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.
Radiotherapy To Part Of The Breast
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.
Radiation To The Pelvis
Radiation therapy to the pelvis can cause bowel and bladder problems in some patients, including:
- Urinating more than usual
- Sexual and/or problems getting pregnant or fathering a child
Management of Side Effects during Pelvic Radiation Therapy
- Do not eat raw fruits, vegetables or whole grains
- Eat small, frequent meals
- Do not drink caffeine or alcohol
- Drink lots of fluids
- Drink cranberry juice as part of fluid intake
- Ask your doctor or nurse for medicine if you have painful urination or to lessen frequent loose stools
- Use birth control to prevent pregnancy
- Your doctor may prescribe medicines that decrease the number of bowel movements.
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What Should I Expect
During each session, you will lie on a special table.
You may be asked to hold your breath while the radiation is given. This is one way to minimize radiation exposure to the heart.
If lymph nodes were removed during surgery and contained cancer, often the area near the lymph nodes is also treated with radiation.
Each session lasts about 10-20 minutes. Most of this time is spent positioning your body to ensure the treatment is given exactly as planned.
With any standard radiation therapy you will not be radioactive when you leave the radiation treatment center. You will not pose any radiation risk to your family or your pets.
Talk To Your Radiation Oncologist About Respiratory Gating
If you have left sided breast cancer, some radiation will likely make its way to your heart, and heart disease related to radiation for breast cancer is a significant concern. Radiation has been linked with a number of different forms of heart disease ranging from valve disease, to rhythm disturbances, to coronary artery disease.
Fortunately, the technique of respiratory gating or “breath hold” can reduce the amount of radiation that hits your heart significantly. With this technique, your technician will have you hold your breath for short periods of time during each session. It is important to ask about this before beginning your treatments, as special measurements will need to be taken to be sure that inhaling air into your lungs will move your heart away from the field of radiation.
Even though research has found benefit in these techniques, not everyone is informed of this option. Make sure to be your own advocate, so that you either receive this heart-sparing technique, or at least clearly understand why it may not be needed.
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Contact The Radiation Oncology Program At Upmc Hillman Cancer Center
To learn more about what to expect during radiation oncology treatment at UPMC Hillman Cancer Center, please call us at 412-647-2811.
The Difference Between Chemo and Radiation
Your treatment plan may be chemotherapy, radiation therapy, surgery, or any combination of these so it is important that you understand your options.
Cancer Doctors Usually Treat Cancer With Radiation Therapy Surgery Or Medications Including Chemotherapy Hormonal Therapy And/or Biologic Therapy Either Alone Or In Combination
If your cancer can be treated with radiation, you will be referred to a radiation oncologist a doctor who specializes in treating patients with radiation therapy. Your radiation oncologist will work with your primary doctor and other cancer specialists, such as surgeons and medical oncologists, to oversee your care. He or she will discuss the details of your cancer with you, the role of radiation therapy in your overall treatment plan and what to expect from your treatment.
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When Is Radiation Therapy Used
Radiation therapy can be used to treat all stages of breast cancer.
Pregnant women should not have radiation therapy because it can harm the unborn baby. Read about Treatment for Breast Cancer During Pregnancy.
Radiation therapy after lumpectomy
Radiation therapy is recommended for most people who have lumpectomy to remove breast cancer. Lumpectomy is sometimes called breast-conserving surgery. The goal of radiation after lumpectomy is to destroy any individual cancer cells that may have been left in the breast after the tumor was removed. This reduces the risk of the cancer coming back and the risk of passing away from breast cancer.
Heres a good analogy for understanding the role of radiation therapy after surgery:If you drop a glass on the kitchen floor, you must first sweep up all of the big pieces of glass and throw them away you can think of breast surgery in this way, says Marisa Weiss, M.D., founder and chief medical officer of Breastcancer.org and director of breast radiation oncology at Lankenau Medical Center. Radiation therapy is like vacuuming the area after you sweep, getting into the corners and under the furniture, to get rid of any tiny shards of glass that might be left behind.
Radiation therapy after mastectomy
Radiation therapy may be recommended after mastectomy to destroy any cancer cells that may be left behind after the surgery. During mastectomy, it’s difficult for surgeons to take out every cell of breast tissue.
