Breast Cancer Radiation Therapy: What To Expect From Treatment And Recovery

Radiation therapy is a standard treatment for breast cancer. It uses high-energy rays to target and destroy cancer cells. This can help to either shrink existing tumors or prevent cancer from returning after surgery.

While radiation treatment isn’t painful, it can result in some short and long-term side effects. Understanding the side effects associated with radiation treatment and how to manage them can make the recovery period more comfortable for the patient.

What types of radiation treatments are recommended for breast cancer?

There are two primary types of radiation used to treat breast cancer.

External beam radiation

This type of radiation is administered via a machine. A technician will carefully calibrate the device to target the area of the body affected by cancer. This could be the whole breast, the lymph nodes, the chest wall, or another location your oncologist may choose to target.

External beam radiation is the most common type of radiation used in the treatment of breast cancer. Many patients with breast cancer undergo external beam radiation after initial surgery to remove cancerous tissues. The radiation can help destroy any remaining cancer cells and prevent cancer from returning.

These treatments usually last between two and ten weeks.

Brachytherapy

Brachytherapy is also known as internal radiation. Instead of using a machine to deliver the radiation externally, the oncologist places a catheter directly into or near the tissue affected by cancer. Then, radiation pellets are inserted into the catheter, exposing the affected area to radiation for a short amount of time. The pellets are then removed while the catheter remains in place for the subsequent treatment.

Brachytherapy typically happens twice a day for five days, but the timeline can vary depending on your oncologist's recommendations. Once the final treatment is complete, medical staff will remove the catheter.

When should radiation be used to treat breast cancer?

Radiation therapy is commonly used post-surgery to help destroy any remaining cancer cells and prevent cancer from returning to the site. Patients require three to eight weeks of recovery time to heal from the surgery before beginning radiation therapy.

The oncology team may also recommend chemotherapy. Patients usually wait to start radiation until the chemotherapy treatments are complete.

Radiation therapy can also treat breast cancer when surgery is not an option. It can also help treat breast cancer that has spread to other areas of the body, such as the lymph nodes.

While radiation therapy is commonly used to treat breast cancer, it may not be suitable for every patient. Your oncology team will work with you to develop a treatment plan based on your specific diagnosis and medical history.

What to expect when receiving radiation for breast cancer

During your first appointment, the technicians will take measurements of the treatment area. These precise measurements help minimize the amount of healthy tissue affected by the high-energy beams of radiation.

The team typically makes identifying marks on your skin to ensure they are targeting the right areas. They may also create a mold of your body to help keep you in the correct position during the treatment.

If you require brachytherapy treatments, the team will fit you with a catheter that will remain in place for the duration of your radiation therapy.

Setting up for the treatment will take longer than the radiation itself. Radiation therapy only takes a few minutes (or around 15 minutes for brachytherapy).

Your oncology team will monitor your progress throughout the treatment process, answer any questions you might have, and help keep you comfortable.

What are the side effects of radiation therapy for breast cancer?

While the initial treatment is painless, both external beam and brachytherapy radiation can have short and long-term side effects. Knowing what you could experience and how to manage those side effects can aid in your recovery process.

Short term effects of radiation therapy

The most common side effect after radiation therapy is fatigue. The level of fatigue will vary from person to person, depending on your lifestyle and treatment protocol. You'll want to get as much rest as you can throughout the radiation therapy process.

Consider asking friends or family to help with household tasks or errands. It may also be helpful to join a breast cancer support group to get tips and support from others who have also experienced the effects of radiation therapy.

Another common side effect of external beam radiation treatment is changes to the skin in the treatment area. You might find that the skin is red and tender immediately after the treatment. After a few days, the skin might start to blister, peel, or feel itchy.

These side effects should go away within a few weeks post-treatment. If they become bothersome, talk to your oncology team. They can recommend lotions to help alleviate the dry, itchy sensation. It is important not to expose the treatment area to sunlight and avoid hot showers or baths.

Long term effects of radiation therapy

Most patients experience no long-term side effects of radiation therapy. Most of the side effects tend to go away on their own within a few weeks of completing your treatment sessions.

However, some patients may notice a lasting skin discoloration in the treatment area. There is also a small risk of developing new cancer as a result of the radiation.

Other less common side effects include arm swelling (lymphedema), especially when lymph nodes are treated, damage to the brachial plexus (a bundle of nerves that branch into each arm), and inflammation and scarring of the lungs (known as radiation pneumonitis).

People receiving left breast radiation have a small risk of developing heart problems, but there are breath-holding techniques to shift the heart out of the radiation field, significantly reducing this risk.

Your age, how much radiation you receive, and the treatment area can all impact your risk. Talk to your oncology team to learn more about possible side effects and discuss any concerns you might have.

How to prepare for breast cancer radiation therapy

Radiation therapy can be physically and emotionally exhausting. It may also cause some uncomfortable side effects, especially on your skin. There are a few things you can do to prepare for breast cancer radiation therapy to help ease unwanted effects and speed your recovery.

Recruit help

Radiation therapy can cause extreme fatigue, so reach out to people who can help you keep up with daily tasks and errands. Family, friends, or neighbors can help watch your children, drop off a meal, or help with daily chores. 

Stock up on skincare

Previously, doctors recommended not using topical skincare treatments during radiation therapy due to fears it may increase the skin's radiation dose. But studies¹ have confirmed this is not the case when using approved creams moderately.

Talk to your oncology team about which lotions they'd recommend to help soothe your skin after radiation. Apply the cream moderately all over, not just on the areas affected by the radiation. 

Rest as much as possible

Both before and after radiation therapy. It's likely you won't have much energy to do much, so inform friends and family when you are too tired to participate in activities. Be gentle with yourself as your body recovers.

Nourish your body

Fill your cupboards and fridge with healthy, nourishing, and easy-to-prepare meals. Try to get extra protein and eat foods high in antioxidants, such as blueberries, strawberries, and kale. 

Stay comfortable

Your skin may feel especially sensitive during and after your radiation treatments. Many people find that loose-fitting, lightweight clothes are more comfortable to wear. 

What is the recovery process after radiation therapy for breast cancer?

Most people find that it takes a few weeks after their radiation therapy to start feeling normal again. This is the amount of time it takes for your body to process the radiation.

Consult your oncology team if side effects like fatigue and skin irritation are not dissipating within a few weeks. They may have suggestions that can help speed up your recovery. These symptoms may also be a sign that further treatment is required.

The lowdown

Radiation is a standard treatment option for breast cancer. While external beam radiation is most common, internal radiation via a catheter is also an effective option.

Radiation is often used after surgery to remove cancerous tissue in the breast by destroying any remaining cancer cells and preventing cancer from returning. Radiation may also help treat inoperable breast cancer or cancer that has spread to other areas of the body, such as the lymph nodes.

The radiation treatment itself usually only takes a few minutes. However, the radiation oncology team will need to make precise measurements to ensure high-energy beams target the cancerous cells and avoid healthy tissues.

Radiation treatments are painless but may cause side effects. The most common side effects are fatigue and skin irritation at the treatment site. For most people, these side effects go away within a few weeks after treatment. In the meantime, avoiding sunlight, getting plenty of rest, and applying lotion to the affected area can help.