Breast Cancer

Lesson 5: Adjuvant Therapy & Possible Side Effects

Radiation

Radiation is very effective in treating breast cancer. Used in conjunction with surgery, generally, it is a good form of local control. Radiation therapy is a localized treatment. The machine which delivers the dosage to a specific area of your anatomy is known as a linear accelerator. Your first visit will be with the radiation-oncologist, who is a medical doctor who specializes in radiation therapy. Based on the staging of your cancer and the surgical and chemotherapy options, radiation might be presented to you as a complementary therapy. Some patients who have chronic lung problems might not be good candidates for radiation since there could be a bit of radiation to the lungs. If you have had radiation to the chest area previously, you are generally not allowed to have any more radiation to the same area.

Once you have agreed to radiation, you will have an initial session where you will be measured and re-measured. You will be placed under a simulator, which acts exactly like the linear accelerator, but does not actually emit any beams. You may also be subject to some Xrays or scans to make sure that they have all the data they need to irradiate the correct area of your breast tissue. Sometimes, they make a mold for you to position your arm and head in, so that each time you arrive for radiation they are assured that you are in the exact same position. Most patients are tatooed. This might sound horrible, but in reality, they make extremely tiny dots around the area to receive radiation. The marks are permanent. You may not like the idea of the tatoos, but the benefit (if indeed you ever need radiation again later in life) far outweigh the tiny markings. The process itself feels like tiny pinpricks. Most women comment that the process of staying still for the mold is more uncomfortable than the tatoos themselves.

Radiation therapy is usually given on a daily basis for a period of weeks. The process itself only lasts a few minutes. Most women complain about the time taken out of their schedules to get to and from the radiation treatment center, more than about the therapy itself. The radiation is painless. Often women are a bit unnerved lying on the table and feeling like they are alone in a Star Wars film.

Radiation can burn your skin - some women feel like they have a faint sunburn, others get painfully burned. Check with your radiation-oncologist and ask what he/she recommends for the skin, before you begin treatment. There are prescription creams and salves. Some patients swear by over-the-counter emollients. Radiation can zap your energy and make you tired. The skin can burn, harden (or toughen up) and change colors (to a darker hue) than your normal skin.

Near the end of your radiation sessions, your specialist might suggest a radiation boost (sort of an extra special high-dose zap to those cancer cells). The boost is handled in one of two ways: you can receive an electron beam. You handle this the same way you went through the standard radiation sessions. The second method is the radiactive implant, also known as brachytherapy. This sounds gross, but friends who have undergone this treatment tell me it is not so bad. Under anesthesia, small tubes are threaded through the breast and iridium seeds (radioactive pellets) are inserted into the tubes. This boost usually lasts for up to 48 hours. Since this radiation could affect pregnant women or those at risk for radiation exposure, you could be a problem. Usually, they keep you in the hospital so that you don't irradiate anyone else.

Radiation therapy is intense in that it is daily for 4-6 weeks. The greatest side effect is fatigure. Don't worry - you will get your energy back. The burn will ease, and any soreness and thickening of the skin will lessen. Radiation researchers continue to look for new ways to lessen the dosage, the time involved and to pinpoint the exact area that needs to receive the radiation.

Think of radiation as one more step in the trip on the road to your recovery!

Pictures are of an external beam (left) and linear accelerator (right). (Both look and act similar with you. Technologically different, but you still lay there and have the beams do their work.)

http://radiologyinfo.org/content/therapy...

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