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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What Kind Of Treatment Follow
The major goal of follow-up is, if possible, to detect and treat recurrences in the irradiated breast or lymph nodes and new cancers developing later in either breast before they can spread to other parts of the body. Theroutine use of bone scans, chest x-rays, blood tests and other tests to detect the possible spread to other organs in patients without symptoms does not appear to be useful. Your physician will determine a follow-upschedule for you. This may include a physical exam every few months for the first several years after treatment and then every six to 12 months or so after that. Annual follow-up mammograms are an important part of your care. If symptoms or clinical circumstances suggest a recurrence, diagnostic tests such as blood tests, ultrasound,computed tomography , magnetic resonance imaging , chest x-ray , or bone scan may be needed.
What Happens Before During And After Treatment
Once the diagnosis has been made, you will probably talk with your primary care physician along with several cancer specialists, such as a surgeon, a medical oncologist and a radiation oncologist, to discuss your treatment choices. These specialists will work together to help recommend the best treatment for you. In some cases, your cancer will need to be treated by using more than one type of treatment. For example, if you have breast cancer, you might have surgery to remove the tumor , then have radiation therapy to destroy any remaining cancer cells in or near your breast . You also might receive chemotherapy to destroy cancer cells that have traveled to other parts of the body.
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Side Effects Of Radiation Therapy
If you are going to get radiation therapy, its important to ask your doctor beforehand about the possible side effects so you know what to expect. Possible Side effects of external radiation therapy can include:
- Skin changes in areas getting radiation, such as redness, blistering and peeling
- Nausea and vomiting
- Painful sores in the mouth and throat
- Dry mouth or thick saliva
- Pain with swallowing
These side effects are often worse if chemotherapy is given at the same time as radiation.
Most side effects of radiation are temporary, but some less common side effects can be permanent. For example, in some cases radiation can cause a stricture in the esophagus, which might require more treatment. Radiation to the chest can cause lung damage, which may lead to problems breathing and shortness of breath.
If you notice any side effects, talk to your doctor right away so steps can be taken to lessen them.
Questions To Ask Your Healthcare Provider
Before your appointment, its helpful to write down the questions you want to ask your healthcare provider. 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?
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Skin Irritation In The Treated Area
This may range from mild sunburn to peeling or occasionally blistering. This side effect may not develop until treatment completion. It is usually at its most severe for one to two weeks and then settles over the following three to four weeks.
Its important to try and reduce friction between your skin and clothing to reduce the risk of skin breakdown or blistering. You will be advised how to take care of your skin. For instance:
- Avoid hot water, lotions or other possible irritants on the skin in the treatment area. Using gentle soaps doesn’t seem to increase skin irritation.
- Wear loose, light clothing over the area being treated.
- Avoid heat from hair dryers, electric hot pads, hot water bottles and sun in the treatment area.
- No adhesive tapes or sticking plasters should be applied to the skin in the treatment area
Some patients choose to use a transparent, breathable film dressing applied to the skin in the treatment area to try to reduce the skin reaction. Your radiation oncologist will be able to advise you on these products. Your radiation oncologist will also discuss with you the use of appropriate topical creams for the skin, depending on your skin reaction.
What Are Common Side Effects Of Radiation Therapy
Radiation therapy is called a local treatment. This means that it only affects the 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. These side effects depend on which part of the body received radiation therapy and other factors. 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 nurse or other 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 side effects.
Fatigue. Fatigue is a term used to describe feeling tired or exhausted almost all the time. Many patients experience fatigue. Your level of fatigue often depends on your treatment plan. For example, radiation therapy combined with chemotherapy may result in more fatigue. Learn how to cope with fatigue.
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Who Is On My Radiation Therapy Team
A highly trained medical team will work together to provide you with the best possible care. This team may include the following health care professionals:
Radiation oncologist. This type of doctor specializes in giving radiation therapy to treat cancer. A radiation oncologist oversees radiation therapy treatments. They work closely with other team members to develop the treatment plan.
Radiation oncology nurse. This nurse specializes in caring for people receiving radiation therapy. A radiation oncology nurse plays many roles, including:
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Answering questions about treatments
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Monitoring your health during treatment
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Helping you manage side effects of treatment
Medical radiation physicist. This professional helps design treatment plans. They are experts at using radiation equipment.
