Chapter: 6 - Treatment
Subchapter: 7 - Radiation Therapy
Radiation therapy, which commonly follows surgery, uses x-rays or other types of radiation to kill cancer cells and shrink tumors. People with Stage 0 (DCIS ) or Stage 1 invasive cancer and higher, who have had a lumpectomy, can expect radiation therapy to be a part of their treatment regimen.
Radiation therapy is administered by a radiation oncologist at a radiation center, and usually begins three to four weeks after surgery. The radiation is used to destroy undetectable cancer cells and reduce the risk of cancer recurring in the affected breast.
Let’s discuss adjuvant radiation therapies in further detail. Keep in mind that the course of treatment you decide is something you should discuss with your radiation oncologist in order to ensure that it is as effective as possible.
External Beam Radiation
External beam radiation (also known as traditional or whole breast radiation therapy) uses external beam radiation, like that of a regular x-ray, but the beam is highly focused and targets the cancerous area for two to three minutes. This form of treatment usually involves multiple appointments in an outpatient radiation center — as many as five days a week for five or six weeks. Certain situations may require a slightly higher dose of radiation over a shorter course of treatment, usually three to four weeks.
Internal radiation is another form of partial breast radiation. During the treatment, the doctor inserts a radioactive liquid with needles, wires, or a catheter in order to target the area nearest the cancer and kill any possible remaining cancer cells.
Radiation Side Effects
Radiation therapy can have side effects, and these vary from person to person. The most common side-effects are sunburn-type skin irritation of the targeted area, breast heaviness and discoloration, and fatigue. If you experience side effects, you should discuss them with your doctor, who may be able to suggest other more comfortable treatments.
You need to be aware that more intense treatment methods will tax your body. During radiation therapy, it is essential to take care of yourself by getting extra rest and making good nutrition a priority.
Asked by anonymousLearning About Breast Cancer
I believe everyone should use Crystal or Toms deodorant. They are aluminum free. We for years have been absorbing aluminum into our bodies where there are many lymph nodes. I hate to sound so strongly about this but why absorb things that are dangerous to us. You can find them in every drug store.1 comment 1
Hi Norma, I dident have to do chemo but had 30 radiation treatments you will be fine What got me was 6 weeks Monday - Friday god bless have a wonderful evening1 comment 1
Asked by anonymousStage 2B Patient
I have that problem too. I take Tylenol pm and it works very well. Just Tylenol and benedryl so I'm not taking anything strong.Comment 0
I definitely had trouble sleeping (except for my 5-hour "chemo coma" when I finished a treatment!). I was told it was also due to the steroids I got IV before chemo. I was given Trazadone for sleep. It really helped. If you don't sleep well at night be sure to take a good nap or naps during...
I definitely had trouble sleeping (except for my 5-hour "chemo coma" when I finished a treatment!). I was told it was also due to the steroids I got IV before chemo. I was given Trazadone for sleep. It really helped. If you don't sleep well at night be sure to take a good nap or naps during the day. It'll throw you off your regular schedule but you'll be getting the sleep you need.
Asked by anonymousSurvivor since 2011
1. It has been standard for many decades that radiation does not result in less deaths from breast cancer [called disease specific survival]. In fact, reputable studies have shown a slight increase in the overall or all cause death rate [called overall survival rate] for women treated with...
1. It has been standard for many decades that radiation does not result in less deaths from breast cancer [called disease specific survival]. In fact, reputable studies have shown a slight increase in the overall or all cause death rate [called overall survival rate] for women treated with radiation versus those who did not have it. Before concluding radiation is overall causing more deaths than it is saving, there are other theories about these results, such as women who get radiation as opposed to women who don't tend to be more unwell and therefore at higher risk of dying from all cause conditions.Most radiation oncologists will not tell you this - most of them are trained not to as they believe this information may influence more women not to agree to RT. In fact, I find they deliberately try to obscure and dumb down any statistical information to try and get me to go along with whatever they are recommending.
2. Studies however do show an RT benefit when it comes to reducing BC recurrence. Recurrence reduction is important for the following reasons - each recurrence places you under more health stress, and expense but also each recurrence raises your risk of it being more dangerous.
3. This brings us to Connie's question. The benefit an individual breast cancer patient gets from radiation is relative to her risk of recurrence. So, first you need to find out what your individual BC recurrence risk is. I found I had to push my Radiation Oncologist to give me the true facts about my recurrence stats. In my case and with my type and grade of BC as well as other makers such as no lymph node involvement, ki 667 score and all those other results on the histopathology report arising from my excised tumour and lifestyle [I do not drink alcohol, I do not smoke, I take a daily asprin but I am overweight] - well, it was enlightening to FINALLY have him admit my risk of recurrence without radiation was 5% [ie., 95% no recurrence]and if I submitted myself to what he recommended which was 6 weeks radiation plus boost to my entire breast, the best I could improve the situation was by 2%, which means 97% no recurrence risk. I was not offered partial breast irradiation which is a less damaging RT option for women with my stats but PBI is another topic.
