What Is Radiation For Breast Cancer

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:

Other Treatment Schedule Considerations

Researchers are studying newer approaches that give radiation over other shorter periods, such as single-dose external beam and brachytherapy schedules. They are working to learn more about which people are most likely to benefit from shorter-course radiation.

If you have been diagnosed with metastatic breast cancer and your doctor has recommended radiation therapy to relieve symptoms such as bone pain, your radiation schedule will probably be different than a typical 3-5-week whole breast schedule. You and your doctor will decide on a plan thats unique to the size and location of the cancer, the reason for treatment, other treatments you are receiving, and your overall health.

As you make a radiation therapy plan, its important to know that in many cases, radiation therapy cannot be given more than once to the same part of the body. The bodys organs and tissues can handle a certain, limited amount of radiation, but too much radiation can cause permanent damage. But there are exceptions. Dr. Taunk explains, In specific situations, repeat radiation to the same area may be recommended. However, the risks of repeat radiation should be discussed with your radiation oncologist. Careful planning by an experienced radiation oncologist is recommended in these situations.

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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When Is Radiation Therapy Used In Breast Cancer Treatment

Radiation therapy is used to treat breast cancer in the following circumstances:

• Radiation after lumpectomy: A lumpectomy is the surgical removal of a breast tumor and the surrounding tissue. It is an important procedure in breast-conserving surgery . Radiation therapy is used in conjunction with surgery to kill any leftover cancer cells in the adjacent tissue, to reduce the possibility of the diseases resurgence at a later date.
• Radiation after mastectomy: A mastectomy is the surgical removal of the entire breast, due to the size of the tumor or the spreading nature of the cancer. Radiation is used to check the possible reappearance of cancer in the lymph nodes.
• Radiation for locally advanced breast cancer: Some tumors cannot be removed by surgery. Radiation is a primary therapy in these situations.
• Radiation for metastatic breast cancer: Radiation can also be used to shrink metastasizing tumors that are an ongoing source of pain.
• Proton therapy: Proton-beam therapy replaces X-rays with protons as the radiation agent. Proton beams release energy in narrower intervals, which means that, in theory, they can be focused more completely on cancer cells than X-rays.

What Is A Radiation Boost

Radiation boosts are sometimes used in treating several types of cancer, such as cervical, brain, or rectal cancer. They also may be a part of breast cancer treatment.

The radiation boost may be given after radiation for breast cancer is complete. The focus of a boost is a little different than the previously completed treatment, though.

While the bulk of radiation therapy focuses on the whole breast, a boost targets the area of tissue where the primary tumor was located. It’s meant to kill any remaining breast cancer cells in that spot that could lead to a recurrence.

However, radiation boosts aren’t always a part of breast cancer treatment. Whether or not a booster dose is needed will depend on factors that include your age and the type and stage of breast cancer for which you’ve been treated.

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Enhancing Healthcare Team Outcomes

Breast cancer still remains a common malignancy in females, and although there are reports that the incidence is declining in certain countries, prompt diagnosis and treatment are necessary to prevent morbidity and mortality. The management of breast cancer is by an interprofessional team that includes an oncologist, surgeon, radiation oncologist, a pathologist, and an oncologic nurse. With a higher emphasis on breast-conserving surgery followed by radiation, many studies report favorable results. Further, many techniques have been developed to deliver radiation to the breast and studies have shown that the risk of recurrence outside the excised lesion is similar whether the whole or partial breast is treated. The treatment of breast cancer continues to evolve, and there are now studies trying to determine the feasibility of delivering radiation intraoperatively. Because breast cancer is a heterogeneous disorder, the key is proper patient selection to achieve the highest cure rates with the least morbidity.

Q: How Can Patients Cope With These Concerns

A: The first step is to recognize ones fears and worries. The next step is to find a way of dealing with these worries. Information and education are essential to regain some control. Sharing ones fears and worries with loved ones, a support group, or seeking professional help can and will bring relief. It is normal to have many concerns after completing treatment for cancer and important to feel supported and accompanied in this journey.