Dosimetrist. The dosimetrist helps your radiation oncologist calculate the right dose of radiation.
Radiation therapist or radiation therapy technologist. This professional operates the treatment machines and gives people their scheduled treatments.
Other health care professionals. Additional team members may help care for physical, emotional, and social needs during radiation therapy. These professionals include:
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Social workers
Learn more about the oncology team.
Is Radiation Therapy Safe
Some patients are concerned about the safety of radiation therapy. Radiation has been used successfully to treat patients for more than 100 years. In that time, many advances have been made to ensure that radiation therapy is safe and effective.
Before you begin receiving radiation therapy, your radiation oncology team will carefully tailor your plan to make sure that you receive safe and accurate treatment. Treatment will be carefully planned to focus on the cancer while avoiding healthy organs in the area. Throughout your treatment, members of your team check and re-check your plan. Special computers are also used to monitor and double-check the treatment machines to make sure that the proper treatment is given. If you undergo external beam radiation therapy, you will not be radioactive after treatment ends because the radiation does not stay in your body. However, if you undergo brachytherapy, tiny radioactive sources will be implanted inside your body, in the tumor or in the tissue surrounding the tumor, either temporarily or permanently. Your radiation oncologist will explain any special precautions that you or your family and friends may need to take.
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When Will I Start Getting Radiation Therapy
After you leave your first appointment with your radiation oncologist, they will use your scans to map out the exact location of the cancer within your body as well as noting the location of any surrounding healthy organs that need to be avoided during treatment. Computer modeling is then used to simulate the dose of radiation that will be delivered to the tumor during treatment, and the model is reviewed before your treatment begins. This process can take up to two weeks before you return for your first actual radiation therapy treatment.
When your treatment plan is developed, it will outline whether you will be receiving radiation therapy before, during, or after other treatments. Once you are ready to begin radiation therapy, you can usually be seen within one to two days at Rocky Mountain Cancers Centers.
What Is The Difference Between Radiation Therapy And Chemotherapy
There are several distinct differences between radiation and chemotherapy. One is the delivery method. Chemotherapy is delivered either orally or through an infusion, whereas radiation therapy involves high-dose radiation beams. Radiation therapy is more targeted, but it can impact adjacent cells. Chemotherapy can unintentionally target cells throughout your body, including hair follicles, bone marrow, and other vital components.
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Radiation Therapy Uses High Energy X
Its a localised treatment affecting only the area which is specifically targeted. Although some healthy tissue may be in the treatment area, it generally has the ability to repair itself, unlike cancer cells.
In early breast cancer, radiation therapy is used with the aim of getting rid of any malignant or pre-cancerous cells remaining in the breast following partial mastectomy or lumpectomy. This reduces the risk of developing a local recurrence of cancer in the breast in the future. Radiation therapy is also used to treat the chest wall after mastectomy if the cancer has high-risk features.
The regional lymph nodes in the axilla , supraclavicular fossa or internal mammary chain may also be treated in some cases.
In these settings, large international trials have demonstrated that radiation therapy reduces the incidence of local breast cancer recurrence.
Radiation therapy is usually given after surgery, once the wounds have healed. For people needing chemotherapy, radiation is given after that treatment has been completed.
These Steps Can Help:
- Gently cleanse the treated area using lukewarm water and a mild soap. Donât rub your skin. Pat it dry with a soft towel, or use a hair dryer on a cool setting.
- Donât scratch or rub the treated area. Use only an electric razor if you need to shave there. Donât put on medical tape or bandages.
- Donât apply any ointment, cream, lotion, or powder to the treated area unless your doctor or nurse has prescribed it. This includes cosmetics, shaving lotions, perfumes, and deodorants.
- Choose clothes made from natural fibers like cotton rather than tight-fitting clothing or harsh fabrics like wool or corduroy.
- Avoid extreme heat or cold where you’ve had radiation — no electric heating pads, hot water bottles, or ice packs.
- Also avoid hot tubs and tanning beds.
- Stay out of direct sunlight, especially between the hours of 10 a.m. and 2 p.m., even after you’re done with treatment. The sun can intensify skin reactions and lead to severe sunburn. Choose a sunscreen of SPF 30 or higher. Wear protective clothing, such as a long-sleeved shirt, pants, and a wide-brimmed hat, too.
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