What to Expect From External Beam Radiation Treatment
Thanks to mammograms and careful breast exams, most Midwestern women who are diagnosed with breast cancer have the option of treatment without undergoing the removal of the entire breast or mastectomy.
For the majority of women who are treated with breast preservation, their treatment will involve both surgery and radiation therapy. While there are now different types of radiation treatment that can be used in the treatment of early breast cancer, in this blog post I will focus on the most commonly used type of radiation treatment for early breast cancer, which is external beam radiation therapy.
The process of deciding a treatment plan for a woman diagnosed with early invasive breast cancer usually goes something like this:
- A woman decides, with the help of her breast surgeon, if she desires to preserve the breast in which the cancer was found. If she does want to try to preserve this breast, the surgeon will normally recommend removal of the breast tumor along with a small rim of surrounding normal-appearing breast tissue.
- This procedure, called a lumpectomy, is normally done along with a sampling of the lymph nodes under the arm. This lymph node sampling is generally referred to as a sentinel lymph node biopsy. If the sentinel lymph node biopsy is positive for cancer, additional underarm lymph nodes may be removed by the surgeon.
- After the surgery is performed, the woman will again meet with her surgeon to discuss the results. If the removal of the tumor went well and no further surgery is recommended, the surgeon will normally make arrangements for the patient to see a medical oncologist and a radiation oncologist.
- The medical oncologist will tell the patient whether there are any medications that she should take in order to lower her risk of breast cancer recurrence.
- The woman will meet with a radiation oncologist to discuss the plan for radiation treatment. Radiation treatment is given to lower the risk of cancer recurrence in the breast. Radiation treatment may also be given to decrease the risk of cancer recurrence in the lymph nodes located near the breast.
- Radiation therapy is started about a month after the last received dose of chemotherapy. If chemotherapy is not needed, then radiation therapy can be planned and started as soon as the woman has healed sufficiently from her surgery.
Treatment planning for radiation therapy is pretty easy for patients. Often a custom mold is made to hold the patient’s arms above her head in the same position every day for treatment.
The patient is then placed on an inclined board that is on the CT scan table with her arms above her head in the custom mold. CT images are then obtained of the entire chest. These images are then transferred to a special treatment planning computer. The radiation oncologist and a specially trained radiation treatment planner carefully plan the radiation beams’ sizes, shapes and intensities so that the right doses are delivered to the areas that the radiation oncologist wishes to treat.
Normally, the initially treated area includes the entire breast, and it may also include the lymph nodes near the treated breast. Additional radiation treatments may be delivered only to the part of the breast from which the tumor was removed. These are often called “boost” treatments and are usually given after the treatment to the whole breast is completed.
Once the treatment planning process has been completed, radiation treatment can begin. Usually treatment for early breast cancer takes only a few minutes per day. The treatment is not painful, and it’s actually well-tolerated by most patients. Patients are not radioactive as a result of this treatment. I tell many of my breast cancer patients that this type of treatment is actually one of the easiest forms of external beam radiation treatment to receive.
Most women who are working at the time that their radiation treatment begins continue to work right through their radiation treatment. Some common side effects are tiredness, skin redness or peeling and mild discomfort. Most women will be seen weekly by their radiation oncologist and their radiation oncology nurse. At the time of these visits, treatment-related symptoms are discussed and care recommendations are made. Although there are some serious possible late side effects of radiation therapy that are important for patients to understand, most patients never experience any of these.
About a month after the completion of radiation treatment, the patient will again meet with her radiation oncologist to discuss the management of any radiation therapy side effects that she may be experiencing.
The radiation oncologist and the radiation oncology nurse can also help to educate the patient about the breast cancer care that she may need to receive after the completion of radiation therapy. I stress to women that they should get regular mammograms and do regular breast self-examinations. The overall prognosis for most women with breast cancer is good when the disease is caught early.
Our goal at Avera Cancer Institute is for our patients to return to all of the things that they were doing in their pre-diagnosis personal and professional lives as soon as possible.