Radiation therapy is a treatment that uses high-energy rays to destroy cancer cells. It is much like getting an x-ray, but the radiation administered is much more intense (yet painless). Most women receive radiation therapy after undergoing a form of breast cancer surgery. This form of therapy is used to ensure that any remaining cancer cells are destroyed, thereby reducing the chance that the patient develops breast cancer again. Women sometimes also receive this form of therapy prior to the surgery, in order to destroy cancer cells, and shrink the tumor. It is used when the tumor is large or may be hard to remove. There are two main types of radiation therapy; in certain cases women can receive both forms:
External radiation is the more common of the two types. This therapy focuses the radiation on the area affected by cancer. The radiation is admitted by a machine that is outside the body. The extent of the radiation depends on the surgery the patient received (lumpectomy or mastectomy). If a lumpectomy was preformed, the entire breast receives radiation, and the area where the tumor was is given an extra boost to prevent it from coming back. The radiation may also include the chest wall and underarm, depending on how much damage the cancer did.
If the external radiation is performed after surgery, there is a healing period of about a month, so that the operated tissue has time to recover. If the patient also receives chemotherapy, radiation therapy is postponed till the chemo has been completed.
To make sure that the radiation team beams the right area of the patient, they first make careful measurements to determine the correct angles and the proper dose. They will also make some ink marks on the patient's body, so that they can use them later as a guide to focus on the right area again (these marks can sometimes be permanent). Patients are often advised not to use lotions, powders, antiperspirants, etc. during the radiation therapy, as these might interfere with the beam.
Patients receiving radiation after a lumpectomy are usually treated about 5 days a week for about 6 or 7 weeks. The treatment itself only lasts a few minutes, but the setup time is much longer.
Potential side effects of radiation therapy are:
- Swelling and heaviness in the breast.
- Sunburn-like skin changes in the treated areas.
- Breasts become smaller and firmer.
- Weaken ribs (very rare)
Your doctor will probably also advise you to avoid exposed your treated area to the sun, as this will only increase the changes to your skin. The changes however are only temporary, and usually go away 6 to 12 months after the therapy is complete.
Also known as Brachytherapy, Internal Radiation is the second method for delivering radiation therapy. The difference between this form and internal radiation is related to the way it is administered. Internal Radiation, as the name says, is administered internally (from inside the patient). The doctor places (small) radioactive implants in the breast tissue, next to the tumor site. A woman who has received the implants must stay in the hospital until they are removed, this may take several days. Not everyone can receive internal radiation; it depends, among others, on the tumor size and location. There are two types of internal radiation:
- Intracavitary branchytherapy: this form of internal radiation uses a small balloon attached to a thin tube. The balloon is inserted (deflated) into the space left by the lumpectomy and is filled with a salt water solution. The balloon and tube are left in place throughout the treatment, with the end of the tube sticking out of the breast. The doctor then places a source of radioactivity in the middle of the balloon, and removes it twice a day. This form of therapy is administered for a 5 day period, after which the balloon is deflated and removed.
- Interstitial branchytherapy: several small, hollow tubes (catheters) are inserted into the breast around the area of the lumpectomy, and are left there for several days. Radioactive pellets will then be inserted into the catheters for short periods each day and then removed.