Preparing for Radiation

External Beam Radiation Machine
External Beam Radiation Machine. Photo © National Cancer Institute

Radiation therapy usually begins three to four weeks after lumpectomy surgery to remove a breast cancer. Radiation therapy is used to eliminate any remaining cancer cells in the breast or armpit area.There are two primary types of radiation used in treating breast cancer. They are:

  • External Beam Radiation - a traditional approach to delivering radiation.Treatment usually takes several weeks with a Monday through Friday schedule. In certain instances, a shorter treatment regimen, called accelerated radiation, is used. It delivers a higher dose of radiation over three or four weeks. Daily treatment with external beam radiation consists of set up time and positioning activities followed by receiving radiation, which takes about 2-3 minutes. Treatment is painless.

Following a lumpectomy for my first breast cancer, 16 years ago, I had 6 weeks of external beam radiation. Here is what I learned from the experience:

  • While my care team described the cumulative effect of treatment as tiredness, I felt as if my energy level was slowly being drained away.
  • Get home and work responsibilities streamlined. Don't plan any major projects during the  weeks of treatment.
  • Speak with family members, friends and neighbors you are comfortable sharing about your cancer and your upcoming radiation treatment. Accept offers of help with things like grocery shopping, laundry, errands, meal prep and child care. Most people want to help and prefer being told what they can do to help.
  • Come up with a schedule of what help will be needed and when it will be needed. Radiation has a cumulative effect. There will probably be no decrease in energy or other side effects for the first several sessions.
  • If the plan is to work during treatment, know that when the cumulative effects of treatment set in, adjustments may have to be made, such as: a shorter work day, rest periods during the day, and an earlier bed time.
  • Use the weekends to recuperate from treatments. Don’t try to fight the feelings of tiredness and loss of energy; lay down and rest.
  • Tell the radiation oncologist about any medications you are taking, before starting treatment, even over-the-counter medications.
  • Eat well balanced meals and avoid losing weight. Snack healthy. Foods rich in protein are important.
  • Wear loose-fitting camisoles and tops for the duration of radiation treatment. If you must wear a bra, make it a comfortable one and place a soft cloth between your bra strap and skin.
  • Don't rub or scrub the treated area.
  • To avoid blistering, keep the skin under your breast clean and dry.
  • Don't use any lotions, powders, perfumes, soaps or deodorants on the area being treated without checking them out first with your doctor.
  • Don't starch your blouses or shirts, and use a mild laundry detergent when washing your clothes.
  • Wash the treated area with lukewarm water. Extreme temperatures can hurt your skin.
  • Stay out of the sun as much as possible and ask your doctor before you use sunscreen.
  • Get as much sleep as you want and need after radiation. Fatigue can last for up to six weeks after treatment.
  • Be good to yourself. When you feel up to it, go out with friends and family and have some fun.
  • When the "what ifs" get the best of you, turn to a fellow survivor or trusted family person and talk until you get things in perspective again.

    Once treatment is over, fatigue will fade away. It will happen gradually; it may take time to return to your energy level prior to radiation therapy.

    Jean Campbell is a 2x breast cancer survivor and the former founding director of the American Cancer Society New York City Patient Navigator Program in 14 public and private hospitals.She is executive director of a nonprofit organization providing research and resource information and support to women and men newly diagnosed with breast cancer.