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.
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.
What Can I Expect If I Am Receiving External Beam Radiation Therapy
External beam radiation treatment for cancer is typically administered every day, Monday through Friday, for five to eight weeks. About two weeks after your first radiation therapy appointment when you have the simulation scan, youll begin your treatments.
Each visit will be relatively short, lasting between 15 and 30 minutes. Most of that time will be spent lying on a table while the radiation therapist gets the equipment set up around you.
At Rocky Mountain Cancer Centers, we utilize image-guided radiation therapy, or IGRT. During each visit, new X-rays or low-dose CT scans of your body will be made and compared with the initial scan to determine if the tumor has moved even by just a hairs distance and the radiation is adjusted accordingly.
Our dosimetrist check and calibrate our equipment daily and the equipment will not run if it is not calibrated correctly. All of this is done to ensure your safety and the effectiveness of treatment.
You will be asked to lie still for the actual treatment, which will last only a few minutes. The treatment itself is painless and is similar to getting an X-ray. You may hear clicking and whirring sounds during the treatment as the machine positions itself. During the treatment, the radiation therapist will be in a small room adjacent to your treatment room and watching you at all times. You will be able to communicate with your radiation therapist via intercom and should feel free to ask to stop if you feel sick or scared.
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What To Expect From Radiation Therapy
Radiation therapy uses high-energy beams to kill cancer cells. It is often used in combination with chemotherapy or surgery. The radiation therapist will determine the dose and schedule of treatments based on the size and location of the tumor.
Radiation therapy can cause side effects such as fatigue, skin irritation, and nausea. These side effects usually go away once treatment is finished.
Late Effects Of Radiotherapy For Breast Cancer
Radiotherapy to the breast may cause side effects that happen months or years after radiotherapy. They are called late effects.
Newer ways of giving radiotherapy are helping reduce the risk of these late effects happening. If you are worried about late effects, talk to your cancer doctor or specialist nurse.
The most common late effect is a change in how the breast looks and feels.
Radiotherapy can damage small blood vessels in the skin. This can cause red, spidery marks to show.
After radiotherapy, your breast may feel firmer and shrink slightly in size. If your breast is noticeably smaller, you can have surgery to reduce the size of your other breast.
If you had breast reconstruction, using an implant before radiotherapy, you may need to have the implant replaced.
It is rare for radiotherapy to cause heart or lung problems, or problems with the ribs in the treated area. This usually only happens if you had treatment to your left side.
Tell your cancer doctor if you notice any problems with your breathing, or have any pain in the chest area.
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Types Of Radiation Therapy
- External beam radiation is most commonly used to treat breast cancer. A machine outside your body aims a beam of radiation on the area affected by the disease.
- Brachytherapy delivers radiation to the cancer through something implanted in your body.
- Proton therapy sends highly targeted radiation just to your breast tissue and not into your heart or lungs.
Brachytherapy Delivered Via Implantable Device
The doctor places a device inside the breast at the time of the surgery or shortly thereafter which carries targeted radiation to the tissue where the cancer originally grew . This type of radiation may take only one treatment delivered in the operating room or may take 5-7 days given on an outpatient basis in the radiation therapy department.In nearly all cases, the appropriate method is determined by the radiation oncologist based on the location and size of the tumor.
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Radiation Boost After Mastectomy
The same has been noted when a radiation boost has been used for women who had a mastectomy. While a radiation boost reduces local chest wall recurrence of breast cancer, this hasn’t been found to translate into longer survival.
From a different angle, however, a radiation boost after mastectomy does appear to influence the success of reconstruction, with those who have a boost being more likely to have unsuccessful surgery. What this means is that each woman will need to weigh the lower risk of a chest wall recurrence against the higher risk that reconstruction won’t be successful when making a decision.
What To Expect From Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. It is generally used in combination with other treatments, such as radiation therapy or surgery. There are many different types of chemotherapy drugs, and the type that you receive will depend on the stage and type of your cancer.
Chemotherapy can cause a wide range of side effects, including nausea, vomiting, hair loss, and fatigue. These side effects can be quite unpleasant, but they usually go away once treatment is finished.
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How Do I Prepare For My Treatments
Before your first radiation treatment, you will have a simulation appointment. This appointment will last approximately one to two hours. During this appointment, the doctor will identify the exact fields on your body to treat with radiation. This involves lying on a table while the radiation therapist marks the field with small dots made with permanent ink. Each dot is similar to a very small tattoo. You will not receive any radiation treatment during this appointment.
