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Why Do I Need Chemo And Radiation For Breast Cancer

Does Everybody With Breast Cancer Have Radiotherapy

Radiation Therapy for Breast Cancer

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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Increased Risk Of Leukemia

Very rarely, certain chemo drugs can cause diseases of the bone marrow, such as myelodysplastic syndromes or even acute myeloid leukemia, a cancer of white blood cells. If this happens, it is usually within 10 years after treatment. For most women, the benefits of chemo in helping prevent breast cancer from coming back or in extending life are far likely to exceed the risk of this rare but serious complication.

How Long Can You Wait For Radiation After Lumpectomy

Radiation therapy usually begins three to eight weeks after surgery unless chemotherapy is planned. When chemotherapy is planned, radiation usually starts three to four weeks after chemotherapy is finished. You will likely get radiation therapy as an outpatient at a hospital or other treatment facility.

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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:

  • Answering questions about treatments

  • Monitoring your health during treatment

  • 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:

  • Social workers

Learn more about the oncology team.

Radiation For Metastatic Breast Cancer

What Radiation Is Really Like

Sometimes breast cancer spreads to other parts of the body. When this happens, the breast cancer is called metastatic or stage IV.

If youve been diagnosed with metastatic breast cancer and are having symptoms, your doctor may recommend radiation therapy to:

  • ease pain
  • lower the risk of a cancer-weakened bone breaking
  • open a blocked airway to improve breathing
  • reduce pressure on a pinched spinal cord or nerve that might be causing pain, numbness, or weakness
  • treat cancer that has spread to the brain

The radiation dose and schedule to treat metastatic breast cancer depends on a number of factors, including:

  • the level of pain or amount of function lost
  • the size of the cancer
  • the location of the cancer
  • the amount of previous radiation youve had
  • the schedule for any other treatments

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Answers From The Community

  • Penny82

    You don’t HAVE to do anything in regards to medical treatment. But you need to be informed about what may happen if you don’t. There is a reason why radiation is part of the regimen for treating breast cancer. Your chances of recurrence may increase if you decide to skip it. Can I ask why do you not want it? There are accommodations that can be made if it is the 5 days a week you don’t like.

  • meyati

    Talk to your regular oncologist and listen to him. Barry Boomer here is treating his with diet, and an oncologist sees Barry, runs labs and scans on him. I was told by 2 oncologists that only surgery would work for me, but I had radiation instead. A person can certainly choose, but you need to talk to the radiologist before you say-NO- So talk to your regular ONC-take someone with you. It will help you to be calm, and remember everything they say. Barry and I made informed decisions. You just need to hear them out–

  • BoiseB

    Indeed you can certainly opt out. You can also opt for a second opinion that is my suggestion. My mother celebrated her 94th birthday yesterday about 12 years ago, she had a lumpectomy for breast cancer. Because she developed a serious infection after surgery she could not have follow-up radiation or chemo. She has had clear mammograms ever since.

  • Starting With Neoadjuvant Therapy

    Most often, these cancers are treated with neoadjuvant chemotherapy . For HER2-positive tumors, the targeted drug trastuzumab is given as well, sometimes along with pertuzumab . This may shrink the tumor enough for a woman to have breast-conserving surgery . If the tumor doesnt shrink enough, a mastectomy is done. Nearby lymph nodes will also need to be checked. A sentinel lymph node biopsy is often not an option for stage III cancers, so an axillary lymph node dissection is usually done.

    Often, radiation therapy is needed after surgery. If breast reconstruction is done, it is usually delayed until after radiation is complete. In some cases, additional chemo is given after surgery as well.

    After surgery, some women with HER2-positive cancers will be treated with trastuzumab for up to a year. Many women with HER2-positive cancers will be treated first with trastuzumab followed by surgery and then more trastuzumab for up to a year. If after neoadjuvant therapy, any residual cancer is found at the time of surgery, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses. For people with hormone receptor-positive cancer in the lymph nodes who have completed a year of trastuzumab, the doctor might also recommend additional treatment with an oral drug called neratinib for a year.

