Radiotherapy Page 1
This section describes radiotherapy, one of the treatments that patients with breast cancer may be offered. In this section we aim to give information that will be helpful to you and your family and friends regarding radiotherapy treatment. We hope this will help you discuss your radiotherapy treatment with the doctors, nurses and therapeutic radiographers involved in your care. It is important to understand that there may be some differences between radiotherapy centres. Remember not to compare treatments with other patients, as each person’s treatment plan is tailor-made for them as an individual.
What is radiotherapy?
Radiotherapy is the use of high energy x-rays to treat cancer. These high-energy rays are produced by a machine called a linear accelerator and are able to damage and destroy cancer cells within the treatment area. Radiotherapy also affects normal cells in the area being treated, but they are generally better able to recover than cancer cells. Treatments are usually given regularly over a period of time to have the greatest effect on the cancer cells whilst limiting the damage to normal cells.
When is radiotherapy given?
It is important to remember that patients’ treatment plans vary. In most cases it is given after surgery to reduce the risk of cancer coming back by getting rid of any possible remaining cancer cells in the area. If you have a lump removed or a part of your breast removed you will most likely receive radiotherapy to the remaining breast tissue. If you have a mastectomy (removal of the whole breast) you may receive radiotherapy to the chest wall area if the tumour was large or cancer cells had spread to lymph nodes under the arm.
If you are to have chemotherapy a decision will be made as to when radiotherapy will be given. Radiotherapy may be given before, during or after chemotherapy, depending on the type of chemotherapy given. Radiotherapy cannot be given at the same time as some chemotherapy drugs. Your doctor will arrange your schedule according to which chemotherapy drugs you are on. Radiotherapy may also be used in more advanced stages of breast cancer. It can help to control previously untreated disease in the breast or help relieve cancer-related symptoms, such as pain caused by the cancer spreading to other parts of the body (secondary breast cancer). In these situations, the extent of treatment will depend on individual circumstances, but would usually be given over a much shorter period of time.
What about treatment arrangements?
It is recommended that radiotherapy starts about four to six weeks after surgery. It will usually be given daily, Monday to Friday, for a total of three to six weeks. Some centres treat patients on alternate days, rather than every day.
First you will see the radiotherapy specialist (radiation oncologist) in the outpatient department to talk about your treatment. A further appointment will be made to plan the treatment, and you will then be given a starting date.
Radiotherapy is a specialised treatment and so is not available in every hospital. However, each breast unit will have a link with a hospital that has a radiotherapy department. You will usually be treated as an outpatient. If you think you will have problems attending appointments, tell the radiotherapy staff. Sometimes transport can be arranged. It is important that treatment continues as planned and that you don’t miss any appointments. If, for example, you have a holiday booked, tell the specialist or radiographer who is treating you so that s/he can decide what arrangements to make.
The staff treating you will check how you are each day, but if you have any problems tell the therapeutic radiographer or nurse. An appointment can then be arranged with your specialist and/or breast care nurse if necessary.
Treatment planning
Treatment is individually planned for each patient, so do not compare treatment sites and number of treatments with other patients. Treatment planning, also known as simulation, identifies the exact area to be treated, using the maximum dose of radiation, while causing the fewest possible side effects to the patient.
A special x-ray machine called a Simulator is used for treatment planning. Each patient will be called to their radiotherapy centre for this planning. We understand that you may be nervous on this day, as it may be your first visit to your radiotherapy centre. Try to bring someone with you on this day for company and support. Remember to wear an old bra or vest as the markings from the treatment planning may stain your underwear and often these stains are difficult to remove.
You are also advised to have enough arm movement after your operation to allow you to raise your elbow to at least shoulder level so that you are comfortable in your treatment position. If you find this difficult ask to see a physiotherapist prior to starting treatment. If you are on pain medication take your painkillers before you go to your appointment.