Breast cancer radiotherapy, know the procedure & when needed

Apart from chemotherapy and surgery, radiation therapy or radiotherapy is also often recommended as an effective breast cancer treatment. What is the process and are there any side effects from radiotherapy that may arise?

What is breast cancer radiotherapy?

Radiotherapy is a treatment using high-energy X-rays such as protons or other particles to kill cancer cells, including breast cancer. This therapy is often used as a complement in the treatment of breast cancer, which is often done in conjunction with breast cancer surgery and chemotherapy.

In radiation therapy, the X-rays that are shot are painless and invisible. You also will not become radioactive after the treatment is done. Therefore, you will stay safe around children or pregnant women.

Radiation therapy can be used to treat patients in almost all stages of breast cancer. As the treatment progresses, radiation is directed directly to the site of the breast tumor, lymph nodes, or chest wall.

In this way, the spread of cancer cells can be stopped and the risk of recurrence can be reduced. In addition, radiation therapy can also relieve symptoms of breast cancer that has spread to other parts of the body.

When is breast cancer radiotherapy necessary?

Not all women with breast cancer need radiotherapy. This procedure is usually required at certain times or conditions, such as:

1. After a lumpectomy

Radiation therapy is generally performed after lumpectomy surgery. This procedure helps destroy any remaining cancer cells that were not removed during surgery, reducing the chances of the cancer growing back.

Lumpectomy combined with radiation therapy is often referred to as breast conservation therapy. Reporting from the Mayo Clinic, this therapy has proven to be as effective as surgical removal of the entire breast area (total mastectomy).

In this condition, the type of radiotherapy that is usually recommended by doctors, namely external radiation of the entire breast and partial radiation of the breast. External radiation to the whole breast can be given in five days for 5-6 weeks or shorter.

Meanwhile, partial breast radiation is generally performed on women with early stage breast cancer, both externally and internally. This treatment can last only about 1-2 times for 3-5 days.

2. After mastectomy

Breast cancer radiotherapy after mastectomy is usually given 5 days a week for 5-6 weeks. You will be advised to undergo radiotherapy after a mastectomy if:

• Breast cancer cells have spread to lymph nodes near the breast.
• Large tumor size, which is more than 5 cm.
• Cancer cells reappear in the tissue in the breast that has been removed.

3. When the cancer has spread

If breast cancer has spread to other parts of the body, radiotherapy can help shrink the tumor and relieve symptoms. However, this procedure is not recommended for those of you who:

• Have had radiotherapy in the same area.
• Have certain medical conditions that make you very sensitive to their effects.
• Is pregnant.

4. Advanced breast cancer

Radiotherapy is also often the treatment of advanced breast cancer to help treat:

• Breast tumors that cannot be removed surgically.
• Inflamed breast cancer, which is an aggressive type of cancer that spreads to the lymph ducts of the skin. Previously, the patient will be asked to do chemotherapy, mastectomy, and then radiation.

Different types of radiotherapy and procedures

Generally, radiation therapy is given in two ways, namely:

External radiotherapy

External radiation is most often used for breast cancer patients. In this type, a machine that is outside the body will emit radiation or X rays. The radiation will be directed directly to the area of ​​the body or breast that is affected by cancer.

During the procedure, you will be asked to lie down on a special board and after that the staff will take X-ray pictures or scan to make sure you are in the right position. Later, the machine will make a buzzing sound to indicate the procedure is running.

External radiotherapy usually lasts several minutes in each session. Breast cancer patients usually need to do this radiation therapy five times per week for 5-7 weeks.

Internal radiotherapy (brachytherapy)

Internal radiotherapy is performed by placing a radiation-containing device directly into the cancerous breast tissue. This device is installed for a certain period of time around the location of cancer cells or tumors.

To do this, the doctor will insert a narrow, hollow tube (catheter) into the breast tissue that has previously been removed through a surgical procedure. This catheter placement can be done simultaneously with breast cancer surgery or on a different day.

Then, a radioactive implant will be inserted through the tube and left for several days or inserted at a certain time each day. This procedure is performed depending on the size of the tumor, location, and various other factors.

Process before breast cancer radiotherapy

Radiation therapy is usually started 3-8 weeks after surgery, unless there is a plan for chemotherapy for breast cancer. If you are going to chemotherapy, radiotherapy is usually started 3-4 weeks after chemotherapy is finished.

Before performing this procedure, your doctor will first check your medical history and perform a physical examination to assess whether you will benefit from this radiation therapy. The doctor will also discuss the potential and side effects that you may experience with this therapy.

During the examination process, don't forget to tell your doctor about breast cancer herbal medicines, supplements, or other drugs that you may be taking. The reason is, certain supplements and drugs can have adverse side effects during breast cancer radiotherapy.

What to do after breast cancer radiotherapy?

After completing breast cancer radiotherapy, the doctor will schedule follow-up visits to monitor the progress of your condition. On this occasion, the doctor will also look for side effects that may arise due to radiation therapy and check for signs of breast cancer recurrence.

After the therapy is over, you should tell the medical staff if:

• Have constant pain.
• A new lump, bruise, rash, or swelling appears.
• Weight loss drastically for no apparent reason.
• Fever or cough that doesn't go away.

If there are other symptoms that appear, you can also immediately see a doctor for further tests.

Side effects of breast cancer radiotherapy that may occur

The side effects of radiotherapy for breast cancer on the body can appear in the short and long term. Here are some of the possible effects:

Short term side effects

Short-term side effects that commonly occur due to breast cancer radiotherapy include:

• Skin irritation in the exposed area, such as itching, redness, and peeling or blistering, such as sunburn.
• Fatigue.
• Swelling of the breast.
• Change in skin sensation.
• Loss of armpit hair if radiation is targeted to the underarm area.

These side effects are usually only temporary. You will gradually recover in the last weeks of treatment.

Long term side effects

Breast cancer radiotherapy can also cause long-term side effects. The skin of the breasts may appear darker and the skin pores may become larger. The skin may also be more or less sensitive and feel thicker and tighter.

Sometimes, the breasts may also become bigger due to the buildup of fluid or smaller due to scarring. Although long term, these side effects usually only occur for a year after radiation therapy.

However, if after that time your breasts are still not back to normal, tell your doctor right away to get the right treatment.

Rare side effects

If you have had lymph nodes removed prior to breast cancer radiotherapy, you are at risk of developing lymphedema or blockage of the lymph system. Lymphedema causes swelling of the arm where the lymph nodes are removed.

Other rare complications are:

• Ribs fracture due to weakened bone strength.
• Inflammation of the lung tissue.
• Heart damage when radiation is given to the left side of the chest.
• Other cancers caused by radiation.

Make sure you tell the radiation oncologist about any side effects associated with breast cancer radiotherapy.

Overcoming the side effects of breast cancer radiotherapy

The side effects of breast cancer radiotherapy are almost impossible to avoid. However, there are a number of things you can do to reduce these side effects.

• Wear loose clothing if you experience skin irritation.
• If wearing a bra, choose a bra without wires.
• Use a moisturizing, but fragrance-free, soap when you shower.
• Do not rub or scratch the affected skin.
• Avoid ice packs and heating pads on the affected skin. Use only warm water to wash the irritated skin area.
• Overcome fatigue by taking more time to rest.
• Maintain a healthy diet to help the body repair itself from the radiotherapy effects of breast cancer. This healthy lifestyle also helps you prevent breast cancer from coming back, because a bad lifestyle is one of the risk factors for breast cancer.