This week we shared hints and tips to help with radiotherapy treatment. Radiotherapy is used to kill and control malignant cancer cells and is often given after surgery and/or chemotherapy in the treatment of breast cancer. It is also used in treating secondary breast cancer that has spread to other parts of the body. Not all breast cancer patients are given radiotherapy, but for those who do need it, we hope our summary may be useful.
We don’t want to worry women who are coming up to radiotherapy treatment, but for most of our group members, knowing as much as they can about what’s to come is helpful in managing anxiety. Preparing and being aware of what may happen is helpful, although we would like to stress that for many, radiotherapy is a simple and effective treatment that causes very few problems.
Although occasionally we hear of radiotherapy teams not recommending the use of a moisturiser on the affected area, most do suggest that regular moisturising is a great help. Pure perfume free creams and lotions are best, and 100% aloe vera gel is a popular choice. Many women are told not to wear deodorants or perfumes during treatment.
The most gruelling part of this treatment may be the daily treks to the hospital as radiotherapy is most commonly delivered as a 5 days a week treatment for a number of weeks. For women who don’t live near a hospital this is a very tiring time, with long drives or journeys by public transport adding to the fatigue that is commonly induced by the treatment itself. Machines appear to break down regularly causing long waiting times and many hospitals make appointments day by day so that planning ahead is difficult.
Keeping well hydrated during treatment is recommended, and keeping the arms and shoulders moving with gentle exercise is encouraged as the patient has to lie still in the same position every day so that the radiation can be accurately targeted. The set-up appointment is often quite lengthy, while the machine settings are made. Women will often have a number of tiny dot tattoos to assist with lining up the machine. Some women have to hold their breath while the radiation is applied to avoid damage to the heart and lungs, and many report that this is very difficult. A few practice runs are usually offered and for those daunted at the thought of this, it is do-able though a challenge.
Some women experience very little skin irritation from this treatment, others will find that their skin remains darker for some time afterwards. Sometimes the burning effect can be quite severe and can last for a week or two after treatment ends. This is often the time that tiredness kicks in. Often radiotherapy may be the last stage in active treatment, and many women reported feeling flat and exhausted for a while. Good advice is not to book a holiday or strenuous activity directly after the end of treatment - a quiet recovery period is preferable. On the other hand, many women reported sailing through radiotherapy, with many continuing to work and take part in their regular daily activities.
Some women reported being taken by surprise at how they felt during the two or three weeks after treatment ended. It seems that the medical teams are not good at warning us about this. Several say that had they known, they would have planned more rest, used more cream, drank more water, and so on.
Post treatment problems may include costochondritis, which is inflammation of the ribs, sore itchy skin, tightness and stabbing pain. The radiotherapy penetrates deep inside the body so there is a huge amount of invisible healing going on inside the body as well as that which is visible on the outside.
Radiotherapy for secondary breast cancer brings its own set of problems as areas other than the breast, underarm and neck are targeted. Just a couple of examples: treatment to the throat can cause issues with eating; radiotherapy to the brain can cause hair loss and often a mask has to be worn which may be uncomfortable. Other side effects may include muscle weakness and diarrhoea, and memory impairment. It is often delivered as part of a complex treatment plan which will be individually tailored. For these women, treatment is ongoing for life.
The emotional impact of radiotherapy can be difficult, as we tend to hear the phrase ‘radiotherapy is a doddle compared to chemo’ bandied around a lot. Some women found lying on the machine table undignified, particularly with male radiographers and some insensitive female ones too. Most reported having kind and considerate nurses though, who were understanding and supportive.
Many women spoke about building in little treats to get them through the treatment, coffee and cake on the way home, a chat with a friend, an afternoon nap, a movie. Behaving towards ourselves with kindness always makes a tough time a little easier.
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