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How Often Will I Go For Treatment

Treatment is most often given once a day, 5 days a week, for 3-6 weeks.

The schedule of radiation sessions is designed to treat your breast cancer and varies from person to person.

Many women now get a shortened course of radiation therapy . This is called hypofractionated whole-breast irradiation.

Its like standard whole-breast radiation therapy except it uses a slightly higher dose of radiation per session . This reduces the number of treatment sessions, making the overall course shorter.

For most women with early breast cancer, hypofractionated whole-breast irradiation is as effective as standard whole-breast radiation therapy .

After radiation therapy to the whole breast, you may have more radiation to the part of the breast that had the tumor.

This boost increases the amount of radiation given to the area at highest risk for breast cancer recurrence.

Your boost radiation session is similar to a regular session.

Radiation therapy often delivers radiation to the whole breast. Partial breast irradiation delivers radiation only to the area around the tumor bed .

Its typically done in a shortened course over only 5-10 days. This reduces the number of treatment sessions. It can also be done over 3-4 weeks, similar to whole breast radiation therapy, or may be done at the same time as surgery.

Partial breast irradiation is an appropriate treatment for select people with early-stage breast cancer .

Methods of partial breast irradiation include:

Special Diet Needs While On Radiation Therapy

Radiation can cause side effects that make it hard to eat, such as nausea, mouth sores, and throat problems called esophagitis. Since your body uses a lot of energy to heal during radiation therapy, it is important that you eat enough calories and protein to maintain your weight during treatment.

If you are having trouble eating and maintaining your weight, talk to your doctor or nurse. You might also find it helpful to speak with a dietitian. For more information about coping with eating problems see the booklet Eating Hints or read more about side effects.

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What Questions Should I Ask My Doctor

Coping with a diagnosis of cancer and researching the various treatment options can be a stressful experience. To assist you in this process, below is a list of questions you may want to ask your radiation oncologist if you are considering radiation therapy.

Questions to ask before treatment

• What type and stage of cancer do I have?
• What is the purpose of radiation treatment for my type of cancer?
• How will the radiation therapy be given? Will it be external beam or brachytherapy? What do the treatments feel like?
• For how many weeks will I receive radiation? How many treatments will I receive per week?
• What are the chances that radiation therapy will work?
• Can I participate in a clinical trial? If so, what is the trial testing? What are my benefits and risks?
• What is the chance that the cancer will spread or come back if I do not have radiation therapy?
• Will I need chemotherapy, surgery or other treatments? If so, in what order will I receive these treatments? How soon after radiation therapy can I start them?
• How should I prepare for this financially?
• What are some of the support groups I can turn to during treatment?
• If I have questions after I leave here, who can I call?
• Will radiation therapy affect my ability to have children?
• Do you take my insurance?

Questions to ask during Treatment

Questions to ask After Treatment Ends

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What Are The Physical Side Effects

Receiving the radiation will not be painful. Side effects vary from person to person and depend on the site being treated. The most common side effects in the treatment of breast cancer are:

• Fatigue
• Skin changes
• Uncomfortable sensations in the treated breast

Please talk to your doctor or nurse if you have concerns about side effects before you begin treatment or if you have questions about managing your side effects during treatment.

Use The Weekends To Recuperate Not Catch Up

Many people try to delegate to the weekends what doesnt get done during the week, but this can lead to exhaustion. Make your number one weekend priority be to rest and heal, rather than trying to complete your to-do list.

A Word From Verywell

Taking the time to prepare not only physically but mentally for radiation can pay off when the fatigue hits full force. While the treatments may seem to go on forever, in reality it is just a short hiatus from life. Let yourself rest and pamper yourself as you would a good friend.

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External Radiation Planning And Treatment: What To Expect

Daily external radiation treatments require careful planning to make sure the treatment area is mapped out as accurately as possible and that each day of your treatment goes smoothly.

