than it does to recommend it.
Its important to recognize that this is a controversial area, says Shumway. You cant say that offering radiation to older women is wrong. It really is a patient-driven decision, and it depends on the patients own values and preferences, in addition to her risk of recurrence and overall health.
As the point of first contact for breast cancer patients, surgeons have a tremendous influence on how patients choose treatment options.
Which is why Shumway thinks they could play a crucial role in counseling older women about options for less aggressive therapy.
The population is aging, and this is going to be an issue that affects more women, says Shumway. There is increasing attention given to considerations that are unique to older patients and in this case, their vulnerability for overtreatment.
Shumways future work will focus on developing interventions to help patients make fully informed decisions and understand the concept of competing causes of mortality.
Learn more about breast cancer and breast cancer treatment:
Will Side Effects Limit My Activities
Not necessarily, says Yale Medicine radiation oncologist Lynn Wilson, MD, who is the chair of Therapeutic Radiology and a professor of therapeutic radiology at Yale School of Medicine. It will depend on what side effects you experienceand how severe they are. Many patients are able to go to work, keep house, and enjoy leisure activities while they are receiving radiation therapy. Others find that they need more rest than usual and therefore cannot do as much. You should try to do the things you enjoy, as long as you don’t become too tired. Your doctor may suggest that you limit activities that might irritate the area being treated. In most cases, you can have sexual relations if you wish. However, your desire for physical intimacy may be lower because radiation therapy may cause you to feel more tired than usual.
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