Narayana Health Care

Radiation therapy is a treatment using an external beam to kill cancer cells. The high-intensity energy beams used in radiation therapy mostly uses X-rays. Sometime protons can also be used instead of x Rays for the purpose.

When is Radiation Therapy Recommended?

Radiation therapy is used at all stages of breast cancer treatment, most commonly post-surgically.

Post-Surgical Intervention

• It reduces your risk of breast cancer recurring after surgery.
• It is frequently used to ease the symptoms caused by cancer
• It limits the extent of its spread as in case of metastatic breast cancer

Breast cancer is the most common cancer in urban India and the second most common in rural India. An estimated 70,218 women died of breast cancer in India, in 2012, which is the highest in the world.

In breast cancer, a systematized approach is used depending on

1. Type of cancer cells
2. Extent of cancer
3. Age
4. Size of Breast
5. Size and location(wherein breast)of tumor

Step by step approach

• Initiate with chemotherapy
• Followed by mastectomy or breast-conserving surgery
• Then after 20-30 days later, the radiation treatment starts which accommodates in many sessions spread over a month.

How is Radiation Therapy in breast cancer performed?

Post Surgically two types of the procedure follows:

1. External Beam breast Cancer – Commonest

• Painless
• Area to be treated is marked and an external beam like an X-Ray is targeted to it
• The session lasts for around 5- 10minutes
• Are scheduled five days a week for about five to seven weeks
• Side effects:

1. Fatigue
2. Redness or tenderness skin
3. Swollen breasts
4. Blisters or peeling skin

Potential long-term side effects include:

• Smaller breasts
• Issues with breastfeeding
• Neural damage
• Swelling and pain in the arm or chest
• Rarer side effects include weakened or fractured ribs or cancer-related to blood vessel lining.

2. Internal breast cancer radiation or Brachytherapy

• Radioactive seeds are implanted through a device in the area where cancer might return
• Shorter duration- a week
• Fewer Side effects

Both types of procedures are performed complimenting each other to increase the reach and effect of radiations.

Possible side effects of Internal Radiation are:

1. Nausea
2. Redness
3. Breast pain
4. Bruises
5. Infection
6. Breakdown of breast fat tissue
7. In rare cases weakness and fracture of the ribs

Brachytherapy further classifies as:

1. Interstitial brachytherapy where several tubes are inserted into the breast post-surgery. These tubes deliver radioactive pellets to the affected area 2-3 times a day for several days.
2. Intracavitary brachytherapy where a single tube-like device is placed into your breast with one end sticking out. Through this end, radiation is sent inside. The treatment takes place twice a day for 5 days.

Intraoperative Radiation

• The procedure is picked when the tumor is too close to healthy tissue for external radiation to be conceivable
• During Surgery, once the cancer tissue is exposed, one single high dose beam is cast, shielding the rest of the healthy tissue.
• Works best for early-stage breast cancer treatment
• This can be achieved through:

1. A linear accelerator for two minutes
2. A smaller device for 10 minutes

The procedure has lesser side effects.

Expected Outcome:

Various studies have concluded that the average 10-year survival rate of a treated breast cancer female is 83%. If the cancer is located only in the breast, the 5-year survival rate of women with breast cancer is 99%. If cancer has spread to the regional lymph nodes, the 5-year survival rate is 85%.

Radiation therapy in breast cancer treatment is indeed a systematized approach and is given to only females who require them in conjunction with other available treatment measures. The best part is their success rates assuring NO CANCER!!

Dr. Indu Bansal Aggarwal, Senior Consultant – Oncology, Radiation Oncology | Narayana Superspeciality Hospital, Gurugram