- Breast Cancer: Radiation Therapy: What to Expect Center
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- Introduction
- When Is Radiation Therapy Given?
- What Happens On Treatment Days?
- How Will The Radiation Therapist Know I Am In The Correct Position?
- Why Are There Marks On My Skin?
- Will My Diet Make A Difference On The Effect Of My Treatment?
- What Side Effects Will I Have?
- How Can I Reduce Skin Reactions?
- Will Radiation Therapy Make Me Tired?
- Who Can I Contact If I Have Personal Concerns About My Treatment?
- What About Follow-Up Care?
Introduction
Radiation therapy is a form of cancer treatment that uses high levels of radiation to kill cancer cells or keep them from growing and dividing -- while minimizing damage to healthy cells.
Radiation is delivered to the affected breast and, in some cases, to the lymph nodes under the arm or at the collarbone.
When Is Radiation Therapy Given?
Radiation therapy is usually given after a lumpectomy and sometimes after a mastectomy to reduce your risk of local recurrence of cancer in that breast. The treatments generally start several weeks after the surgery so the area has some time to heal. If your doctor recommends chemotherapy along with radiation therapy, this might be given before you start radiation therapy.
Once radiation treatments start, you can expect to receive small daily doses of radiation over a period of several days to several weeks.
What Happens On Treatment Days?
The radiation therapist will escort you into the treatment room. The therapist will help you onto the treatment table and help place you in the correct treatment position. Once the therapist is sure you are positioned correctly, he or she will leave the room and start the radiation treatment.
You will be under constant observation during the treatment. Cameras and an intercom are in the treatment room, so the therapist can always see and hear you. If you should have a problem, you can let the therapist know. It is very important that you remain still and relaxed during treatment.
The therapist will be in and out of the room to reposition the machine and change your position. The treatment machine will not touch you and you will feel nothing during the treatment. Once your treatment is complete, the therapist will help you get off the treatment table.
How Will The Radiation Therapist Know I Am In The Correct Position?
The radiation therapist will take a "port film," also known as an X-ray, on the first day of treatment and approximately every week thereafter. Port films verify that you are being accurately positioned during your treatments.
Port films do not provide diagnostic information, so radiation therapists cannot learn about your progress from these films. However, port films are important to help the therapists maintain precision in your treatment.
Why Are There Marks On My Skin?
Small marks resembling freckles will be tattooed on your skin along the treatment area by the radiation therapist. These marks provide a permanent outline of your treatment area. Do not try to wash these marks off or retouch them if they fade. The therapist will remark the treatment area when necessary.
Will My Diet Make A Difference On The Effect Of My Treatment?
Yes. Good nutrition is an important part of recovering from the side effects of radiation therapy. When you are eating well, you have the energy to do the activities you want to do, and your body is able to heal and fight infection. Most importantly, good nutrition can give you a sense of well-being. Since eating when you don't feel well can be difficult, a dietitian can help you find ways to get the nutrients you need during your radiation therapy.
What Side Effects Will I Have?
During your treatment, radiation must pass through your skin. You may notice some skin changes in the area exposed to radiation. Your skin may become red, swollen, warm, and sensitive -- as if you had a sunburn. It may peel or become moist and tender. Depending on the dose of radiation you receive, you may notice a loss of hair or decreased perspiration within the treated area.
These skin reactions are common and temporary -- they will subside gradually within four to six weeks of completing treatment. If skin changes appear outside the treated area, inform your doctor or primary nurse.
Long-term side effects, which can last up to a year or longer after treatment, may include a slight darkening of the skin, enlarged pores on the breast, increased or decreased sensitivity of the skin, a thickening of breast tissue or skin, and a change in the size of the breast.

QUESTION
A lump in the breast is almost always cancer. See AnswerHow Can I Reduce Skin Reactions?
- Gently cleanse the treated area using lukewarm water and a mild soap such as Ivory, Dove, Neutrogena, Basis, Castille, or Aveeno Oatmeal Soap. Do not rub your skin. Pat your skin dry with a soft towel or use a hair dryer on a cool setting.
- Do not scratch or rub the treated area.
- Do not apply any ointment, cream, lotion or powder to the treated area unless your radiation oncologist or nurse has prescribed it.
- Do not apply cosmetics, shaving lotions, perfumes, or deodorants on the treated area.
- Use only an electric razor if you need to shave within the treated area.
- Do not wear tight-fitting clothing or clothes made from harsh fabrics such as wool or corduroy -- these fabrics can irritate the skin. Instead, choose clothes made from natural fibers such as cotton.
- Do not apply medical tape or bandages to the treated area.
- Do not expose the treated area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle or ice pack.
Will Radiation Therapy Make Me Tired?
Everyone has a different level of energy, so radiation treatment will affect each patient differently. Patients frequently experience fatigue after several weeks of treatment. For most patients, this fatigue is mild. However, a loss of energy may require other patients to change their daily routine.
If your doctor thinks it may be necessary for you to limit your activity, he or she will discuss it with you.
To minimize fatigue while you are receiving radiation treatment:
- Be sure to get enough rest.
- Eat a well-balanced, nutritious diet.
