Radiotherapy, or radiation (therapy), has been used for the treatment of breast cancer for decades. Thanks to advanced technology and improved techniques, radiotherapy can now be used very accurately and effectively.

How is the radiation administered?

The radiation is administered by means of a machine. Different kinds of machines are used, for example cobalt machines, linear accelerators or x-ray machines. 

The machines are fairly large, with moving parts that are used to radiate the breast from different angles. Some machines make a noise almost like an electric mixer. 

The treatment is like an x-ray examination, but it lasts longer. The patient must remain in a prescribed position without moving. 

This machine does not touch the patient or cause any sensation or discomfort. Although the patient is alone in the treatment room, the staff are in contact with the patient by means of a video camera and voice monitor.

Do all breast cancer patients need radiotherapy?

Radio therapy is usually recommended after a lumpectomy (partial mastectomy) and sometimes after a total mastectomy to destroy cancer cells that could still be present in the breast area or lymph nodes. Your medical team will assess whether you require radiotherapy.

• Surgery is followed by a recovery period. 
• Radiotherapy can start once the wound has healed. 

How many radiotherapy sessions will I need?

The number of treatment sessions depends on the radiation dose required. It is usually given over a period of 6-7 weeks, five days per week, Monday to Friday. 

To protect healthy tissue, the treatment is given in small doses, and lasts only a few minutes, but it takes a bit longer to place you in exactly the correct position.

What is a lumpectomy?

A lumpectomy involves the removal of the tumour and a small amount of surrounding tissue. 

It is always followed by radiation of the remaining area of the breast. This treatment is recommended in the early stages of breast cancer, when the tumour is still relatively small.

Who does radiotherapy? Is it a specialist?

The doctor in charge of the treatment is a radiotherapist, or radiation oncologist, a specialist in the treatment of cancer with radiation. 

The treatment is administered by a team of radiographers, who administer treatment as prescribed by the radiation oncologist. The team also includes nursing staff and technicians.

Radiotherapy is usually administered in small doses over a period of a few days or weeks, to limit damage to normal tissue. 

Feel free to discuss the following with the radiotherapist:

• The procedure and treatment programme that is recommended
• The purpose of the treatment
• The risks and side effects that are associated with the treatment
• How it will affect your appearance and how you will feel after treatment.

What are the side effects of radiotherapy?

Most patients do not experience significant side effects. Possible side effects depend on the nature of the treatment. 

The staff monitor patients closely to identify and handle problem areas:

• Fatigue can be expected, particularly towards the end of the treatment period. Most people continue their daily activities and work routine, but it is advisable to get enough rest, avoid stress and have balanced meals. If you follow a regular exercise programme, consult the medical team.
• You might have a slight swelling or feeling of heaviness in the breast. Sometimes the breast becomes smaller and firmer after radiotherapy.
• Skin irritation, like a minor degree of sunburn might occur on the treated areas about 12 hours after exposure. However modern techniques ensure that the electromagnetic rays used during radiation affect the skin as little as possible. In some cases, dryness and flaking of the skin may occur.

How can I treat the side effects of radiotherapy?

Most of the changes to the breast disappear after 6 -12 months during which your skin may be marked. Skin irritation should subside about two weeks after completion of treatment, although the skin might still be flaky. 

The treated area might feel a bit harder than the surrounding area.

• You can start applying unscented moisturising cream, using small circular motions. Use a creamy soap for washing the skin.
• Protect the skin on the treatment areas as much as possible. Avoid exposure to direct heat, sunlight, sunscreen containing alcohol, sun lamps and chemicals.
• Avoid infection, burns, injuries to the hand and arm, insect bites and tight elastic or jewellery around the affected arm. Consult your doctor before beginning to shave under your arms.
• Fatigue will lessen gradually, but adapt your activity level to your energy level. 
• Continue exercising the affected arm, for example by using that arm to comb your hair.

The radiotherapist will inform you about follow-up visits and breast self-examination. 

Follow-up visits every three to six months for three years are usually recommended, including regular mammograms.

For most women breast surgery and radiotherapy bring about a temporary interruption in their lives, after which they continue leading a full and productive life, with a normal routine. 

In many cases breast cancer is cured by surgery and radiotherapy, but radiotherapy also plays a major role in controlling symptoms and improving the quality of life of cancer-patients.