Heres what you can generally expect from the planning session through your daily treatment routine.

Your first radiation therapy session is called a simulation. It is a planning and practice session, and you receive no radiation.

During the simulation session, your radiation oncology team maps out the area of the breast that needs treatment using imaging such as a CT scan, MRI, or X-ray.

Because it is so important to position the angles of radiation accurately, the simulation session can sometimes last up to an hour.

During the simulation session, your doctor will:

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  explain the pros and cons of radiation, the planning and treatment process, and answer any questions or concerns you may have

• precisely identify the area where you will receive radiation

There are different kinds of immobilization devices. Some look like a cradle others look like a foam box that is shaped to your form. You will not be trapped or closed in. You may be asked to lie down in a custom-shaped mold that just touches your back and sides, or your treatment center may use a “breast board” that places your head, arm, and hand in a fixed position. If you have left-sided breast cancer, you may receive special breathing instructions to help protect your heart during radiation treatment.

When Radiotherapy Is Given

Radiotherapy is given after surgery to reduce the risk of breast cancer coming back in the breast, chest area or lymph nodes.

Your specialist or breast care nurse will tell you when you can expect to start radiotherapy.

If youre having chemotherapy after surgery, radiotherapy is usually given after the chemotherapy.

Radiotherapy may be delayed for a medical reason, for example if you need to wait for a wound to heal or if you develop a seroma .

Radiotherapy may not be suitable if:

• you have previously had radiotherapy to the same area
• you have a medical condition that could make you particularly sensitive to its effects
• youre pregnant

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Side Effects Of Radiation Therapy:

The field of radiation therapy has dramatically reduced its side effects over the last decade. CT Scan Radiation Planning has revolutionized the ability to better focus radiation on the area of cancer and avoid damaging adjacent normal tissue.

Some side effects and toxicities

• Your breast and skin can become irritated and tender
• Some constricting or shrinkage of the treated breast and surrounding tissue may occur
• Breast reconstruction and implants can be affected
• General fatigue is common
• Your breast and ribs can be sore for an extended period of time
• You cannot have radiation if you are pregnant
• There is a small risk of increasing coronary heart disease
• There are very rare cancers that can be caused by breast radiation

Are There Any Side Effects

Radiation therapy is usually well tolerated and many patients are able to continue their normal routines. However, some patients may eventually develop painful side effects. Be sure to talk to a member of your radiation oncology treatment team about any problems or discomfort you may have. Many of the side effects of radiation therapy are only in the area being treated. For example, a breast cancer patient may notice skin irritation, like a mild to moderate sunburn, while a patient with cancer in the mouth may have soreness when swallowing. Some patients who are having their midsection treated may report feeling sick to their stomach. These side effects are usually temporary and can be treated by your doctor or other members of the treatment team.

Side effects usually begin by the second or third week of treatment, and they may last for several weeks after the final radiation treatment. In rare instances, serious side effects develop after radiation therapy is finished. Your radiation oncologist and radiation oncology nurse are the best people to advise you about the side effects you may experience. Talk with them about any side effects you are having. They can give you information about how to manage them and may prescribe medicines or changes in your eating habits to help relieve your discomfort.

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Keeping Health Insurance And Copies Of Your Medical Records

Even after treatment, its very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

At some point after your treatment, you might find yourself seeing a new doctor who doesnt know about your medical history. Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.

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Expectations And What To Avoid

Radiation therapy should not cause pain or discomfort during the procedure. However, minor side effects are common in the days or weeks afterward. Before beginning radiation therapy, an individual should schedule a consultation with their doctor to work out the details.

People should also take some precautions while they are receiving radiation therapy. For example, they should avoid direct sun exposure by using sunscreen and covering up areas of bare skin when outside.

Also, taking antioxidant supplements, such as vitamins A, C, D, and E, can interfere with radiation therapys effectiveness. People should, therefore, focus on eating a well-balanced diet so that their body can absorb the nutrients and vitamins it needs from food.

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