One of the most common treatment modalities for breast cancer is radiation therapy, but patients may have problems coping with its undesirable effects. Breast cancer is a type of cancer that forms in the cells of the breasts. It is one of the most common cancers in women. Radiation is a choice of treatment for breast cancer because of its precision and efficacy.
Radiation treatment does cause side effects, which is why doctors continuously monitor patients undergoing the therapy. Most patients find radiation treatment tolerable. If side effects do occur, they usually only affect the areas undergoing treatment.
How Radiation Is Used to Treat Breast Cancer
The thought of undergoing radiation therapy, also known as radiotherapy, can be a stressful one for those who don’t understand how the treatment works. Radiation is high-energy particles or waves that kill cancer at high doses. Exposure to radiation kills cells by either damaging the genetic material directly or causing formation of free radicals that also damage cell’s genetic material. Unfortunately, radiation also damages healthy, non-cancerous cells too. Doctors prescribe radiation to treat cancer or prolong lives and alleviate pain in those suffering with incurable cases. Depending on the dose and number of treatments, radiation can eliminate a tumor and prevent it from recurring. For cancers that have extensive metastases (stage IV and higher), radiation is used to shrink tumors and relieve pain (like in cases where a tumor grows near the spine).
There are several different methods used to introduce radiation into the body. For breast cancer, the most common type used is external beam radiation. In this form of radiation therapy, the doctor aims a large machine, called a linear particle accelerator, that releases a beam of high-energy radiation to pre-marked areas on the skin. The doctor will position your body, sometimes in awkward angles, and you will be required to remain very still so the radiation will pass over the cancerous area with minimal exposure to healthy areas. External beam radiation is done several times a week for several weeks, depending on the patient’s case.
Internal radiation is a newer method wherein radiation comes from inside the body rather from an external source. Also known as partial-breast radiation or brachytherapy, internal radiation is often given after a lumpectomy. To perform this treatment, the doctor implants radioactive ‘seeds’ or pellets into the body near the tumor and leaves them for a time so that the seeds will irradiate the cancer cells. For breast cancer, the radioactive pellets are planted under the chest or just below the underarms. Since they must be inserted and removed several times throughout the treatment, the pellets are placed inside the body using a catheter. The main advantage of internal radiation is that it has shorter treatment times. In addition, healthy cells have less exposure to radiation in this method. Unlike external radiation, which is typically only performed once, internal radiation can be performed more than once. Although the long-term effects of internal radiation treatment for breast cancer are still being studied, early reports show that the method is quite promising.
Another method of treatment is intraoperative radiation. This procedure involves treatment with radiation from a linear accelerator or a radiation machine, shortly after lumpectomy. It requires specialized treatment; thus, it is only available in select health facilities.
Specific Side Effects of Radiation
Your doctor will explain to you all the possible side effects of radiation before treatment. The immediate effect of radiation is changes to the skin, which is inevitable as radiation initially passes through it. Radiation can cause the skin to incur damage that resembles a second-degree burn or a severe sunburn. Soon after the treatment, the skin may start to swell, turn red, and form blisters. Since radiation treatments are performed repeatedly, skin irritation and pain persists for a time. After treatment, some patients find that the previously affected skin is darker and more sensitive.
Aside from skin changes, radiation therapy can also cause other side effects. Some of these side effects include:
Many patients suffer from intolerable fatigue soon after radiation treatment. Fatigue can be also caused by chemotherapy, which is sometimes done concurrently with radiation. It often worsens as the patient goes through the treatment. In some cases, fatigue may persist long after the radiation session has ended.
Patients often report a lack of energy and an inability to perform exercises or other physical activities. Patients have also reported experiencing severe fatigue for the two hours following their radiation session. It may be caused by intensive repair being done by the body to its tissues due to damage from radiation exposure.
Fatigue can also be caused by anemia, lack of sleep, poor nutrition, and pain – things that are also typical in cancer patients. Note that fatigue can also be caused by medicines used to relieve cancer pain as well.
Another side effect of radiation therapy is eating issues; however, this is uncommon in breast cancer patients receiving radiation therapy unless they are receiving higher doses in their treatment. Patient may develop mouth sores that interfere with chewing and swallowing.
Some also experience frequent nausea and vomiting, which cause problems in nutrition. Eating problems are more commonly seen in breast cancer patients receiving chemotherapy.
Radiation treatment can block some of the lymph vessels near the breasts, causing buildup of lymph that results in swelling. This is called lymphedema. Some of its signs and symptoms include:
- Tingling, pain, or increased warmth in the arm, hand, chest, or breast.
- Bursting pain or shooting sensations
- Trouble fitting into a bras or clothing.
How to Cope
Here are some useful tips to deal with the side effects of radiation therapy for breast cancer:
- Irritated, swollen, and blistering skin is very sensitive. Avoid wearing restrictive, rough-textured, or stiff clothing that can squeeze or abrade the area. Wear loose clothing made from soft, loose fabrics.
- If the area must be bandaged, only use paper tapes or special bandages for very sensitive skin. Tape the bandage outside the affected area. Do not scratch, rub, or scrub the affected skin.
- Make sure to shield the affected skin from the sun, which worsens irritation. Wear dark clothing to shield the skin from sun’s ultraviolet rays.
- To wash the affected area, let water and mild soap run on it. Do not rub or scrub the area. Using regular bath soap can cause irritation. Ask your doctor for a good mild soap to use.
- It can be really difficult to chew and swallow at this time. To reduce chances of poor nutrition, eat foods that are high in protein and calories.
- To reduce pain caused by mouth sores – avoid tart, sour, or salty foods. It is also recommended that you avoid canned items or foods containing vinegar and tomatoes.
- You can reduce the likelihood of developing new mouth sores by not eating rough-textured foods like dry toast, potato chips, raw fruits and vegetables, crackers, and granola.
- Avoid irritants such as alcohol, tobacco, caffeine, curry, chili, hot sauce, pepper, and nutmeg. You may have to try different spice to figure out which ones are not irritating to you.
- Soft and creamy items – like custards, cheese, mashed potatoes, yogurt, eggs, puddings, cooked cereals, and ice cream are well tolerated and easy to swallow. It is recommended to eat more of these items.
- Elevate your arm to promote drainage of lymph. Use a doctor-prescribed garment to control swelling.
- Ask your doctor or nurse to teach you how to do manual lymphatic drainage. This method involves light touches to move excess lymph fluid out of the tissues.
- It is very important to be extra cautious and avoid cuts or injuries to the arm or chest; such injuries will take a very long time to heal.
- Gradual increases in exercise have been known to benefit lymphedema.
These side effects can prove both physically and emotionally draining for the patient. Doctors and nurses are fully aware of these symptoms and will monitor them and provide treatments.