Before Beginning Radiation Therapy
You will have at least two important appointments before you begin radiation treatments. Your first visit with your radiation oncologist will be a consultation. Bring any information you have about your medical history and a list of your medications. Your radiation oncologist will examine you and discuss your treatment options with you, to choose the best treatment plan for your breast cancer diagnosis. Your second visit to your radiation oncologist will be a simulation session (SIM). You will have a CAT scan of the treatment area and if you will use a mold or removable cast for accurate positioning, that will be made. Skin markings or tattoos will be made on the skin above your treatment area, to help your technician aim the energy for your radiation treatments.
How Radiation Therapy Is Scheduled
Radiation treatments use high-energy beams of radiation to target your surgery area and destroy any cancer cells that may remain. Radiation treatments may also be used to shrink a tumor before surgery, to spare breast tissue. Each treatment is done in a radiation oncology clinic during a scheduled session. Treatments are painless and relatively quick. You may develop side effects from radiation treatments, but with care those will diminish as you recover. The total amount of time you will need to complete your radiation therapy depends on which method is used to treat you.
Radiation Treatment Methods and Appointment Schedules
- External Beam Radiation: A standard course of breast radiation treatments are scheduled every weekday for six or seven weeks. Each session should take 30 minutes or less.
- Accelerated Breast Irradiation: For whole or partial external breast radiation, treatments will be set up every weekday for three weeks. If larger doses of radiation can be given, you may receive the whole dosage over five days.
- Brachytherapy - Internal Breast Radiation: Using special catheters, breast brachytherapy can be completed with twice-daily treatments for five days. At the end of the final session, your catheter can be removed and the incision will be cleaned and closed.
Radiation During Breast Surgery
Intraoperative radiation therapy (IORT) is an experimental radiation technique in clinical trials in the United States. IORT uses one large dose of radiation, given directly into the tumor bed, after the tumor has been removed with a lumpectomy and the incision is still open. You will have one treatment only, if you qualify for this type of treatment.
Asking For Help Between Radiation Treatments
Between radiation appointments, if you have trouble with side effects don't hesitate to call your clinic and ask for help. You may develop some fatigue, breast pain, or skin reactions. Be sure to ask how you can prevent radiation side effects with proper skin care. Your radiation technicians and nurses will know many tips for coping with side effects, so be sure to ask them for help, even if you don't have a scheduled appointment. List your symptoms - along with duration, severity, and frequency of occurrence - before you call for help. This makes it easier for your nurses to suggest ways to make you feel better.
Detailed Guide: Breast Cancer. Radiation Therapy. American Cancer Society. Last Revised: 03/02/2009.
Long-term cosmetic results and toxicity after accelerated partial breast irradiation: a method of radiation delivery by interstitial brachytherapy for the treatment of early-stage breast carcinoma. Chen, P.Y., et al., Cancer, 2006. 106(5): p. 991-9.