Breast cancer and radiotherapy – Exploring various aspects

Understanding Radiation therapy/ Radiotherapy for breast cancer.

Radiotherapy or radiation therapy employs high-energy rays, protons or other particles that target and selectively destroy the cancer cells. This hinders the uncontrolled growth of cancer cells and prevents its further spread. In radiotherapy treatment for breast cancer, the affected breast is radiated and, in some cases, also involving the lymph nodes (if affected) under the arm or at the collarbone.

Role of radiotherapy in Breast cancer treatment

Breast Radiotherapy is an integrated and multifaceted approach with an established role in reducing the local relapses in breast cancer patients. Not only radiotherapy controls tumor growth but it also reduces/shrinks the tumor-size simultaneously causing minimal damage to the adjacent normal tissues. Mostly, breast radiotherapy is given after surgery to reduce the risk of recurrence of breast cancer in the breast, chest area or lymph nodes. Although radiotherapy has side effects, it is considered as one of the effective treatments for breast cancer. There are various factors which determine the correct treatment regimen for breast cancer including patient’s age, existing medical conditions, overall health and even the stage, type, spread/metastasis of cancer, etc.

Conditions where radiotherapy is given

American Oncology Institute provides one of the top breast cancer radiotherapy treatment in Hisar embellished with modern technology and one of the best doctors in Hisar for breast cancer radiotherapy with their well-planned and customized treatment regimen for each patient.

The radiation oncologist i.e., doctor specialized in radiation therapy plans and decides the appropriate dose and treatment regimen for each patient receiving radiotherapy for breast cancer treatment. Radiotherapy for breast cancer is usually given after the surgical removal of tumor tissue from breast (lumpectomy) or sometimes entire removal of the breast tissue (mastectomy) to ensure complete removal of tumor plus any residual margins posing a risk of recurrence in future. A few weeks gap is given between the surgery and start of treatment to allow the operated area to heal enough. However, the treatment duration depends on several factors.

Radiation therapy for breast cancer can be indicated or given in several conditions such as:

• After lumpectomy (surgery which removes only the cancer tissue to conserve the breast-structure) – to help lower the chance of the cancer recurring in the same breast or nearby lymph nodes.
• After mastectomy (removal of the entire breast tissue) in conditions like:
• Tumor size > 5 cm (about 2 inches)
• Tumor has metastasized (spread) to lymph nodes
• Surgical margins with cancer such as the skin or muscle.
• Metastasized cancer to other parts of the body, such as the bones or brain.

Types of radiotherapy for breast cancer

American oncology Institute, backed-up with advanced technologies and techniques is one of the best breast cancer radiotherapy hospital in Hisar, and serves to provide high-string Radiotherapy for breast cancer in Hisar. The external beam radiotherapy and brachytherapy or internal radiation therapy are one among the radiotherapy techniques at American Oncology Institute.

The main types of radiation therapy that are used to treat breast cancer are:

• External beam radiation: One of the commonly used radiotherapy techniques that applies radiation externally to the breast and surrounding area. It is employed mostly for radiation of the whole breast (whole-breast irradiation) following lumpectomy. Previously, breast radiotherapy was done into everyday-basis fractional treatment for 5 days-a-week followed for 5-6 weeks. But the introduction of accelerated radiation approaches such as hypo-fractionated radiation therapy, the duration and treatment regimen are shortened. Studies have shown that this reduces breast cancer recurrences and the risk of some side effects.
• Internal radiation therapy (Brachytherapy): Brachytherapy differs from external beam that it uses needles/catheters and involves placing a small radioactive pellet or ‘seed’ through skin into the tumor tissue or near it for a short period. Later, beams of photons are shot to this area through the skin. This allows radiation delivery specifically to the tumor tissue, sparing the normal tissue. Few factors such as tumor size, it’s location, and other related factors may limit who receive brachytherapy.