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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What Is The Prognosis After Recurrence
Many patients with a recurrence of breast cancer can be successfully treated, often with methods other than radiation if radiation was used in the initial treatment. For patients treated initially for invasive breast cancer, five percent to 10 percent will be found to have distant metastases at the time of discovery of the breast recurrence. The same proportion will have recurrences that are too extensive to be operated on. While in these cases the patients disease can often be managed over a period of years, the goals of treatment change from obtaining a cure to preventing further progression or managing symptoms. Five-year cure rates for patients with relapse after breast conservation therapy are approximately 60 percent to 75 percent if the relapse is confined to the breast and a mastectomy is then performed.
For patients treated initially for DCIS, about one-half of recurrences are invasive and one-half noninvasive DCIS. Long-term control rates following recurrence after initial breast conservation therapy have been high, often over 90 percent.
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When Is Radiation Therapy Used
There are several instances when our team will use radiation for cancer treatment. Radiation therapy can be used to:
- Shrink a tumor
- Eliminate remaining cancer cells after surgery
- Destroy tumors that cannot be removed surgically
Our care team will utilize advanced imaging equipment to identify your tumors exact dimensions and location during the treatment planning phase. After they have done so, your care team will be able to determine which treatment approach is best suited for your diagnosis.
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Vitamins And Dietary Supplements
Its OK to take a multivitamin during your radiation therapy. Dont take more than the recommended daily allowance of any vitamin or mineral.
Dont take any other dietary supplements without talking with a member of your radiation therapy team. This includes vitamins, minerals, and herbal or botanical remedies.
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.
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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.
What Are Some Of The Possible Risks Or Complications
Minor complications include:
- Slight swelling of the breast during radiotherapy. This usually goes away within six to 12 months.
- The skin becomes darker during the course of radiotherapy, similar to tanning from the sun. In most cases, this also fades gradually over six to 12 months.
- Most women will have aches or pains from time to time in the treated breast or the muscles surrounding the breast, even years after treatment. The reason why this happens is not clear however, these pains are harmless, although annoying. They are NOT a sign that the cancer is reappearing.
- Rarely, patients may develop a rib fracture years following treatment. This occurs in less than one percent of patients treated by modern approaches. These heal slowly by themselves.
More serious complications include:
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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.
Role Of Radiation Treatment In Breast Cancer
Breast cancer is primarily treated with surgery. After surgery, radiation treatments are used to reduce the risk of the tumor coming back, even though tumor cells may not be visible to your doctors. The benefits of radiation therapy depend upon the type of surgery performed and particular features of your tumor found at the time of surgery. You may see a radiation oncologist before surgery, but most decisions are not finalized about radiation treatment until the post-operative period in order to give your doctor more information about how helpful it may be for you.
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How Long Does Radiation Therapy Take
Each session of radiotherapy lasts about 15 minutes or less once youve been placed in the exact position you need to be in. For many patients, radiation therapy is started a few weeks after breast cancer removal surgery. Generally, radiation therapy is recommended five days a week for 4 to 8 weeks, based on how your body responds.
In the case of internal radiation, a catheter is placed at the lumpectomy side. The device remains in place until the end of the treatment that should take a week or less. A radioactive pellet is placed inside the catheter during the treatment session and allowed to stay for about 10 minutes. In internal radiation, oncologists recommend two treatment sessions for five days. The treatment plan may change based on the biology of your tumor.
What Happens During Radiation Therapy Treatment
What happens during your radiation therapy treatment depends on the kind of radiation therapy you receive.
External-beam radiation therapy
External-beam radiation therapy delivers radiation from a machine outside the body. It is the most common radiation therapy treatment for cancer.
Each session is quick, lasting about 15 minutes. Radiation does not hurt, sting, or burn when it enters the body. You will hear clicking or buzzing throughout the treatment and there may be a smell from the machine. Typically, people have treatment sessions 5 times per week, Monday through Friday. This schedule usually continues for 3 to 9 weeks, depending on your personal treatment plan.
This type of radiation therapy targets only the tumor. But it will affect some healthy tissue surrounding the tumor. While most people feel no pain when each treatment is being delivered, effects of treatment slowly build up over time and may include discomfort, skin changes, or other side effects, depending on where in the body treatment is being delivered. The 2-day break in treatment each week allows your body some time to repair this damage. Some of the effects may not go away until the treatment period is completed. Let the health care professionals if you are experiencing side effects. Read more about the side effects of radiation therapy.
Internal radiation therapy
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The permanent implant loses it radioactivity
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The temporary implant is removed
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Radiotherapy For Breast Cancer
Radiotherapy uses high energy x-rays to kill cancer cells. Find out about planning radiotherapy for breast cancer, how you have treatment, and about the possible side effects.
Internal radiotherapy to the breast is not standard treatment in the UK. You might have it as part of a clinical trial.
Questions about cancer? Call freephone 9 to 5 Monday to Friday or email us