Radiotherapy To The Lymph Nodes
Radiotherapy can be given to the lymph nodes under the arm to destroy any cancer cells that may be present there.
It may also be given to the lymph nodes in the lower part of the neck around the collarbone, or in the area near the breastbone .
If radiotherapy to the lymph nodes is recommended, your specialist will explain why.
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.
Does Everybody With Breast Cancer Have Radiotherapy
Not all women with breast cancer will be recommended to have radiotherapy. It is usually recommended, however, for women who have breast-conserving surgery . Radiotherapy is sometimes used following a mastectomy to target any cancer cells that may remain in the chest wall. If you are having chemotherapy as well as radiotherapy, you will usually have your chemotherapy treatment first.
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External Beam Radiation Therapy
The most common way of delivering radiation to the breast is with a treatment machine called a linear accelerator, which delivers radiation beams from outside the body, targeting the whole breast or chest wall.
The patient is positioned on a bed and the head of the linear accelerator is lined up to focus the radiation to the targeted area. At each treatment appointment additional time is taken to ensure the correct positioning of the patient prior to treatment delivery. Once correctly positioned, the treatment takes only a few minutes to deliver. The head of the linear accelerator moves around the patient, delivering the beams. Patients do not feel the treatment being delivered.
Although the radiation therapists leave the room while the treatment is being given, they monitor the patients on closed circuit television and through microphones in the treatment room.
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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How Can I Handle Fatigue
The fatigue you feel from cancer and radiation therapy is different from other times you may have felt tired. Itâs an exhaustion that doesnât get better with rest and can keep you from doing the things you normally do, like going to work or spending time with family and friends. It also can seem different from day to day, which makes it hard to plan around it. It can even change how well you’re able to follow your cancer treatment plan.
Let your doctor know if youâre struggling with fatigue. They might be able to help. There are also things you can do to feel better:
- Take care of your health. Be sure you’re taking your medications the way you’re supposed to. Get plenty of rest, be as active as you can, and eat the right foods.
- Work with a counselor or take a class at your cancer treatment center to learn ways to conserve energy, reduce stress, and keep yourself from focusing on the fatigue.
- Save your energy for the activities that are most important to you. Tackle them first when youâre feeling up to it.
- Keep a balance between rest and activities. Too much bed rest can make you more tired. But don’t over-schedule your days without giving yourself breaks.
- Ask for help from family and friends. If fatigue is interfering with your job, talk with your boss or HR department and ask about taking some time off from work or making adjustments in your schedule.
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 provider may suggest special creams to ease this discomfort.
Sometimes the skin peels further and the area becomes tender and sensitive. This is called a moist reaction. Its most common in the skin folds and the underside of the breast.
If a moist reaction 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 problems sleeping .
Learn more about fatigue and insomnia.
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Things To Remember While Going Through Radiation Therapy
Things to remember
Adapted from National Cancer Institute materials .
Radiotherapy For Breast Cancer What To Expect
Radiotherapy, also referred to as radiation therapy, is a common cancer treatment prescribed by a Radiation Oncologist to treat a cancer diagnosis.; Radiotherapy works by making small breaks inside the DNA of cells, causing them to die and prevent them from continuing to grow, spread or multiply. The radiation is delivered as External Band Radiation Therapy , which consists of precisely targeted radiation beams, from outside of the body. It is a fast, painless and safe treatment commonly started about four weeks after surgery, or if chemotherapy is also prescribed, about four weeks after chemo has finished. Radiotherapy will be prescribed:
- following breast-conserving surgery to ensure any undetected cancer cells that may be in the breast are destroyed and to reduce the risk of a localised cancer reoccurrence.
- after a mastectomy, depending on the risk of a cancer reoccurrence in the chest area.
- if lymph nodes from the armpit were removed and the risk of a cancer reoccurrence in this area, is high.
Longer term effects of radiotherapy
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Radiation Therapy And Risk Of A Second Cancer
In rare cases, radiation therapy to the breast can cause a second cancer.
The most common cancers linked to radiation therapy are sarcomas . For women who are long-term smokers, radiation therapy may also increase the risk of lung cancer .
The risk of a second cancer is small. If your radiation oncologist recommends radiation therapy, the benefits of radiation therapy outweigh this risk.
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Side Effects Of Radiation For Breast Cancer
Radiation treatments today are very precise, resulting in little harm to surrounding skin or healthy tissues. Many women tolerate radiation therapy to the breast very well and report few lasting side effects.
That said, after a few weeks of radiation, patients may experience:
- a sunburn-like condition on the skin
- changes in the color of the skin
- swelling and heaviness in the breast
Our radiation oncologists will explain in detail what to expect and when side effects are likely to appear. They can also prescribe a topical cream to minimize any changes in the skin. The fatigue women experience during treatment varies greatly, but in general women can remain active in all of their normal daily activities. Most women are able to continue working throughout the course of their care.
