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Radiation therapy is a common part of breast cancer treatment. It may be used alone, or in conjunction with other therapies. As with any kind of medical procedure, there can be side effects. Side effects can vary, depending on the kind of radiation therapy you have and your individual response to it.

Knowing what to expect, and potential side effects, can help you prepare for your treatment.

Skin changes are some of the main side effects of external radiation. These changes occur in the area being treated by the radiation. It’s similar to a sunburn, and can include:

  • soreness
  • blisters
  • peeling
  • redness and itching
  • darkening of the skin

These changes happen gradually over the course of treatment, and in some people it can last for years after treatment. Some people also develop spider veins in certain areas months to years after treatment.

What to do

There are several ways to manage skin changes and side effects, including:

  • keep the area moisturized daily with A&D or Aquaphor
  • dress in cotton, loose-fitting shirts
  • avoid underwire bras
  • use warm water instead of hot in the shower
  • avoid strong soaps and cleansers with fragrances
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Fatigue is also common, with about 9 out of 10 people experiencing it during cancer treatment. It doesn’t improve with rest, and can impact concentration, daily activities, and speech.

Tell your doctor about your fatigue. There’s no one treatment for it, but they might be able to provide specific ways to help.

What to do

There are several ways to manage fatigue, including:

  • complementary treatments like meditation, massage, and yoga
  • eating a healthy diet
  • stress relief
  • regular exercise, even just a short walk around the block every day
  • stay hydrated
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Some women experience lung inflammation years after radiation therapy. This is especially true if they have also had chemotherapy. If there is significant heart exposure because of left breast radiation, in some cases injury to the heart can occur, causing heart conditions or heart disease. This is not as common these days, thanks to greater understanding of this potential link.

What to do

Methods to avoid injuring the heart and lungs include prone breast radiation therapy, where you lie on your stomach instead of your back, and the breast hangs through a hole in the treatment table. This reduces exposure to your heart and lungs.

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If you have radiation to your lymph nodes, you may experience lymphedema, even years after radiation therapy. If lymph nodes have been removed, there’s a risk of lymphedema because the removal interrupts the flow of lymph, leading to swelling. Radiation to lymph nodes can cause scarring and blockages.

If you experience swelling in the hand, arm weakness, and trouble moving the arm or joints, see your doctor. They can do an exam to confirm if you have lymphedema. During and after treatment, you can help reduce the risk of lymphedema in the following ways:

  • ask for injections and blood draws to be done on the opposite arm
  • carry your purse and heavy items with the other arm
  • use a clean razor when shaving underarms
  • do approved exercises to improve lymph flow
  • consult a massage therapist or physical therapist for manual lymphatic drainage treatment
  • eat a low-sodium diet
  • avoid temperature extremes

What to do

Talk with your doctor and healthcare team about ways to reduce your risk of lymphedema and how to detect it. If it does occur, treatment typically involves exercise, bandages, and massage therapy.

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There are two main types of radiation therapy for breast cancer:

  • external beam radiation
  • brachytherapy, or internal radiation

Each type has several subtypes, mainly differing in how the radiation is delivered to the body.

Your doctor will discuss the types of radiation and which one(s) are most appropriate for you. Your larger treatment will be taken into consideration, as well as tumor location and spread.

External beam radiation therapy can include:Brachytherapy can include:
whole breast radiation
accelerated partial breast irradiation
– intraoperative radiation therapy (IORT)
– 3D-conformal radiotherapy (3D-CRT)
– intensity-modulated radiotherapy (IMRT)
chest wall radiation
lymph node radiation
proton therapy for breast cancer
prone breast radiation therapy
intracavity brachytherapy
interstitial brachytherapy

While common side effects are typically from external beam radiation therapy, there are also side effects with brachytherapy. Side effects can include:

  • redness at the treatment site
  • breast pain
  • infection
  • damage to fatty tissues
  • collection of fluid in the breast

Before starting radiation therapy, talk with your doctor about what to expect before, during, and after each therapy session. Ask them about possible side effects, how to reduce your risk of them, and best treatments.

Knowing what to expect can reduce anxiety and help you be prepared.

During and after radiation therapy, tell your doctor about side effects you may have, even if you think it’s harmless. They can provide you with tips and tricks to cope with them, and monitor anything that may interfere with your health.

Breast cancer treatment support groups

During treatment, support is important. Whether it’s in-person or online, having a group that knows what you’re going through and can provide emotional support can be valuable.

Resources include:

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Radiation for breast cancer is a common part of treatment plans. It does carry the risk of side effects, many of which are manageable.

Talk with your doctor prior to starting treatment about possible side effects, how to reduce your risk of developing them, and how to manage any that do arise — plus when to seek immediate attention.

Knowing all of this can help you feel prepared and in control for your radiation treatment.