Radiotherapy - What is it and How it is Used?

Radiotherapy (or radiation therapy) uses high energy X-rays to kill cancer cells. Normal cells are also affected but to a lesser degree. The dose of radiotherapy needed is calculated by a specialist, called a radiotherapist, and depends upon the size of the cancer, its characteristics, and also the reason for giving the radiation treatment (see below). The patient does not become radioactive after treatment!
Radiation therapy is given for the following reasons:
. To reduce the likelihood of cancer coming back to the breast after surgery, i.e. to reduce the incidence of local recurrence.
. To treat breast cancers that cannot be removed by surgery, e.g. large tumours, fixed to the chest wall and/or ulcerating through to the breast skin.
. To treat cancer deposits in the bones and brain.
 

Will I Need to Have Radiotherapy?

Radiotherapy to the whole breast or chest wall is recommended for the following groups of patients:
. All patients treated by breast-conserving surgery (lumpectomy) for invasive or non-invasive breast cancer.
. Women undergoing total mastectomy whose armpit lymph glands (more than 3 glands) contain cancer.
. Women undergoing total mastectomy whose main invasive breast cancer extends to the edges of the wound site from where the tumour was removed surgically (called excision margins).
. Patients with large, inoperable cancers (radiotherapy may shrink the tumour down, making it suitable for surgery).
Radiotherapy also seems to reduce the risk of cancer developing in the same breast in women undergoing lumpectomy for non-invasive breast cancer (DCIS). However, radiotherapy is unnecessary for patients who are treated by total mastectomy for DCIS.
Radiotherapy to the area above the collarbone is recommended if the cancer involves more than three lymph glands in the armpit.
 

What does Radiotherapy Treatment Involve?

After the oncologist has made the decision regarding the need for radiotherapy, the patient is invited for a treatment planning session. During this meeting, the procedure is explained and the patient's questions are answered.
Before the first treatment, the area of the body to be treated is marked with ink. Each radiotherapy session usually lasts for only a few minutes. The patient will receive treatments for five days per week over a 5-6-week period. Radiotherapy is not painful but it may make the patient feel tired. The patient may continue to work if she feels well enough.
Radiotherapy can be associated with several side-effects, including the following:
. Changes in the skin colour over the treated area - it may become tanned, pale or red.
. Feeling tired or 'washed-out' - usually occurs during the mid-treatment programme and improves within weeks of finishing the therapy.
. Distortion of the breast at the surgical wound site - this is caused by tissue scarring owing to the radiotherapy. If the distortion is very severe, plastic surgery may be considered.
. Arm swelling (lymphoedema) - the risk is increased if it follows an axillary dissection.
. Inflammation of the lung (pneumonitis) - a rare problem and usually settles within a few weeks. Occasionally steroid drugs may be required.
 

Chemotherapy - What is it and How it is Used?

Chemotherapy is the use of drugs to kill cancer cells. The drugs used target the cells that are growing or dividing quickly, and cancer cells do both much faster than normal body cells. Chemotherapy drugs will also affect normal cells, but to a much lesser degree, and periods of rest when no treatment is given will allow the normal cells to recover. Chemotherapy is used to remove cancer cells that have escaped from the main breast tumour into the blood stream. If such cells are left, they can act as 'seeds' for new tumours and result in metastatic spread. These cells may not be detectable by physical examination, blood tests or by standard X-rays and scans. Chemotherapy can prolong life in patients with early invasive breast cancer.
 

Will I Need to Have Chemotherapy?

Chemotherapy is recommended following surgery for some groups of patients. This is called adjuvant chemotherapy, and is given to those fit patients (usually younger than 65 years) with:
. Breast cancer that has spread to the lymph glands in the armpit.
. Large invasive cancers.
. Aggressive, invasive cancers (grade 3+) especially cancers that lack hormone receptors.
Chemotherapy has been shown to be of particular benefit to younger women with breast cancer (i.e. of pre-menopausal age). Having said that, healthy post-menopausal women can also benefit.
Chemotherapy can be given before surgery to reduce the size of a cancer and allow its subsequent removal without the need for total mastectomy. This type of chemotherapy is known as neo-adjuvant. Chemotherapy may also be given to patients with widespread (metastatic) disease.



 

Next >          < Back