4. I realised immediately at this point why he did not want to inform me about my real risk stats. I am a numbers person and try to make rational decisions based on facts - I am not an emotional decision maker and I was not sitting there crying or anything like that. He knew from my personality and presentation that there is no way I was going to subject myself to radiation for a measly 2% improvement in my already great stats. So getting this most basic medical information about the the Radiation Oncologist was time consuming and he was as uncooperative as a hostile witness on the stand - it took me an hour to drag the most basic medical information out of him about my stats to enable me to make an informed decision about my own health care and stats but I hunted him down verbally an kept up a steady stream of polite but increasingly pointed questions till I eventually dragged out of him the information I needed as was in fact entitled to in order to make an informed decision about my own health care. My surgeon and Oncologist were the total opposite - they handed over information generously and wanted me to be an adult and make up my own mind.
5. I elected not to have any RT after quadruply checking on things and reading all the leading scientific reports on the topic.
6. I had a rare form of BC called tubular carcinoma which was incredibly slow growing with other helpful features even though it was invasive. I also researched thoroughly every single finding on my histopathology report so I understood what it all meant.
7. My approach was because I had large breasts and a small wide local excision meant I still had plenty of flesh left so if I had regular checks for the rest of my life, any recurrence is likely to be detected and I still have enough breast for another lumpectomy etc and RT if its worse than my first BC. However if I had RT now, I am not permitted to have it a second time - its straight to mastectomy. As my initial BC was so favourable I preferred to keep RT up my sleeve to use in the future as a future BC may not be so indolent. I am also in my 50's so I had on average another 30 years of life in which BC could happen again so I did not want to use up my one go at RT now.
8. Some women are understandably so distressed by the word cancer that they would elect to make RT even for a tiny boost to avoiding a recurrence.
9. I am being so careful here setting out the steps as the overwhelming majority of women with BC are not in my situation and they will get an appreciable or even significant benefit from recurrence by having RT.
10. The question for you Connie is what are your individual BC recurrence stats, and what is your appetite for risk? Its a sliding scale on both questions so its a very personal decision based on what you believe you can cope with. Some women I meet say they would hate themselves if they did not undertake all treatment options no matter how painful, expensive or minimal the benefit and the BC recurred. They would grab any treatment even if it gave less than 1% benefit. Others are like me, weigh up and the pros and cons and have to think there is enough of a benefit to put our bodies through more stress. Your question is where do you fit on this continuum?
11. The one consideration I constantly kept hearing from BC survivors was that RT was a piece of cake compared to eg., chemo, surgery etc simply because it was quick, there was no cutting, and they were not throwing up constantly. My view is RT is not a piece of cake simply because you cannot see and feel all the damage the RT does to your body in the same way we can see and feel surgery or chemo! To me those considerations are irrelevant. To others they feel comforted by their perception is that RT poses the least insult on their body in comparison to their other treatments.
12. I am not encouraging anyone with BC to refuse RT. To me that is irresponsible because I do not know your personal stats, values, personality, options and lifestyle. What I am doing is encouraging any one with BC to carefully question their Radiation Oncologist so you know your true stats with and without RT and you make a decision about your own treatment based on that knowledge. Other patients prefer to know nothing, ask no questions and go through whatever treatment regime is recommended by their medicos.
13. Anyone who is having RT - ask to see the practices stats on radiation errors so you understand what your risk are of over or under treatment. If they don't keep such stats or won't show them to you - flee and go somewhere that has decent quality assurance program in place and is willing to show you results!
14. I know this is a detailed response Connie but this is a very serious question you are posing here, I take it very seriously and I do not want to give you a glib answer.
Asked by anonymousLearning About Breast Cancer
Maybe Occupational Therapy (OT)? I'm one in my "other life" and would work with anyone with chronic illnesses to get their stamina for daily living back and learn to pace and conserve energy. Google one in your area.... Some physios are good too - especially if they have worked in oncology. Or a...
Maybe Occupational Therapy (OT)? I'm one in my "other life" and would work with anyone with chronic illnesses to get their stamina for daily living back and learn to pace and conserve energy. Google one in your area.... Some physios are good too - especially if they have worked in oncology. Or a personal trainer/kinesiologist that is familliar with rehabilitation.
I got a dog for my therapy. Makes me walk daily even when i can barely get up the stairs - those days i just drive to a flat location. And just like "they" keep lecturing us - once you start to get active you do actually feel more energetic. I can hike trails now 4 months later and am still getting Herceptin chemo every 3 weeks......But it's a tough balance. As soon as i do too much i nap for 3 days. But it's slowly recovering.
Don't forget to just put one foot in front of the other and you will get there girlfriend!
Not yet but will be. I can barely climb stairs without losing my breath :-)Comment 0
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