Radiotherapy to the breast. Information and advice for patients, relatives and carers

Transcription

1 Radiotherapy to the breast Information and advice for patients, relatives and carers

2 Introduction This leaflet is a basic guide to radiotherapy to the breast or chest wall and the possible side effects. External beam radiotherapy involves a planning session, followed by a series of daily outpatient treatments, Monday to Friday, usually over several weeks. The length of your course of treatment will be discussed with you, and decided by your clinical oncologist. This leaflet may not answer all of your questions, but it aims to answer the ones most commonly asked. Your clinical oncologist, radiographers, radiotherapy nurse and/or dietician will be happy to answer any further queries. What side effects will I get from radiotherapy? The side effects experienced vary from person to person, depending on the dose and duration of treatment. Radiotherapy works by damaging the tumour cells ability to multiply. Healthy cells near the tumour may be affected, but they are able to repair themselves in a way tumour cells cannot. You may notice some side effects after one or two weeks. If you do, they may continue until your treatment finishes and for two to four weeks afterwards before they gradually improve. It is important to remember that any treatment side effects are expected and most can be easily managed. Medications may be prescribed to manage and ease any side effects. The radiographers will monitor you throughout your treatment, but please inform them of any changes you notice, or if you have any worries or queries. Your radiotherapy nurse will see you once a week. Your clinical oncologist will also usually see you once a week during the course of your radiotherapy treatment.

3 Side effects from radiotherapy to your breast or chest wall may include: Local skin reaction (red, dry and/or itchy) Sensations in your breast, for example warmth, itchiness, prickliness, tenderness, soreness, hardening or numbness Swelling of your breast Hair loss in the treated area only Tiredness What kind of skin reaction will I get? You may notice some skin changes in the area being treated. After about two to three weeks the skin may become dry, pink/red and feel hot, itchy and/or tender. Below are guidelines to caring for your skin during radiotherapy, but please talk to your radiographers or clinical oncologist during treatment for further advice on how to care for your skin. How do I care for my skin during radiotherapy? In line with national guidelines*, we recommend that you: Do: Take a shower rather than soaking in a bath. Make sure the water is warm and not hot. Use only unperfumed products such as Simple (bar) or Johnson s baby soap and wash very gently. Gently pat the treated area dry using a soft towel.

4 Wear loose clothing made with natural fibres such as cotton or silk. Wear a soft cotton bra (non wired), cropped top or vest. Try to go without wearing a bra as much as possible (at home). Discuss the use of deodorant with your team, as some brands are not recommended and may cause irritation. Use the moisturising cream provided which is gentle, unperfumed and will help to prevent skin dryness. Use this cream from the beginning of treatment and apply to the treated area at least twice a day. Smooth a thin layer of the cream onto the breast and allow it to be absorbed into the skin. Do not rub in vigorously. If the lymph nodes around your collarbone are to be treated, you will need to apply aqueous cream to the collar bone area as well as to the corresponding area on your back. Do not: Use any perfume, deodorant, antiperspirant or talcum powder to the treated area, except those recommended. Rub or itch the skin as it may become quite fragile. Apply cream to a moist, weepy skin reaction. Advise the radiographers and/or radiotherapy nurse who will provide you with an alternative gel. Use cosmetics/make up or any creams in the treatment area, other than those recommended. Shave or wax under the treated arm (you may use an electric shaver if necessary). Wear tight clothing, especially anything that leaves an impression on the skin in the treated area. Use sunscreen on the treated area during the treatment period.

5 Allow direct sunlight on the treated area. Will I lose my hair? Any radiotherapy related hair loss you may experience will only be in the treated area and this would begin to occur approximately two to three weeks after treatment starts. The rate of regrowth of hair will be different for each individual, but hair usually starts to grow back two to three months after treatment finishes. Will the treatment make me tired? Tiredness may be experienced towards the end of treatment. This is usually a combination of travelling to and from the radiotherapy department, a side effect of the treatment and coping with your diagnosis as well as continuing with a normal life. It is advisable to rest as often as necessary and to keep yourself well hydrated. It may also be beneficial to do some gentle exercise such as walking.

6 Will radiotherapy make me feel unwell? Radiotherapy should not generally make you feel unwell. However, as discussed earlier, you may feel more tired than usual, particularly towards the end of your treatment and for approximately four weeks afterwards. Try to drink plenty of fluids, such as water, and eat a healthy, balanced diet. If you are feeling anxious, or feel at any point during your treatment that you are not coping, remember that it can sometimes be helpful to discuss your feelings. A specialist counsellor is available to support you. There are also support groups which you may find helpful. Tell your friends and family how you are feeling so that they know how to support you through the treatment. After radiotherapy treatment has finished Radiotherapy has a cumulative effect. The side effects will begin to peak 7 to 10 days after your treatment has finished and will then start to improve. It is important that you continue with your prescribed care routine until the effects have settled. Most side effects should improve within 4 weeks of finishing treatment. Continue to rest as necessary, do some gentle exercise and aim to get back to a normal life again. You will have follow up appointments and scans with your clinical oncologist following treatment; however it may be some time until you will know the full benefits of your course of treatment. Your clinical oncologist will have explained this previously. If you have any concerns, or need advice or support, please contact your clinical oncologist, radiographers, radiotherapy nurse or dietician.

7 * SCoR, Skin care advice for patients undergoing radical external beam megavoltage radiotherapy. 10 February Available from: [Accessed 11 May 2015]

8 The London Radiotherapy Centre at Guy s & St Thomas Borough Wing, Lower Ground Floor Guy s Hospital, Great Maze Pond London SE1 9RT T: / 7511 The London Radiotherapy Centre at University College Hospital Basement Level, UCLH Tower Euston Road London NW1 2BU T: / JR