Radiation Therapy for Breast Cancer: What to Know

Radiation therapy is one treatment option your doctor might suggest for your HR+/HER2- breast cancer. Radiation uses high-energy electromagnetic waves and particles to damage the DNA of your cancer cells. This damage either kills the cancer cells or slows their growth over time.

Some radiation is external, which means a machine sends a beam of radiation into your body where the cancer cells are. This is the most common type of radiation. Another type is internal radiation, or brachytherapy. If you have surgery to remove a tumor, your doctor puts a radiation device into your breast that emits radiation from inside your body.

The larger and more widely spread your cancer is in your body, the higher the chance your doctor will suggest radiation. Earlier stages of breast cancer (stage 0 or I) are less likely to need radiation than higher stages, but doctors use it for all stages. If you have a lumpectomy, you'll have radiation in the area afterward to lower your risk of recurrence.

A radiation session happens in a cancer center, radiation center, or hospital. Sessions are short. Your doctor may tell you to plan to be there for 30-60 minutes, but the radiation itself is only a few minutes long. Typically, you take off your shirt and the radiation therapist marks the area with a marker or ink. You'll lie very still on a table during your session and may be asked to hold your breath. A radiation therapist operates the machine from another room. Radiation therapy isn't painful. You shouldn't feel anything when you have it.

The number of radiation sessions you need will depend on how high a dose of radiation your doctor gives you at each session. Most commonly, people get radiation once a day, five days a week, for three to five weeks. This means you'd have 15 to 25 sessions total. Sometimes, but not often, doctors will recommend seven weeks of sessions.

You may want to find someone to give you a ride to and from your sessions. Also be sure to check with your insurance to see what is covered and what to expect in terms of paying for treatment. Have some easy snacks or meals prepared ahead at home so you can focus on resting and recovering for your next session.

If you're feeling anxious or worried during your session, let your radiation therapist know. They can pause the session and start again. Some centers offer music during sessions. You might find this calming or pleasantly distracting. Wear clothes you can take off easily, and follow all the prep instructions your center gives you.

Typically, you won't feel any different just after you have a radiation session. Note that if you have internal radiation, your body will give off radiation while the treatment is active, and you may have to limit contact with people during that time. External radiation doesn't make you radioactive.

The most common side effects people have while they're getting radiation therapy are fatigue, skinirritation, and skin color changes. Your skin might get rough to the touch, turn red, flake, or peel. Some people have pain in the breast that has radiation therapy.

Plan to be tired for the weeks you're having radiation. If possible, take some time off of work or shorten your hours. Some people don't have fatigue, but if you do, you'll have the time to rest. Keep your clothing loose and breathable, and wash only with lukewarm water and mild soap in your radiation area.

Don't use any deodorants, lotions, or other products while you're going through radiation. Not only can they irritate your skin, they may create a film that could interfere with your radiation treatments. If possible, try to maintain the same weight the whole time. Doctors use very precise measurements when mapping out where to point the radiation beam.

Radiation takes time to work. It continues to damage DNA in cancer cells for weeks or even months after your sessions are done. Your doctor will schedule follow-up appointments with you. You may have side effects that happen after treatment ends, such as spider veins, swelling, changes in breast size, and long-term fatigue. This is all normal, but talk to your doctor if your side effects are impacting your quality of life.