WOMEN: TREATMENT OF BREAST CANCER. RADIATION AND SYSTEMIC THERAPIES
Radiation therapy
Radioactivity can damage all living cells, but it is more destructive to cells that are multiplying rapidly (as cancer cells do) than to normal, slow-growing cells. Radiotherapy, which focuses a measured amount of radioactivity on an area affected by cancer, may be used to shrink a tumour before surgery, as a follow-up to surgery, and in some forms of spread. Your radiotherapist will discuss possible side-effects with you before treatment.
Radiation following lumpectomy doesn’t often cause troublesome side-effects: many women manage to drop in for their treatment before or after work. There may be mild nausea and tiredness that disappear when the treatment is finished. Changes such as skin discolouration, altered skin texture and tightening of the breast may persist in the area treated, though the focusing of the rays has become so accurate that these side-effects are now much less common.
Systemic therapy
This is treatment given by mouth or injection so that it circulates to all parts of the body. It is used to prevent further growth of any cancer cells that may have spread beyond the breast. There is increasing evidence that systemic therapy can reduce the risk of relapse of breast cancer.
There are two types of systemic therapy.
Tamoxifen, an anti-oestrogen drug, prevents the growth of cancer cells that are stimulated by oestrogen. It has few serious side-effects. Some patients experience nausea, hot flushes, headaches and vaginal dryness.
Anticancer drugs (chemotherapy) are toxic to all cells but, like radiotherapy, are much more destructive to the rapidly growing cancer cells. Chemotherapy usually causes some side-effects, mostly on the day of treatment and for a day or so after. Some patients have persistent problems that need treatment, including nausea and vomiting, mouth ulcers, tiredness and anaemia. Temporary hair loss is common, but complete regrowth is usual within six months.
Your doctor will tell you the reason for advising any systemic therapy, what side-effects to expect, how long they may last, and what can be done to relieve them.
Whatever surgery and other treatment you have, you will probably be more shocked than you expected by the reality. Many patients become depressed after treatment for breast cancer. The more you know about your condition and the reactions you may have to its treatment, the better you will be able to cope with your feelings afterwards. Don’t be afraid to admit that you need some help. Speak to your doctor about how you feel. Be honest with your family and friends – don’t tell them you’re ‘fine’ when you’re miserable. You’ll need their support, but they can only give it if they know how you really feel. During recovery from surgery, Breast Cancer Support Service volunteers will visit you in hospital or at home if requested, so do make use of this service.
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