It's normal to feel a little scared and nervous when you hear the words "cancer" and "radiation therapy" or as we like to call it, "radiation therapy." But what exactly is this? What does this mean? Once you know exactly what it is, your fear will go away. So, today we'll talk about everything about radiation therapy for breast cancer, very simply, in a way that you can understand.
Simply put, what is radiation therapy?
Radiation therapy uses high-powered X-rays to kill or damage cancer cells in your breast. Most often, a person with breast cancer has surgery to remove the cancer. But even after that, there may be very small cancer cells left in the area that we can't see. Radiation therapy is used to completely destroy any remaining cancer cells.
Sometimes, if the cancer has spread to other parts of the body (metastatic breast cancer), this treatment is also used to control symptoms such as pain. It's like taking a high-powered torch and aiming it precisely at the cancer cells and destroying them.
What radiation treatments are available?
There are several ways to give this treatment. Your doctor will decide which method is best for you, depending on many factors, such as the type of cancer you have and where it is located.
Let's look at the main methods like this.
| Name of the treatment method | The way to do it is simple. |
|---|---|
| External Beam Radiation Therapy (EBRT) | This is the most commonly used method. A large machine (Linear Accelerator) is used to deliver radiation beams to the breast. This treatment is usually given five days a week, for one to six weeks. |
| Internal radiation therapy (Brachytherapy) | This involves inserting a radioactive seed-like substance through a small tube (catheter) into the area where the cancer was. It is left in place for a few minutes and then removed. This treatment is done twice a day for about five days. |
| Intraoperative Radiation Therapy (IORT) | This is done at the same time as the operation. The doctor removes the cancerous tumor and gives a dose of radiation to the area where the tumor was before closing the wound. |
What happens on the first day? (Planning session)
The first day of your treatment isn't actually the day of treatment. It's a day of planning. We use this day to ask all your questions, and to help the medical team explain everything to you.
What will happen then?
- Talking about the treatment schedule: They will explain to you how long you will need to have the treatment, how many times, and how long it will take at a time. Although it usually takes about 30-45 minutes, the radiation is actually given for only a few minutes.
- You will be explained the process: how the radiation will be given, where the medical team will be at that time, and what you cannot do (for example, not moving).
- You will be taught techniques to protect your heart and lungs: You will be taught special techniques, such as deep inspiratory breath holds, during treatment. This will help reduce the effects of radiation on your heart and lungs.
- You will be advised on things you can do to make yourself comfortable: for example, wearing loose, non-tight clothing when you come for treatment, as this will reduce the amount of skin rubbing against your breasts.
- Talking about side effects and how to deal with them: It explains to you what side effects may occur and what you can do about them.
CT scan performed during planning session
On the same day, you will have a CT scan to mark exactly where in your breast you want to receive radiation. This can take about an hour.
- You will be held still on the treatment bed with the help of a special device. This helps keep you in the same position throughout each treatment.
- Then, four small marks are placed on the four corners of the area to be treated. These are small marks that look like a mole. Sometimes these are permanent tattoos, sometimes they are temporary. This can be decided by talking to your doctor, depending on your preference. These marks are there to help you aim the radiation at the same spot every time.
What actually happens during treatment?
When you arrive for treatment, a member of the medical team will greet you and give you a special gown to wear during your treatment. Then:
1. You will be taken to the treatment room.
2. Helping you get onto the treatment bed. Most of the time, you will have to lie on your side. You will need to keep the arm on the side where your cancer is above your head.
3. You will be positioned precisely inside the aforementioned immobilizing device.
4. After that, the medical team will leave the room. But don't worry, they can see you on the cameras and hear what you are saying.
5. The machine is turned on. You will hear a small sound from the machine, but you will not see any radiation beams, and you will not feel anything.
6. When the treatment is over, they will come back to the room and help you get out of bed.
Remember, you won't feel any pain during this entire process, so there's no reason to be afraid.
What are the possible side effects of the treatment?
Radiation therapy does not cause side effects immediately after starting. However, short-term and long-term side effects may occur during and after treatment.
| Short-term side effects (during treatment and shortly after) | Long-term side effects (months or years after treatment) |
|---|---|
| Fatigue: Many people feel a little tired. This goes away within a few weeks after treatment ends. | Spider veins (Telangiectasias): Small red veins may appear on the surface of the skin. This is normal and nothing to worry about. |
| Skin changes: The skin may become dry, flaky, and red. Some people may develop moist desquamation in the armpits or under the breasts. | Change in breast size: The breast may become larger or smaller than before. |
| Skin discoloration: A person with fair skin may have a sunburned appearance, while a person with dark skin may have a darker complexion. | Lymphedema: If radiation is given to the lymph nodes in the armpit, the arm on that side may swell. |
| Breast pain: Some people may experience occasional mild pain or a stabbing pain in their breasts. | Long-lasting fatigue: Some people may feel tired for months after treatment ends. |
Important: Unlike chemotherapy, this treatment does not remove hair from the scalp. However, armpit hair may.
What are the benefits of this treatment?
Radiation therapy is a highly effective way to target cancer cells without harming surrounding healthy tissue. Research has found that early-stage breast cancer patients who receive radiation therapy after surgery have a much lower risk of their cancer coming back. In fact, less than 5% of patients with both surgery and radiation therapy have a recurrence rate 10 years after surgery.
Are there any risks or complications?
These are very rare occurrences, but it's important to be aware of them.
- Rib fractures
- Heart problems (Radiation heart disease)
- Lung problems (Pulmonary fibrosis)
- Damage to the nerves in the shoulder and arm (Brachial plexopathy)
- Very rarely, new cancer (Angiosarcoma) may develop in the treated area.
Remember that these risks are very small. Your doctor will do everything he can to minimize these risks.
How do I take care of myself during and after treatment?
The treatment period may be a little uncomfortable for you. You may feel itchy, sore, and tired. Here are some tips to help you during this time.
- Wear loose cotton clothing: Wearing tight clothing and tight bras can rub against the skin and increase pain.
- Take extra care of your skin: Wash your skin with a mild soap and lukewarm water. Ask your medical team about a non-irritating cream that is suitable for your skin.
- Get plenty of rest: You may feel more tired during the last few days of treatment. Make sure to take time to rest during your daily activities.
- Eat well: A nutritious diet (grains, fruits, vegetables, lean meats, low-fat dairy) will help keep you strong.
- Exercise: Simple exercise like walking for 30 minutes a day can help control fatigue.
Some important questions to ask your doctor
Don't be afraid to talk to your doctor about everything that's on your mind. Here are some questions you can ask.
- What radiation therapy is recommended for me and why?
- How long does this treatment take? How often do I need to come?
- What short-term side effects can I expect during treatment?
- What can be done to reduce those side effects?
- If I have side effects, who should I tell? How soon should I tell them?
- How will this treatment affect my daily life? Will I be able to go to work or exercise?
- What are the possible long-term side effects of this treatment?
- If I feel very scared or anxious about this treatment, who can I talk to?
- When will we know if this treatment is successful? How?
Take-Home Message
- Radiation therapy is a very effective, targeted treatment for breast cancer. Don't be unnecessarily afraid of it.
- This treatment method greatly reduces the risk of cancer recurrence.
- Side effects such as fatigue and skin changes may occur during treatment, but most of them can be managed.
- Never hesitate to inform your doctor or medical team about any discomfort you may be experiencing.
- It is very important to get enough rest, eat nutritious foods, and keep your mind relaxed during treatment.
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