Out of all cancers, breast cancer is the most common among women in India. The major treatment pillars of breast cancer are surgery, chemotherapy, radiotherapy, targeted therapy and hormonal therapy. The majority of patients receive radiation therapy as part of their treatment plan.
Radiation therapy for breast cancer
Radiation therapy involves the use of high-energy rays to treat the disease. These beams can be high-energy photons (otherwise X-rays), electrons or protons to deliver the radiation dose. The mechanism of radiation therapy is killing the tumour cells or inhibiting their growth and division. Breast cancer is typically treated using a technique called external beam radiation therapy involving large machines known as linear accelerators (LINAC) to deliver beams of radiation to a specific area.
The need for radiation treatment for breast cancer
Radiation therapy involves the treatment of local and/or regional areas for microscopic diseases. It is an integral part of ‘Breast Conservations Treatment’ which involves a combination of ‘Breast-Conserving Surgery and Radiotherapy’. Radiation therapy is also indicated after mastectomy which is the removal of the entire breast depending on post-operative histopathological features.
Preparation for radiation therapy
Post the registration for treatment, you will have a simulation appointment. During this time, you will undergo a CT scan of the area, that needs irradiation. In most cases, a thermoplastic cast is made for immobilisation during treatment. Sometimes a breath-hold technique is used to minimise motion from breathing and to protect the heart. This is done by inflating the lungs with air and pushing the heart away from the chest wall where most of the radiation dosage is administered.
Duration of treatment
The total duration of radiotherapy treatment for breast cancer lasts for 3 to 5 weeks.
Techniques/variations for radiotherapy treatment
There are many techniques for radiotherapy treatment, such as:
- 3-dimensional Conformal Radiotherapy (3DCRT)
- Intensity Modulated Radiotherapy (IMRT)
- Image Guided Radiotherapy (IGRT)
- Volumetric Arc Radiotherapy (VMAT)
- Deep Inspiratory Breath Hold (DIBH)
During the radiation treatments
At the beginning of each treatment session, you will lie on a treatment couch which will be exactly like how you were during your simulation appointment. Once the position and radiation shifts are verified the therapists will leave the room during the treatment but throughout, they will always be in communication with you. The total time spent on the machine will be approximately 10-15 minutes. Radiation therapy is painless. It is similar to an X-ray. You will not feel anything.
Side effects of breast cancer radiotherapy
These can vary from person to person and depend upon the area and treatment volume. Common side effects of radiation therapy for breast cancer patients include fatigue, skin changes, discomfort in the treated breast and occasionally difficulty in swallowing.
Precautions to take during radiation treatments
Some precautionary measures are given here, but are not limited to. Hence, a proper consultation is necessary.
- Do not rub the radiation area. You can bathe, shower or shampoo as usual however the skin over the treatment area must be under care and you can gently towel dry and not rub. Do not scratch or apply a razor over the treatment area.
- Apply only those lotions which your radiation oncologist will recommend. These are safe during radiation treatment. Apply the prescribed cream 2/3 times a day. Avoid using it before receiving radiation therapy. Do not use any other cream lotion or deodorants.
- Wear cotton and loose clothing. For clothing next to your skin, cotton is best. Avoid tight clothing. Do not allow clothes to rub the treated area, especially irritating straps.
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