Benefits of radiotherapy for Breast cancer

With the modern radiotherapy techniques, more precise and limited dose radiation can be delivered to tumor tissue ensuring minimal/no harm to the surrounding normal tissues. Technologies such as accelerated external beam radiation, have shown to shorten the duration of radiotherapy regimen and reduction in breast cancer recurrence and risks of side effects as well. Brachytherapy allows radiation delivery specifically to a cancerous tissue with a well-defined margin and spares the normal tissue. Radiotherapy in the treatment of breast cancer aids to conserve the unaffected breast tissue without sacrifice in terms of survival likelihood for women with locally advanced disease undergoing mastectomy.

In advanced cases of breast cancer, radiation therapy, if started early, can provide symptomatic relief to the patient and even prevent fractures of bones. Patients developing metastatic cancer to the bone, skin, selected lymph nodes, and other sites can achieve a complete remission when treated with radiation to the site of cancer recurrence.

Side effects of radiotherapy for breast cancer

Though radiotherapy is one of the effective treatments for breast cancer, patients undergoing radiotherapy may be associated with side effects. But these side effects may last from a few days to weeks or months depending on the radiation dose, duration of regimen and patient’s clinical condition.

Common side effects of breast cancer radiotherapy:

• Skin changes: Skin damage is a common side effect of radiation therapy, and having a good skincare routine is essential during treatment. Changes to the skin can include:
  • Changes in skin color
  • Flaking of skin
  • Tender, dry and itchy, sore skin
  • Red, swollen or warm skin
  • Blisters on skin
• Ways to manage skin problems:
  • Avoid rubbing or scratching the treated area/skin.
  • Use a soft towel to pat dry skin.
  • Apply ointment, cream, lotion, or powder only when prescribed by your radiation oncologist.
  • Do not apply cosmetics, shaving lotions, or perfumes on the treated area.
  • Avoid tight-fitting clothes, and woolen or corduroy which can irritate the skin. Prefer clothes made from natural fibers such as cotton.
  • Do not apply extreme heat or cold to the treated area. Prevent the area from sun exposure.
• Pain: Mild pain around the breast, or stiffness in the shoulder area but this subsides with time and treatment.
• Swelling: Mild swelling or inflammation (irritation and redness) of the treated breast or surrounding tissue may occur. Swelling usually reduces within a few weeks by the end of treatment.
• Hair loss in the armpit: This occurs due to the radiation applied to the lymph nodes in the armpit region, which results in hair loss in these areas. But the hair growth is regained after the discontinuation of radiotherapy.
• Soreness in mouth/ throat: Application of radiation to the lymph nodes around the collarbone can cause difficulty in swallowing and sometimes a sore throat or sore mouth. These symptoms subside after the treatment is over.
• Ways to manage mouth/throat soreness:
  • Prefer soft and greasy foods to avoid irritation to your mouth or throat, such as scrambled eggs, cheese, bananas, etc.
  • Avoid spicy, citrus and rough foods that irritate your mouth or
  • Fatigue and weakness: Undergoing treatment for cancer itself can make patients feel tired and exhausted accompanied with the other side effects of therapy.
• Ways to manage fatigue & weakness:
  • Take enough rest and sleep for at least 8 hours.
  • Try to be physically active with light exercise.
  • Avoid caffeine late time in a day.
  • Take a healthy diet rich in nutrients and keep yourself well hydrated.

Please remember these points and take care of your health while undergoing treatment:

• Side effects of radiotherapy and/or cancer treatment are usually short-lived and subside gradually after the treatment is completed.
• Get enough rest.
• Eat a well-balanced, nutritious diet. Good nutrition helps in healing and fighting-off infections.
• Take enough rest breaks during whole day.
• Take plenty of water and fluids anytime while on treatment, most of the side effects are controlled if your body is well hydrated.
• Avoid alcohol and tobacco use.
• Conditions not to ignore and immediately contact your doctor

If you observe any of these symptoms, do not ignore and immediately reach out to your nurse or doctor:

• Fever with temperature > 100.4 F or fever or chills.
• Newly arising cough not going away.
• Sore throat with dry, burning, scratchy sensation
• Bleeding gums, any new mouth sores or patches inside mouth.
• Changes in bladder habits, increased and frequent visits to loo, burning while peeing, or blood in your urine, etc.
• Bowel habit changes, indigestion or other digestion related changes, such as heartburn, nausea, vomiting, constipation, or diarrhea lasting more than 2 – 3 days, or blood in stools, etc.