Other side effects can appear months or years after treatment has ended. These are called late effects.
Late effects of breast cancer radiation are not common but may include:
- inflammation in the lung, especially for women who have also received chemotherapy
- injury to the heart when there is significant heart exposure
- lymphedema in the arm, especially when radiation therapy is given after lymph node dissection
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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.
Radiation Therapy Timing And Breast Reconstruction
The timing of radiation treatment in your overall breast cancer treatment plan depends on your individual situation and the characteristics of the breast cancer.
In many cases, radiation therapy is given after surgery. If chemotherapy is planned after surgery, radiation usually follows chemotherapy.
If youre having mastectomy and have decided to have breast reconstruction, its important to know that radiation can cause a reconstructed breast to lose volume and change color, texture, and appearance.
In particular, radiation therapy is known to cause complications with implant reconstruction. Research also suggests that a reconstructed breast may interfere with radiation therapy reaching the area affected by cancer, though this can vary on a case-by-case basis.
For these reasons, some surgeons advise waiting until after radiation and other treatments, such as chemotherapy, are completed before breast reconstruction surgery is done.
Other surgeons may recommend a more staged approach, which places a tissue expander after mastectomy to preserve the shape of the breast during radiation treatments. Once radiation is completed and the tissues have recovered, the expander that was used to maintain the shape of the breast is removed and replaced with tissue from another part of the body or a breast implant.
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What Should Patients Receiving Hypofractionation Expect
Patients receiving hypofractionation at Yale Medicine come for care on an outpatient basis five days a week, from Monday to Friday. Treatment session take 15 to 30 minutes, but the majority of that time is spent positioning the radiation machine so it is angled correctly, and getting the patient properly aligned. The actual radiation time is about two to four minutes.
Patients typically lie on their backs at a slight angle, with the arm on the side of the body being treated placed out of the way of the radiation beam. In some cases, patients may be treated lying on their stomachs.
Your First Breast Cancer Care Appointment
At your first appointment, you will meet the team who will take care of you throughout your treatment. During this visit, your doctor will discuss your medical history with you in detail, perform a physical examination, and discuss possible treatment options. During your first visit, we will share some important information about breast cancer and your treatment options.
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What To Expect During Radiation Treatments
Treatments are usually given five days a week for six to seven weeks. If the goal of treatment is palliative treatment will last 2-3 weeks in length. Using many small doses for daily radiation, rather than a few large doses, helps to protect the healthy cells in the treatment area. The break from treatment on weekends allows the normal cells to recover.
It is very important to finish all sessions of radiation therapy. It is important not to miss or delay treatments because it can lessen how well the radiation kills tumor cells.
The radiation therapy technologist may ask you to change into a gown before treatment. It is a good idea to wear clothing that is easy to pull down, adjust, or remove when coming for treatments.
During the actual treatment sessions you will be in the treatment room between 10-30 minutes. You will be receiving radiation for 1-2 minutes of that time.
You will be asked to lie on a hard, moveable bed. The RTT will use the marks on your skin to exactly position the machine and table. In some instances, special blocks or shields are used to protect normal organs. You may be positioned using special holders, molds or boards.
It is extremely important to remain still during the radiation treatments. Breathe normally during treatments. You do not need to hold your breath. You will not feel anything during the treatment. Radiation is painless. You will not see, hear, or smell radiation.
What Is Radiation Recall
Radiation recall is a rash that looks like a severe sunburn. It is rare and happens when certain types of chemotherapy are given during or soon after external-beam radiation therapy.
The rash appears on the part of the body that received radiation. Symptoms may include redness, tenderness, swelling, wet sores, and peeling skin.
Typically, these side effects start within days or weeks of radiation therapy. But they can also appear months or years later. Doctors treat radiation recall with medications called corticosteroids. Rarely, it may be necessary to wait until the skin heals before continuing chemotherapy.
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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:
- Don’t wear tight clothing over the area that’s being treated.
- Don’t 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 youâre having radiation therapy for breast cancer, try not to wear a bra. If that isn’t possible, wear a soft, cotton one without underwire.
- Don’t 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 youâll still need to protect yourself from the sun even after radiation therapy has ended.
What Happens Before Radiation Therapy Begins
Before treatment starts, your;radiation;oncologist will review your health record, talk about your general health and diagnosis,;and;explain the treatment process, options,;and;potential side;effects.;;
Arrangements will;also;be made for a CT;simulation appointment;where;the;radiation therapists;scan you.;Your radiation therapist will help to position you for a CT scan.;Your position;will;vary;depending on the exact area of the breast you are having treated;.;;
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