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    Chemo And Radiation Do Different Jobs

    Chemotherapy is to wipe out cells that are floating around in your blood or lymph and this is a systemic treatment. Radiation is to take care of where the cancer was or is and wipe out the cancer. It is a localized treatment.

    You should have both to give yourself the best odds.


    Goals Of Chemotherapy And Radiation

    Breast Cancer Radiation: Will I Need Radiation?

    Both types of therapy share the same goals:

    • Cure: Get rid of all cancer cells and stop the cancer from coming back
    • Control: Shrink or slow cancer tumors or stop the spread of cancer cells to other parts of the body
    • Relief: Shrink tumors to lessen pain and other difficult symptoms of cancer

    When a cure isnât possible, both therapies can be powerful tools to slow the progress of your cancer and relieve pain and other uncomfortable symptoms.

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    Listen To What Your Body Is Telling You

    Most patients experience little or no side effects during cancer treatment, while some experience any of a number of side effects. Side effects can occur the same day or after treatment.

    Thats because while radiation therapy mostly affects cancerous cells, it can impact healthy cells as well. When good cells are affected, patients may experience various side effects.

    The location of the body targeted by radiation therapy can cause different side effects including:

    • nausea/vomiting
    • dehydration
    • weight loss

    Throughout your treatment, listen to your body and adjust your diet according to what it is telling you. You may find only some foods taste good on a given day. Be flexible and make adjustments to the foods you eat during radiation treatment.

    Your radiation diet may include switching to a bland diet or adding lots of flavorful foods to your meals. Tell your doctor if you begin to experience any side effects from your radiation therapy.

    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
    • Bruising or bleeding
    • 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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    Preparing For External Beam Radiation Therapy

    Before your treatment starts, the radiation team will carefully figure out the correct angles for aiming the radiation beams and the proper dose of radiation. They will make some ink marks or small tattoos on your skin to focus the radiation on the right area. Ask your health care team if the marks they use will be permanent.

    External radiation therapy is much like getting an x-ray, but the radiation is stronger. The procedure itself is painless. Each treatment lasts only a few minutes, but the setup timegetting you into place for treatmentusually takes longer.

    Will I Need Radiation After A Mastectomy

    Why do some breast cancer patients decline chemotherapy ...

    The answer is most likely, no. Post Mastectomy Radiation Therapy is the term for applying radiation to the area of the chest wall after a mastectomy, usually performed about 4 weeks after surgery or after both surgery and chemotherapy are completed. PMRT is generally recommended for those with a high risk of local recurrence.

    If you or your surgeon. before surgery, think you might need PMRT it is essential to see your radiation oncologistbefore you have mastectomy surgery. This way, your radiation oncologist will better understand the size, shape, and extent of your breast tumor before it is removed by surgery or has shrunk away with Neoadjuvant Chemotherapy. Radiation oncologists have a unique insight into breast cancer treatment options that can assist your surgeon in planning the direction of your cancer care.

    The decision to undergo Post Mastectomy Radiation Therapy is complicated. Patients should insist on a multidisciplinary team approach to get the best treatment recommendations for high risk breast cancer situations. When your breast surgeon works closely with your radiation oncologist and medical oncologist, you will be offered the best treatment options. Below is a general outline to help you understand when radiation after a mastectomy is needed.

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    Genetics And Family History

    Treatment for breast cancer may depend partly on having a close relative with a history of breast cancer or testing positive for a gene that increases the risk of developing breast cancer.

    Patients with these factors may choose a preventive surgical option, such as a bilateral mastectomy.

    Clinical trials are studies in which patients volunteer to try new drugs, combinations of drugs, and methods of treatment under the careful supervision of doctors and researchers. Clinical trials are a crucial step in discovering new breast cancer treatment methods.

    Emerging treatments for breast cancer being studied in clinical trials include:

    • PARP inhibitors that block protein used to repair DNA damage that occurs during cell division are being used and tested for TNBC.
    • Drugs that block androgen receptors or prevent androgen production are being used and tested for TNBC.

    If youre interested, ask your oncologist for information about available trials.

