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This handout is for women who need 3-6 weeks of radiation to the breast. It describes how we give your treatments and how to take care of yourself. 

What to Expect at Your First Treatment 

During treatment, you will see radiation therapists every day. Your doctor will see you once a week, or more often if you need it. You may also see a radiotherapy nurse. 

Each day we ask you to lay on a treatment table. The radiation therapists help you get into the correct position. Often, you will lay on your back with your arms over your head. Some women may need to lay on their stomachs. This is also called prone breast radiation. The first treatment often takes the longest. We may use the tiny tattoos that were done at your CT visit to help get you positioned for treatment. You have an x-ray, CT, or MRI scan checked by a doctor before we give your first treatment. You will not feel anything during the treatment. Treatment takes about 1-15 minutes. 

What to Expect as Treatment Continues

You may have concerns about side effects. Side effects increase slowly during treatment. Common side effects include: 

  • Skin irritation 

  • Fatigue 

  • Tender and swollen nipple and breast 

Nutrition During Breast Radiation

There is no special diet that you need to follow. Try to eat a well-balanced diet that includes protein. Drink 8-12 glasses of fluid a day. It is ok to take a multivitamin or calcium supplement daily. Avoid high-dose vitamin C, vitamin E, vitamin A, and melatonin. These may work against the radiation. 

Radiation Skin Reaction

Skin in treatment sites may become red and irritated. It can also become dry and itchy. Sometimes, the skin will peel and become moist. This happens most often in skin folds and curves. Some skin reactions can be painful. You can use Tylenol® or ibuprofen for pain. If you need something stronger, let us know. 

Use skin care products as directed. Report any skin changes you notice. If you get a reaction, we will watch it closely. We may ask you to change the way you care for your skin. 

Protecting Your Skin During Treatment 

Follow the guidelines during and after your treatment until your skin has fully healed.

  1. Apply a mild, unscented lotion gently to your skin in the treatment area 1-3 times a day. Your skin may feel softer and more comfortable if you use creams and lotions. Using creams and lotions does not prevent the skin reaction from happening. Here is a list of some well-known types of skin care products.

    • Aveeno® 

    • Aquaphor/Eucerin

    • Calendula cream (look for at natural food stores)

    • Curél®  

    • Lubriderm®

    • Petroleum jelly

    • Neutrogena® 

    • VaniCream® 

    • Vaseline Intensive Care lotion

  2. You may keep using your deodorant. 

  3. Bathe or shower using lukewarm or warm water. If you need soap, use a soap for dry or sensitive skin. Rinse well and gently pat dry. Do not rub the skin in your treatment sites.

  4. Avoid heating pads, very hot water in the bath or shower, and hot water bottles.

  5. Avoid exposing your skin to ice or very cold water or air. You may cool the treatment site gently. Try using an ice pack wrapped in a towel.

  6. Avoid sunlight or sunlamps on the treatment site. When outside, keep the site covered with clothing or use sunscreen with SPF 30 or higher.

  7. Avoid clothing that rubs back and forth over treated skin. It’s best to wear a soft cotton bra without an underwire. Some women go without a bra toward the end of treatment. Others prefer to wear their normal bra. 

  8. Avoid using tape on the skin in treatment sites.

  9. If you smoke or drink large amounts of alcohol you may have a more severe reaction. Please let us know if you want to change these habits. We can help.

  10. If you swim and the chlorine or saline water does not irritate your skin, you may keep swimming. Please stop if you notice the water irritates your skin, or if your skin is peeling.

Breast Tenderness

Sometimes the treated breast becomes swollen and tender over the course of the treatment. You may feel sharp twinges of pain. The nipple may become swollen or tender. These side effects decrease when treatments have ended. 

To help decrease tenderness: 

  1. Take two tablets of acetaminophen (Tylenol®) or ibuprofen every four hours as needed. 

  2. Lie down and rest with a cool (not icy cold) compress over the breast. The radiation therapy nurse may have more ideas for this symptom.

Fatigue

It is common to feel tired during treatment. The amount of fatigue varies from person to person. Some people do not feel fatigue and are able to keep up with their normal routines. Others need to take a daily nap. Still others change their routines like working part-time instead of full-time. Some people don’t do anything that involves a lot of energy. Fatigue can start right away or start after 1-2 weeks of treatment. It can go on for weeks to months after treatment has ended. Rarely, it can last for up to a year.

Tips That May Help When You Feel Tired

  1. Listen to your body. Rest. Take a short nap during the day or sleep a little longer during the night.

  2. Exercise. Take daily walks. Ride an exercise bike. Do yoga, or anything you enjoy. Go at your pace. Listen to your body. Decrease the intensity and frequency of exercise if needed.

  3. Eat well. Drink plenty of water. Try to stop smoking or cut back on cigarette use. Limit alcohol to no more than 7 drinks in a week and three a day. 

  4. You may want to keep working. Some people keep working full-time. Others decide to work fewer hours. Many employers will agree to part-time work. We can schedule your treatment times to fit your work schedule.

  5. Take advantage of your support system. Pent up feelings can add to fatigue. Share your feelings with family or friends. It may help to talk to a cancer psychologist or join support activities through Gilda’s Club or other groups.

  6. Make time for things you enjoy. Take a walk in the fresh air. Visit with a friend. Do a hobby during the times you feel the most energy. 

  7. If you need help with your basic daily needs, ask your nurse or the social worker to help you contact your local resources. You may be able to get help with meals, housekeeping, personal care, transportation, support groups, and respite care.

  8. Accept offers of help from family and friends. If friends ask if they can help, say yes! Be ready with ideas. Often, people want to help, but don’t know what things you need. Things like mowing the lawn, making a dinner, or watching the kids after school for an hour or two can help both you and your friends to feel good.

  9. Visits from family and friends can be nice, but also tiring. You do not need to be the perfect host. Let your family and friends fix dinner and get the drinks and snacks for you!

What can I expect after my last treatment?

The side effects of radiation are at their worst when your treatment is ending. Your skin can look and feel worse for up to 1-2 weeks after your last treatment. Take good care of your skin and contact the radiation oncology clinic if you have questions or concerns (608-263-8500). One to two weeks after your last treatment, you will notice your skin starting to heal. You will also notice that you feel less tired. You will have a follow-up visit about 1 month after your last treatment. 

Other Concerns

You may have other concerns other than how to manage the side effects of treatment. Cancer may affect other parts of your life. People feel its impact on their marriage, family and friends, job, finances, and thoughts and feelings about the future. The doctors, nurses and social workers can help you cope. They can suggest support services and resources. Feel free to talk with them at any time.

Please talk with us if you have questions or concerns. You can also send us your questions through MyChart, or by calling the Radiation Oncology Clinic at (608) 263-8500. 

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.