1.1 About Radiotherapy
Radiotherapy is one of the methods commonly used to treat breast cancer. The principle of radiotherapy is to use ionizing radiation to irradiate cancer cells, causing their destruction and death.
In general, when cells are exposed to ionizing radiation, the genetic material within the cells can be damaged due to the effects of radiation. Normal cells have the ability to repair themselves, so even if the genetic material within the cells is damaged, normal cells can initiate self-repair processes to repair the damaged genes and restore the cells. However, cancer cells have limited self-repair ability, so when they are exposed to radiation, the damaged genetic material cannot be effectively repaired. Therefore, radiotherapy can selectively destroy cancer cells.
1.2 Do I need radiotherapy?
All patients who undergo breast-conserving surgery will require radiotherapy after the surgery. The purpose of radiotherapy is to eliminate any potential residual cancer cells in the body and reduce the risk of recurrence in these patients after the surgery.
As for patients who undergo total mastectomy, they may require radiotherapy after the surgery if any of the following conditions are present:
- The breast cancer tumor is close to the surgical margins or the surgical margins are unclear.
- The tumor has a large volume.
- The patient has cancer cells that have spread to multiple lymph nodes.
- Cancer cells are found in the blood vessels or lymphatic channels within the tumor.
1.3 Stages of radiotherapy treatment
Radiotherapy is usually scheduled to begin three to four weeks after breast cancer surgery.
Treatment Planning
Before undergoing radiotherapy, patients need to undergo a treatment planning process. Doctors use X-rays or computer scans to simulate the position and size of the breast cancer tumor. Based on these factors, they plan the method, direction, dosage, and timing of the radiation therapy for each patient. The design process typically takes about 45 to 60 minutes. Once the treatment planning is complete, radiation therapists mark the patient’s skin in the treatment area to ensure accurate radiation placement.
Radiotherapy Course
The specific course of radiation therapy depends on factors such as the patient’s individual circumstances. Generally, the treatment course consists of 25 to 30 radiation sessions, typically completed within 5 to 6 weeks. Patients typically receive radiotherapy daily during this period.
1.4 Side effects of radiotherapy
The side effects of radiation therapy are localized and may include:
- Skin redness: The skin of the breast may gradually become red and dry, similar to a sunburn, starting around the second week after radiotherapy. However, it tends to improve gradually in the weeks following the completion of treatment.
- Skin damage: Blisters, peeling, or skin breakdown may occur. These symptoms typically improve gradually in the weeks after treatment.
- Skin pigmentation changes: The skin in the area receiving radiotherapy may become darker than the surrounding normal skin.
- Fatigue: Patients may experience increased tiredness or fatigue during the course of radiotherapy.
- Lymphedema: Some patients may experience mild to moderate swelling in the upper limb.
It’s important to note that the severity and occurrence of these side effects can vary from person to person. Patients should discuss any concerns or potential side effects with their healthcare team, who can provide appropriate management and support.