Radiation therapy is targeted local treatment of your cancer field. It eliminates any cancer cell that is left in and around where your tumor was located. It has been shown that a woman who receives radiation greatly improves her chance of living recurrence free.

Radiation treatments have limited side effects and some women get them and some don’t. The biggest drawback is the fact that you have to go every day, five days a week , Monday through Friday, with the weekend off, for as long as 8 weeks.

Note: The treatments themselves last for only a minute or so and do not hurt.

Before your first treatment you will be mapped. What this entails is an x-ray or a CT scan that shows the doctor where your lungs and heart are. They measure to see exactly where they need to point the beam in order to avoid those organs. You will be marked with small, permanent tattoos that look like dots on your skin.

The actual treatment is really very easy. You lie on a table that has a large machine above it. The technician makes sure the marks on your body match up with the machine and then they leave the room and turn on the radiation. This takes only a moment. You then get up and go on with the rest of your day.

You will have the side effect of fatigue. Eating a high protein diet helps fight radiation fatigue.

There are several types of radiation available. The gold standard is external radiation, which is what is described above. However, radiologists are constantly studying better ways to deliver radiation to a tumor site. These newer types include implanted radiation, where the radioactive material is stored in a small seed-like material that is then implanted into the tumor area.

The seeds give off a slow, continuous dose of radiation. It is being studied to see if this method of delivery is better than external radiation. It certainly is more targeted.

Implanted radiation is known as "brachytherapy", which means “short distance,” referring to the fact that the radiation is placed in close proximity to the cancer site itself. This means that no healthy tissue or organs are affected. The seeds that hold the radioactive material, once in place, are highly targeted and very precise.

For advanced disease, there is another emerging therapy― Targeted therapy― that protects vital organs and healthy tissue. This is radiation therapy given with the assistance of a CT Scan machine. Computer Tomography, which is what CT scan stands for, uses its ability to view the body’s internal organs in three dimension to find the exact location of the tumor. Then, with precise measurements pinpointed, 360 degree beams of radiation are given to the tumor alone, and nothing else is affected. Even breathing does not affect the accuracy of this technique. This is cutting edge radiation treatment.

External Radiation’s Worst Side Effect

With traditional external radiation, some women get burns. They range from a slight tingling sensation to blisters and peeling. There are several creams that help this. Aloe Vera used to be the only cream recommended. However, its helpfulness is extremely limited. Ask your radiation oncologist about the more advanced creams before your radiation even begins. One highly recommended cream is Biafine RE cream.

Biafine was first invented for the United States Armed forces to combat the effects of radiation that may be encountered during modern warfare. It was then discovered that it combats the effects of radiation that is encountered during modern warfare against cancer. It actually reduces and often prevents burning from radiation therapy if it is started first prophylactically and used daily.

Another good option is an excellent burn cream called Silvadene. It works very well too.

If you do get burned, there are things you can do. Your radiologist’s office will be able to give you gel pads to put on your burned areas. If they do not stock them ask for a prescription.

It is important to be comfortable during this time, and wearing a bra may not fall into that category. Cotton is really the least irritating next to your skin.

Important Medical Note: If you have a collagen vascular disease such as Lupus, Scleroderma, or rheumatoid arthritis, then radiation must be avoided. It can result in scarring as well as skin ulcerations. Your doctor will know which is the best course for you.

Why Do Radiation?

Scientific research has shown that radiotherapy should be seriously considered by all women being treated for breast cancer. The following appeared in The Lancet

Summary: A new analysis of dozens of breast cancer studies shows that adding radiation to breast cancer treatment doesn't just lower a woman's risk of having a relapse, it also improves survival. The findings were published in The Lancet.

Why it's important: Radiation is standard treatment after breast-conserving surgery (lumpectomy) and is recommended after mastectomy for women with large tumors or whose cancer has spread to many lymph nodes. But many women skip radiation treatment. This study helps explain why they shouldn't.

"These data help strengthen the argument that there is a substantial benefit to radiotherapy [after lumpectomy] and that it should be a rare patient with a very low risk of recurrence or a very short expected life span for whom it should be eliminated," said Christy Russell, MD, chair of the American Cancer Society's Breast Cancer Advisory Group and co-director of the University of Southern California Norris Breast Center. She was not involved in the research.

The study also helps doctors better understand which mastectomy patients could most benefit from radiation, she added.

What's already known: A Canadian study published last year found that radiation after mastectomy could improve survival for women with high-risk breast cancer. But most studies of radiation after any type of breast cancer surgery only showed that the treatment could reduce recurrences -- they didn't show that the treatment helped women live longer. Because this new study includes data from dozens of other studies and thousands of women, it was able to detect a benefit previous research couldn't.

"I believe what this paper does is confirm and add to the data that prevention of a local recurrence can improve your chances of surviving breast cancer," Russell said.

How this study was done: Researchers from the Early Breast Cancer Trialists' Collaborative Group looked at the results of 78 clinical trials involving 42,000 women. The studies had compared different treatment strategies after initial breast cancer surgery: radiation vs. no radiation, more vs. less surgery (with and without radiation), and more surgery vs. radiation. The researchers combined the information from these studies to figure out how much benefit radiation provided in the short-term and the long-term.

What was found: The analysis showed that for every 4 local recurrences prevented by radiation, 1 breast cancer death could be prevented over 15 years.

Among the 7,300 women treated with breast-conserving surgery, radiation reduced the risk of having a relapse in the next 5 years from 26% to just 7%. The risk of dying from breast cancer over the next 15 years dropped from 35.9% to 30.5%.

For the 8,500 women who had a mastectomy, radiotherapy reduced the 5-year risk of local recurrence from 23% to just 6%, and reduced the 15-year risk of death from breast cancer from 60.1% to 54.7%.

The benefits were greatest for women whose cancer had spread to the lymph nodes, and those with larger tumors or higher grade tumors.

The bottom line: Russell said medical oncologists can use the data in this new analysis to help their patients make decisions about whether to seek radiotherapy after breast cancer surgery.

She cautions, though, that the large benefits seen in this analysis may be lower in today's patients.

"Current hormone therapies and chemotherapy regimens are better in reducing local recurrence than those that were used in the clinical trials presented," she explained. "Both those therapies, if used, may make the benefit of radiation therapy less significant with regards to both local recurrence and breast cancer-specific survival."

Citation: "Effects of Radiotherapy and of Differences in the Extent of Surgery for Early Breast Cancer on Local Recurrence and 15-year Survival: An Overview of the Randomised Trials." Published in the Dec. 17, 2005, The Lancet (Vol. 366, No. 9503: 2087-2106). First author: Early Breast Cancer Trialists' Collaborative Group.

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