Radiation Therapy

What is radiation therapy?

Radiation therapy is a treatment that is designed to rid the body of any left-over or stray tumor cells after the removal of the breast cancer. It is used routinely after lumpectomy. It is also used after mastectomy for larger invasive or more aggressive cancers, where the tumor might extend close to the edge of the removed breast.

Radiation therapy is a focused beam of high-energy particles that, when properly adjusted, can destroy cancer cells without causing damage to normal cells. A radiation treatment is entirely painless. In fact, having a radiation treatment is much like having a chest x-ray, in that it is a beam of energy that goes through the body. The patient is not even aware that anything is happening. Although radiation is painless and the treatment takes only a few minutes to perform, it does cause some side effects. The most common side effect is skin redness and sometimes blistering (much like a sun burn). Major side effects are rare, but some women do experience fatigue at the end of a six to eight week course of irradiation. Fortunately, radiation is not associated with any nausea or hair loss.

What’s new in radiation therapy?

The standard course of radiation therapy is usually six weeks (and sometimes longer, if a boost or extra-dose is required). Although the treatment takes only a few minutes to perform, the frequency of visits required to complete a full course of therapy can be problematic for many patients, especially those not living close to a treatment center. Fortunately, there is a new procedure that is available which reduces the treatment period from six weeks to five days.

In standard radiation therapy, a beam of energy is delivered from a source distant from the breast, just like the energy source for a chest x-ray. The patient lies on a special table, and the beam of energy goes through the breast. The beam enters the breast from a shallow angle (i.e. a tangential beam) to minimize exposure of the heart, lungs, and other vital organs to the energy beam.

The alternative approach is to have the radiation source implanted directly in the breast. In the past, this was done with a rather complex series of tubes implanted in the breast. The advantage was that the course of radiation therapy could be delivered in a few days, but the process was complicated and inconvenient.

There is now a much easier alternative offered by new radiation therapy devices, such as the Mammosite. In this procedure, a single tube is placed into the lumpectomy cavity that was created after the cancer was removed. A source of radiation energy (an iridium “seed”) is placed down the tube twice a day for five days, and then the catheter is removed on the fifth day. This procedure is effective and well-tolerated. We have treated a large number of patients with this procedure, and have found it to be an excellent alternative for selected patients with early-stage breast cancers and negative sentinel lymph nodes. For more information on the Mammosite catheter, see http://www.mammosite.com/mammo_whatis.asp.

For additional information on radiation therapy/radiation oncology, see: