How Radiotherapy Is Given
Radiotherapy can be given in several ways and using different doses, depending on your treatment plan.
The total dose is split into a course of smaller treatments , usually given daily over a few weeks.
Its carried out by people trained to give radiotherapy, known as therapeutic radiographers.
Radiotherapy is not available in every hospital, but each breast unit is linked to a hospital that has a radiotherapy department.
What Should I Expect On My First Visit
When radiation therapy might be of help, a family doctor, surgeon or medical oncologist will refer patients to a radiation oncologist.
The doctor will first review your medical records and X-rays. A physical exam will be done.
The doctors will then talk to you about his/her findings and decide how you should be treated. If radiation will help you, the staff will schedule the needed studies to develop a treatment plan. This is sometimes referred to as simulation.
During simulation, the therapist takes X-rays of the part of your body to be treated to help decide how the radiation will be given. Using the X-ray as a guide to the treatment site, the therapist uses a marker to outline the treatment area on your skin. This area is often called a treatment port or treatment field. These marks are very important. They act as a map of the treatment area and the therapist uses them each day to guide your treatment. Sometimes after a few treatments, tiny permanent dots can be used to replace the painted marks on your skin.
Where Do I Start
You first will meet with a radiation oncologist to decide if radiation therapy is a recommended treatment option for your particular situation. If you and your doctors decide to proceed, then you will have an extended consultation in which you discuss the details of your treatment. This includes the exact area to treat, the amount of radiation you will receive, the length of treatment time and potential treatment side effects. The radiation oncologist will also answer any questions you may have. These issues vary for each person, so it is important to make an individual treatment plan.
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Vitamins To Avoid During Radiation Therapy
Your radiation oncologist may tell you to avoid taking certain antioxidant vitamin supplements, such as vitamins C, A, D, and E, while you’re having radiation therapy. These vitamins might interfere with radiation’s ability to destroy cancer cells.This is because radiation works in part by creating free radicals highly energized molecules that damage cancer cells. Free radicals in the environment can damage all cells, but in the case of radiation treatment they are focused on the cancer cells. Antioxidants help keep free radicals from forming or neutralize them if they do form.
Because of the potential conflict between the goal of radiation therapy and the goal of antioxidants , it makes sense to stop taking any antioxidant supplements during radiation therapy. When radiation is finished, you can resume taking your supplements.
Throughout your treatment, do your best to eat a well-balanced diet that contains all of the vitamins you need. Vitamins that come naturally from food are unlikely to interfere with treatment.
Is There A Breast Cancer Cure
There is currently no cure for metastatic breast cancer, or breast cancer that has spread to distant parts of the body. However, early stages of breast cancer that remain localized are highly treatable 99 percent of people who receive treatment in the earliest stages of breast cancer live for 5 years or longer after diagnosis, according to the American Cancer Society.
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What Foods Should I Avoid During Radiation
Foods to avoid or reduce during radiation therapy include sodium , added sugars, solid fats, and an excess of alcohol. Some salt is needed in all diets. Your doctor or dietitian can recommend how much salt you should consume based on your medical history.
In addition to foods to avoid that are listed above, spicy foods can cause gastrointestinal problems during radiation therapy. While nausea and diarrhea are symptoms of radiation therapy, spicy foods can lead to cramping, and diarrhea.
If you are receiving radiation therapy for head and neck cancer, refrain from consuming foods that may get stuck when swallowing or those that are high in acid which can be irritating.
About External Beam Radiation Therapy
With external beam radiation therapy, a treatment machine will aim a beam of radiation directly to the tumor from outside your body. The radiation will pass through your body and destroy the cancer cells in its path. You wont see or feel it.
You may be having external beam radiation therapy to 1 or more of the following areas:
- Your breast
- The lymph nodes near your collarbone
- The lymph nodes under your arm
- The lymph nodes near your sternum
Your radiation oncologist and nurse will talk with you about your treatment plan.
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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.
Things To Avoid During Radiation Therapy Missed Sessions
Perhaps one of the more common causes of unsuccessful cancer therapy is simply missing the appointments themselves an all too common refrain from many patients and certainly something to avoid during radiation therapy.
Aside from simply adding time onto the length of your total treatment, theres plenty of scientific data that illustrates the fact that missing radiation appointments can have a tremendously adverse effect on your cancer treatment.
According to the National Cancer Institute, patients who miss radiation therapy sessions are at increased risk of their disease returning, even if they eventually complete all of their radiation treatment. Researchers also believe continually missing sessions could be an indicator for other risk factors that could negatively affect outcomes, such as mental health needs and lack of a solid social support system.
Theres much to be discussed and dissected as it pertains to these claims, but there is scientific precedent for making them.
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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.
Hair Loss In The Armpit
Radiotherapy to the armpit will make the underarm hair fall out on that side.
Men having radiotherapy will lose the hair on the area of the chest thats being treated.
Hair usually starts to fall out two to three weeks after treatment has started and it may take several months to grow back. For some people, hair lost from radiotherapy may never grow back.