    Radiation For Breast Cancer

    Radiation therapy is treatment with high-energy rays that destroy cancer cells. Some women with breast cancer will need radiation, in addition to other treatments. Radiation therapy is used in several situations:

    • After breast-conserving surgery , to help lower the chance that the cancer will come back in the same breast or nearby lymph nodes.
    • After a mastectomy, especially if the cancer was larger than 5 cm , if cancer is found in many lymph nodes, or if certain surgical margins have cancer such as the skin or muscle.
    • If cancer has spread to other parts of the body, such as the bones or brain.

    The main types of radiation therapy that can be used to treat breast cancer are external beam radiation therapy and brachytherapy.

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    The Radiation Side Effect You Should Know About

    A lot of the focus on radiation therapy is what is does to your skin, and thats fair enough. But you also should talk to your radiation oncologist and radiation therapist about the possibility of lymphedema or swelling in the chest area as a side effect. It was only after receiving physical therapy, post-radiation, that my physical therapist noticed lymphedema, or the buildup of fluid, in my right breast. I honestly just thought it was swelling that would eventually subside. Id heard about getting lymphedema in my arm, but it never occurred to me that it could happen in my breast.

    My physical therapist showed me different self-massages to help move fluid away from the swollen area and get the lymphatic system moving again. She also recommended this WearEase Swell Spot to wear to take the pressure off the swollen breast area. I have been wearing it for one month now and Ive seen a decrease in the swollen chest area of three centimeters .

    My biggest takeaway? Please talk to your radiation oncologist about your risk of lymphedema, especially in the breasts. And if you can see a certified lymphedema specialist prior to surgery, even better. The specialist will take measurements of your upper and lower arm width, as well as the dimensions of your breasts, rib cage, and trunk area. That way, youll be able to keep tabs on whether there is any sort of swelling post-surgery or post-radiation, and if so, you can act quickly to correct any issues.

    Just Saying What Everyone


    Just saying what everyone else wrote, and, that is that rads kill any leftover cancer cells that are lurking around. Whether you do or not is up to you. Even rads won’t guarantee that the cancer won’t come back, nothing will unfortunately.

    Good luck in your decision,



    I am going to have the radiation was just confused on why it was necessary but all you clear that up for me.Thank you so muchHope everyone has a wonderful holiday!Hugs


    Wishing you good luck with rads Christine. When do you start?

    Hugs, Jan


    having the same debate as you did – did you have the radiation? how did you do? do you still feel that it is worth it?


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    Radiation Therapy Benefits All Early

    The risk of recurrence was lower when early-stage hormone-receptor-positive, HER2-negative breast cancer at low risk of recurrence was treated with radiation and hormonal therapy after surgery, compared to treatment with hormonal therapy alone, according to a study.

    The research was presented on April 28, 2019, at the European Society for Radiotherapy and Oncology Congress in Milan, Italy. Read the abstract of “Antihormones with or without irradiation in breast cancer: 10-year results of the ABCSG 8A trial.”

    Doctors call treatments given after breast cancer surgery adjuvant treatments.

    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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    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.

    How The Diet Can Change During Radiation Therapy

    Breast Cancer Treatment  Provision CARES Proton Therapy ...

    When it comes to healthy eating, we know that usually means eating plenty of vegetables and fruits. But what about milkshakes and gravy sauce? Would you ever expect those to be good for you too?

    Your diet during radiation might include foods you wouldnt normally eat when otherwise healthy. Thats because your bodys needs during radiation are different.

    What you eat during radiation therapy will be a combination of what tastes good and what your body needs during treatment. For example, here are some of the ways that the key components of your diet may change:

    Calories: Some radiation patients need a higher-calorie diet to make sure that the food they are able to eat provides the body with enough energy to promote healthy tissue growth.

    Protein: Protein helps maintain muscle and supports a healthy immune system both critical functions needed during radiation. Thats why many radiation patients also have high protein diets.

    Vitamins and Minerals: Vitamins and minerals also help keep the immune system strong and support healthy tissue repair. Maintaining adequate levels can be important. You should discuss with your doctor whether vitamin supplements are recommended. In some cases, your doctor may recommend you stop certain supplements during radiation therapy.

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