Everything You Need to Know: Radiation Therapy for Breast Cancer with Dr. LaCouture
Radiation therapy is an essential component of treatment for many patients battling different types and stages of cancer. It targets the affected area for those who are at risk for remaining cancer cells and reoccurrence.
Below, Dr. Tamara LaCouture, Medical Director of Radiation Oncology at the Sidney Kimmel Cancer Center – Washington Township, shares everything we need to know about how radiation therapy plays a role in breast cancer treatment.
When is radiation used for breast cancer?
It’s used for the majority of women who undergo breast conservation surgery – or lumpectomies. What many people don’t know is that it may also be used after mastectomy – removal of the whole breast(s) – and for metastatic cancer (cancer that spreads to other areas of the body).
What type of radiation therapy is most commonly used for breast cancer?
We use standard photon therapy, in what we call a “conformal” way, meaning we maximize energy to the at-risk area(s) and minimize the energy to surrounding areas. We target the specific area using what we know about the patients’ anatomy and the location of the cancer, as well as analyzing x-rays and CAT scans, to see inside the tissue/inside the chest.
Why might radiation be needed in addition to chemotherapy?
Chemo combats cancer cells throughout the entire body, whereas radiation works in a specific area, such as the breast and surrounding tissue. Many studies have shown over the past few decades that even after surgery, chemo, and hormone therapy, some women still have an increased risk of cancer reoccurrence that radiation can help reduce.
When is radiation given, and how long does it last?
For patients who require both chemo and radiation, chemo always comes first, whether it’s before or after surgery. For others, radiation would begin between four and six weeks following surgery, making sure the patient has enough time to heal. Radiation can be given for as little as one week, twice a day, to as much as six and a half weeks, once a day. It depends on the size of the tumor and location being treated.
How can a patient prepare for radiation?
We always explain to patients the importance of skin hygiene to minimize the risk of radiation reaction. We also have some patients do physical and/or occupational therapy, bettering their range of motion, especially after a mastectomy. During radiation, they’ll need to get their elbow higher than their shoulder, which takes practice before it becomes comfortable. They should also know that they’ll be fitted for an immobilizing cushion, sort of like a bean bag, that will form to the shape of their body and help position them for each treatment.
Are there any side effects?
The most common side effect is skin irritation. It’s like you’ve sat in the sun for 15 minutes a day, every day, for a period of four to six weeks. It only effects the skin in the radiation areas, and it takes a couple of weeks to appear. This irritation is generally mild and can be managed with topical creams and gentle moisturizing soaps. There are very few patients, due to their specific cancer or sensitivity levels, that develop more of a blistering burn, but it is still manageable.
It's a common misconception that you’ll experience extreme fatigue with radiation. This is sometimes true for women who have undergone surgery, chemo, and other therapies – it’s a long, tiring process. However, the vast majority of women only experience mild fatigue, if any.
Can radiation help treat metastatic breast cancer?
Yes. It can greatly reduce pain and improve quality of life. There are two reasons to use radiation for metastatic breast cancer: it spread to the bones, or it spread to the brain. Radiation is an effective treatment for killing cancer cells in the bone; studies show that more than three quarters of patients see significant improvement. For brain metastases, we use stereotactic radiation, which treats brain lesions in a single session, killing cancer cells and reducing neurological side effects.