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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
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.
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The Fabric Is Breathable
According to Dr. Deming “During radiation, women have nothing on. Metals, deodorants, and creams with metal, like zinc, are what we worry about burning into the skin. Therapists also want to see the anatomy clothing in the way.”
You can imagine that leaving a radiation treatment can leave the skin feeling raw and irritated and while Dr. Deming explains that many doctors still advise wearing cotton, the Makemerry team has found that Modal is more breathable and sustainable. According to Dr. Deming, “Modal is a technical fabric that breathes and dries quickly, keeping the moisture from sitting against the skin.” Unlike the natural fiber, modal, cotton goes through harsh processing and is not a performance fabric. Since many women experience hot flashes from chemo and menopause, a fabric that isn’t going to soak up moisture and sit against the skin is ideal.
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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What To Wear When You Have Breast Cancer
From post-surgery camisoles to mastectomy-friendly workout wear, our expert has answers to questions you never even knew you had.
Q& A with Barbara Zarrell, RN, BSN, Womans Personal Health Resource, Inc.
Q. I will be undergoing a double mastectomy, and I havent yet made up my mind about reconstruction. Ive heard that there are now many prosthetic options available in breast forms and clothing. Can you describe what some of the most popular are?
There is a variety of options for breast prostheses in the same way there are options when it comes to a prosthetic arm or leg. Generally, one can choose from breast forms made from regular-weight silicone or lightweight silicone or from various types of poly-fil forms. Some of the poly-fil forms are actually weighted to offer a nice mix between a superlight form and a silicone form.
After a double mastectomy, the issue of weight in a breast form is important. For the bra to stay in place and fit well, some weight is needed. In this case I might choose from one of the newer, lightweight silicone forms or the weighted poly-fils.
Q. Are there specific clothing items or undergarments that I should consider purchasing to wear following my surgery to make my recovery easier or more comfortable?
Q. Im a very active personI swim, run, and spend a lot of time outdoors. Are there breast forms that will accommodate my active lifestyle?
First Things First: Types Of Treatment
External Radiation Therapy
If you had breast surgery, you will most likely receive external radiation. The process begins with the simulation process, which pinpoints the exact area to be treated. You will lie on a table while the radiation technologist uses a special diagnostic xray machine to define your treatment field or port. A special mold will be made to help you remain in the same position during each treatment. This area will be marked with colored, semi-permanent ink on your skin. It is important that these marks not be washed off while bathing.
Using the information from the simulation, other tests and your medical history, your radiation oncologist will meet with the radiation physicist and other members of the radiation oncology staff to determine your individual treatment plan. Generally, this type of radiation therapy is given 5 days a week for 5 to 6 weeks. Your doctor should discuss your individual treatment plan before your treatment begins. Since treatment takes place daily, during the week, negotiate a time of day with your doctor that will be convenient for you and your family.
Internal Radiation Therapy
If you had breast conserving surgery, you may be a candidate for two newer forms of targeted internal radiation therapy.
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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.
After Radiation Therapy: Pay Attention To Your Treated Skin
Some side effects occur weeks, months, or years after your last radiation treatment. This can happen even if you had no side effects during treatment. To catch these side effects early, dermatologists recommend the following:
Watch your treated skin for signs of change. After treatment, its important to pay close attention to the skin that was treated with radiation therapy.If you see redness, a rash, or any other change, call your oncologist or dermatologist.
Rash caused by radiation therapy
The right skin care may lessen the side effects that develop on your skin.
Protect the treated area from the sun. Anyone who has had radiation treatments has a higher risk of developing skin cancer in that area. Skin cancer tends to show up many years later, so this makes sun protection essential for life.To find out how to protect your skin, go to Prevent skin cancer.
Make an appointment to see a board-certified dermatologist. By having a dermatologist, you have a specialist to see if you develop a skin problem later. This is especially important since you have a higher risk of developing skin cancer.
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Head And Neck Radiation
Radiation treatment of head and neck tumors cause some side effects. Dry mouth is caused because the glands that make saliva are in the area of radiation. Saliva can become thick and you may have less saliva. The decrease in saliva can cause a greater chance for cavities in the teeth. You will need to be seen by a dentist before starting treatment. The dentist may need to remove any teeth that might give you problems. The dentist may also make molds for use with fluoride treatments to prevent cavities. It is very important you follow all of the dentists recommendations. Newer techniques of radiation delivery can minimize some of these side effects. It may be helpful for your dentist to speak with your radiation oncologist before any dental work is done, during or after the period of treatment.
What can be done about the side effects?
What Are The Potential Side Effects Of Chemotherapy Drugs
The specific side effects you may experience will depend on the type and amount of medications you are given and how long you are taking them. The most common temporary side effects include:
- Higher risk of infection
- Premature menopause and infertility are potential permanent complications of chemotherapy.
- Heart damage can be a permanent complication of some chemotherapy.
Please contact your health care provider about specific side effects you can expect to experience from your specific chemotherapy medications. Also discuss troubling or unmanageable side effects with your provider.
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