It's normal to feel a little scared and nervous when your doctor tells you that you have breast cancer and you need radiation therapy. The word "radiation" often comes to mind as something dangerous. But this is actually a very effective and common treatment used to treat breast cancer. So let's learn more about it today.
Simply put, what is radiation therapy?
Radiation therapy is, to be precise, the use of high-powered X-rays to destroy or damage cancer cells in your breast. Usually, surgeons who specialize in cancer surgery first remove the cancerous tumor from the breast. However, after that, there may still be small cancer cells that we cannot see left in that area. Radiation therapy is given to completely destroy those remaining cancer cells and prevent the cancer from coming back .
Sometimes, when cancer has spread to other parts of the body (metastatic), this treatment is also used to control symptoms such as pain.
What are the main methods of delivering radiation therapy?
Your specialist will decide which radiation treatment method is best for you based on many factors, such as the nature and location of your cancer. There are several main methods.
| Name of the treatment method | What simply happens |
|---|---|
| External beam radiation therapy (EBRT) | This is the most commonly used method. A large machine (Linear Accelerator) uses an external beam of radiation to target the area of your breast where the cancer cells were. This treatment is usually given 5 days a week for 1-6 weeks. |
| Internal radiation therapy (Brachytherapy) | What happens here is that a radioactive seed is inserted through a small tube (catheter) into the area where the cancer was. It emits radiation for a few minutes and then it is taken out again. This treatment is completed in a short period of time, about 5 days, twice a day. |
| Intraoperative radiation therapy (IORT) | This is done at the same time as the surgery. After the surgeon removes the tumor, before closing the wound, the radiation is delivered directly to the exposed tissue. |
What happens during the first meeting and treatment planning?
Your first appointment is the day when everything is planned. This is where you can ask any questions you may have. The medical team will explain the following to you:
- Treatment schedule: This tells you how long and how often you will need treatment. Although a single session usually lasts about 30-45 minutes, the radiation is actually delivered over a short period of time, about 2-3 minutes.
- Explaining the process: Explains how you should be positioned during the treatment, where the medical team will be, and what you cannot do (e.g., not being able to move).
- Heart and lung protection: During treatment, you will be taught ways to help reduce the effects of radiation on your heart and lungs. For example, you will be taught to practice deep inspiratory breath holds.
- Things you can do to make yourself more comfortable: When you come for treatment, you will be advised to wear loose clothing that does not cut into the skin of your breasts.
- Side effects and remedies: Discusses possible side effects and how to manage them.
Preparing for treatment (Simulation)
On the day of this appointment, your body will be prepared for the treatment. This can take an hour or more.
1. Performing a CT scan: Using a `CT` scanner, the specific area to be treated is mapped out.
2. Immobilization: You will be immobilized on the treatment table with the help of a special immobilization device. This ensures that you will be in the same position throughout each treatment session.
3. Marking: To identify the corners of the treatment area, small dots are marked with a tattooing device. These can be permanent or temporary. These marks ensure that the radiation is directed to the same spot every time.
What happens during treatment?
When you go for treatment, a member of the medical team will greet you and give you a special gown to wear during your treatment. After that,
- You will be taken to the treatment room.
- You will be placed in the correct position on the treatment table. Most often, you will be placed on your side facing up. The arm on the side with the cancer should be held above your head.
- The medical team will leave the room and turn on the machine. They can see you through the cameras and talk to you.
- When the machine is turned on , you will hear a 'whoosh' sound, but you will not feel anything , nor will you see any radiation beams.
- When the treatment is over, they will come and help you get up from the table.
Remember, this treatment does not make your body radioactive. You can socialize with other people normally after treatment.
What are the common side effects?
Radiation therapy has few immediate side effects, but there can be short-term and long-term effects during and after treatment.
Short-term side effects
- Fatigue: Many people feel a little tired during treatment. This goes away within a few weeks after treatment ends.
- Skin changes: The skin in the treated area may become dry and flaky. Sometimes, moist desquamation (`moist desquamation`) may occur in the breast folds or armpits.
- Skin discoloration: If you have fair skin, you may get a red, sunburn-like appearance. If you have dark skin, the area may become darker than usual.
- Breast pain: Sometimes a dull or sharp pain may come and go. The areola or breast may be tender.
Long-term side effects
- Spider veins (`Telangiectasias`): These are small red veins that appear on the surface of the skin. This is normal and nothing to worry about.
- Changes in breast size: The breast may become slightly larger or smaller.
- Lymphedema: If radiation therapy is given to the lymph nodes, some people may experience swelling in the arm on that side.
- Long-lasting fatigue: Some people may feel tired for weeks after treatment ends.
The most important thing is that, unlike chemotherapy, radiation therapy does not cause hair loss on the scalp. However, armpit hair may.
How can you take care of yourself?
Treatment is a time when you need to take great care of yourself.
- Wear loose, cotton clothing: Tight bras and clothing can further irritate the skin.
- Be gentle on your skin: Wash your skin with a mild soap and lukewarm water. Ask your healthcare team about a non-irritating, pain-relieving cream or lotion.
- Get plenty of rest: You may feel more tired during the final stages of treatment. Include rest periods in your daily routine.
- Eat a good diet: A nutritious diet can help maintain body strength.
- Do some light exercise: Simple exercise like walking for 30 minutes every day can help control fatigue.
Questions to ask your doctor
When you meet with your medical team, you can ask these questions.
- What type of radiation therapy is recommended for me and why?
- How long will this treatment take? How often do I need to come?
- What short-term side effects can I expect during treatment?
- What can I do to relieve the side effects?
- Who should I talk to about any side effects I experience? How soon?
- How will this treatment affect my daily life? Can I go to work, exercise?
- What are the possible long-term side effects of this radiation treatment?
- When and how will we know if this treatment is successful?
Radiation therapy is not something to be afraid of. It is a very important and successful step in the journey to defeat cancer. Talk openly with your doctor about everything that is on your mind. They are always ready to help you.
Take-Home Message
- Radiation therapy for breast cancer is a very effective and common treatment used to destroy any remaining cancer cells after surgery and prevent the disease from recurring.
- You will not feel any pain or anything during the treatment. All you will hear is the sound of the machine.
- Side effects such as skin changes and fatigue are common and can be managed . Talk to your medical team about these.
- It is very important to rest well, eat nutritiously, and take gentle care of your skin during treatment.
- Never hesitate to discuss any fears, doubts, or questions you have with your doctor .
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