This year alone, over 200,000 new cases of breast cancer are expected to be diagnosed in the United States. Fortunately, thanks to increased media and medical attention, more women are being diagnosed earlier when the cancer can be treated more conservatively with methods such as radiation therapy or lumpectomy. Twenty years ago, the only treatment for breast cancer was a full, radical mastectomy; today, however, there are many more options, particularly for the earliest stages of breast cancer.
When breast cancer is at stage 0, the cancer has not spread to any of the normal tissue. Stage 0 breast cancer is usually treated with a breast conserving lumpectomy to remove the tumor, followed by radiation therapy. It is estimated that fifteen to twenty percent of breast cancer cases caught during routine screenings are stage 0. Stage I breast cancer, when the tumor is smaller than two centimeters and has not spread to the lymph nodes (but may have spread to surrounding breast tissue), is also often treated with a breast conserving lumpectomy, followed by radiation therapy.
Radiation therapy is designed to follow lumpectomy (surgical removal of the cancerous tumor) to remove any remaining microscopic cancer cells. In radiation therapy, cancer cells are destroyed to ensure they do not cause another tumor. Two different kinds of radiation therapy are commonly used in breast cancer treatment - external beam radiation therapy and brachytherapy (or internal radiation therapy).
External beam radiation therapy is when the radiation is focused from a source outside the body. This is very much like an xray, but the radiation is much more intense. However, like an xray, radiation therapy is painless and requires little effort from the patient. Treatments are normally given five days a week for six weeks, but treatments generally last under a half an hour each day. Brachytherapy is when the radiation is placed directly inside the breast tissue next to the cancer site. This method is still being researched as to its effectiveness, so not all breast cancer treatment centers consider it standard treatment.
Unlike chemotherapy, patients who receive radiation therapy do not become nauseated or lose the hair on their heads. There are however, other radiation therapy side effects that patients commonly experience. Fatigue is one of those common radiation therapy side effects. Patients often complain of mild fatigue that increases over the course of the therapy, but fade one to two months after completion of the therapy. Some patients also complain of dull aches or shooting pains in the breast that may last for a few seconds or minutes. Finally, many patients suffer from a skin reaction at the site of the radiation. Doctors recommend that patients undergoing radiation therapy pay special attention to their skin care regime and keep the skin clean and dry, avoid sun exposure, avoid shaving the treated area, and avoid using perfumes, cosmetics, after-shaves and deodorants in the treated area.
Though rare, there are some possible complications of radiation therapy. Patients can develop fractures of the breastbone, breakdown of the skin covering the treated area or severe pain in the breast that may require surgical treatment. When radiation therapy is targeted at the lymph nodes under the arm, it can cause tingling, pain, numbness and/or loss of strength in the arm or hand. Some patients also have a lung reaction, called radiation pneumonitis, that leads to a cough, shortness of breath and fevers three to nine months after the radiation therapy. Fortunately, this usually resolves on its own without further treatment and with no long term complications.
While there are some side effects and even serious complications associated with radiation therapy, for many women it is an effective treatment where the benefits outweigh the potential pitfalls. With lumpectomy and radiation, most women retain the natural shape of their breasts and continue to feel like healthy, whole women. This in an of itself goes a long way toward a successful recovery.