- Pace your activities and plan frequent rest periods.
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Who Can I Contact If I Have Personal Concerns About My Treatment?
Generally, a social worker will be available to help you during your course of treatment.
The social worker can discuss any emotional issues or other concerns about your treatment or your personal situation. The social worker can also discuss housing or transportation needs or appropriate resources if necessary.
People dealing with certain medical issues often find it helpful to share experiences with others in the same situation. Your physician can provide a list of support groups if you are interested. Your social worker can provide additional information about more support groups that may be of value to you.
What About Follow-Up Care?
After your radiation therapy sessions are complete, you will visit your doctor for periodic follow-up exams and diagnostic X-rays. Your doctor will tell you how often to schedule your follow-up appointments.
Reviewed by the doctors at The Cleveland Clinic Taussig Cancer Center.
Edited by Charlotte E. Grayson, MD, WebMD, February 2004.
Portions of this page © The Cleveland Clinic 2000-2004

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Breast Cancer
Breast cancer is an invasive tumor that develops in the mammary gland. Breast cancer is detected via mammograms, breast self-examination (BSE), biopsy, and specialized testing on breast cancer tissue. Treatment of breast cancer may involve surgery, radiation, hormone therapy, chemotherapy, and targeted therapy. Breast cancer risk may be lowered by managing controllable risk factors.
What you should know about breast cancer
- Breast cancer is the most common cancer among American women.
- One in every eight women in the United States develops breast cancer.
- There are many types of breast cancer that differ in their capability of spreading (metastasize) to other body tissues.
- The causes of breast cancer are unknown, although medical professionals have identified a number of risk factors.
- There are many different types of breast cancer.
- Breast cancer symptoms and signs include
- a lump in the breast or armpit,
- bloody nipple discharge,
- inverted nipple,
- orange-peel texture or dimpling of the breast's skin (peau d'orange),
- breast pain or sore nipple,
- swollen lymph nodes in the neck or armpit, and
- a change in the size or shape of the breast or nipple.
- Breast cancer can also be symptom free, which makes following national screening recommendations an important practice.
- Breast cancer is diagnosed during a physical exam, by a self-exam of the breasts, mammography, ultrasound testing, and biopsy.
- Treatment of breast cancer depends on the type of cancer and its stage (0-IV) and may involve surgery, radiation, or chemotherapy.
Breast Cancer Slides
Learn about breast cancer causes, symptoms, tests, recovery, and prevention. Discover the types of treatments such as surgery and drug therapies as well as the survival rate for breast cancer.Breast Reconstruction
After a mastectomy, breast reconstruction is performed to replace the skin, breast tissue, and the nipple. A patient's goals, medical conditions, cancer treatment, and previous surgery affect the type and timing of the reconstructive surgery.Can HER2-Positive Breast Cancer Be Cured?
HER2-positive breast cancer is associated with cancer cells that have extra copies of the HER2 gene and produce extra HER2 receptor proteins. With recent advances in medicine, it is considered that HER2-positive breast cancer is curable.Fatigue
Fatigue can be described in various ways. Sometimes fatigue is described as feeling a lack of energy and motivation (both mental and physical). The causes of fatigue are generally related to a variety of conditions or diseases, for example, anemia, mono, medications, sleep problems, cancer, anxiety, heart disease, and drug abuse.Treatment of fatigue is generally directed toward the condition or disease that is causing the fatigue.
Lymphedema
Lymphedema is a condition in which one or more extremities become swollen as the result of an impaired flow of the lymphatic system. There are two types of lymphedema: primary and secondary. Filariasis is the most common cause of lymphedema worldwide. In the U.S., breast cancer surgery is the most common cause. Symptoms include swelling of one or more limbs, cracked and thickening skin, and secondary bacterial or fungal infections of the skin. There is no cure for lymphedema.Male Breast Cancer
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Percutaneous endoscopic gastrostomy (PEG) is a surgical procedure used on patients who have difficulty swallowing. Percutaneous endoscopic gastrostomy (PEG) is generally performed in an outpatient facility or hospital. Possible complications with percutaneous endoscopic gastrostomy (PEG) include infection or leakage of the liquid diet fed through the tube.Pericarditis (Symptoms, ECG, Types, Causes, Treatment)
Pericarditis is the inflammation of the pericardial sac that surrounds the heart. The causes of pericarditis include injury from heart attack, heart surgery, trauma, viral or fungal infection, HIV, tumors, mixed connective tissue disease, metabolic disease, medication reactions, or unknown reasons. Treatment for pericarditis is generally medication, however, sometimes surgery is necessary.Radiation Therapy
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- rash,
- skin redness,
- permanent pigmentation,
- scarring,
- diarrhea, and
- a reduction in white blood cells.
What Are the Side Effects of Stereotactic Radiosurgery?
Stereotactic radiosurgery (SRS) is a radiation treatment that uses focused delivery of radiation in high doses to precise locations in the body. It is used to treat certain tumors and other abnormalities of the brain, spine, neck, lungs, liver, etc. This non-invasive approach helps spare healthy tissue while treating hard-to-reach areas.