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Patient information - Breast cancer - External Beam Radiation Therapy (EBRT) - Whole breast (conventional)

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What is Radiation Therapy (Radiotherapy)?

Radiotherapy is the use of high energy x-rays to treat cancer. Radiotherapy is sometimes called external beam radiotherapy (EBRT) and is delivered by a linear accelerator (radiotherapy treatment machine). Your treatment is individualised and carefully planned by your doctor and radiation therapists.

What happens during radiation therapy?

When you are having radiotherapy, you will be on your own in the treatment room. The radiation therapists can see and hear you at all times via cameras in the treatment room. The machine will not touch you during treatment and you won’t feel anything. The machine will move around you and make a buzzing sound.
If you become concerned or feel unwell in any way, raise your hand or call out. The radiation therapists will interrupt the treatment and attend to you.

What is the aim of treatment?

Radiotherapy is given to destroy any remaining cancer cells after surgery and/or chemotherapy.

How long will this treatment take?

The treatment is usually given Monday to Friday as an outpatient in the radiotherapy department. It takes about 20 minutes each time. A course of radiotherapy will take approximately 3 to 6 weeks to complete. Your doctor will talk to you about the number of treatments that is best for you. 

Emergency

IMMEDIATELY go to your nearest hospital Emergency Department, or contact your doctor or nurse if you: 

Emergency contact details

Ask your doctor or nurse from your treating team who to contact if you have a problem
  • have a temperature of 38ºC or higher
  • develop chills, sweats, shivers or shakes
  • feel short of breath.
Daytime:
Night/weekend:
Other instructions:
Before radiotherapy begins and during treatment, if you are pregnant or feel that there is any chance that you may be pregnant it is important to discuss this with your doctor.
Do not try to get pregnant during this treatment. Ask your doctor or nurse about what type of contraception you should use.

Tell your doctor, nurse or radiation therapist if you:

  • develop any changes to your skin
  • develop a cough
  • feel unwell in any way.

At home it is important to:

Cancer treatments can cause damage to normal cells in your body, which can cause side effects. Everyone gets different side effects, and some people will have more problems than others.

The table below shows some of the side effects you may get with this treatment. You are unlikely to get all of those listed and you may also get some side effects that have not been listed.

Tell your doctor or nurse about any side effects that worry you. Follow the instructions below and those given to you by your doctor or nurse.

Short term side effects: May occur during treatment or within a few weeks of finishing radiotherapy and usually settle within 4 weeks

Skin changes

  • In the area of treatment, your skin may become
    • red
    • warm
    • dry
    • itchy
    • more sensitive
    • darker than normal
    • painful
    • blistered.
  • Skin changes usually start to develop 2 to 3 weeks after the start of treatment. They usually begin to settle down about 2 to 4 weeks after treatment has finished.
  • It is important to care for your skin during treatment and for 4 weeks after treatment as directed by your treating team.
  • Do not scratch the affected area and avoid tight fitting clothing that rubs the skin.
  • Protect your skin from the sun.
  • Ask your doctor or nurse for eviQ patient information - Skin changes and skin care during radiotherapy. 
  • Tell your doctor or nurse if you get any skin changes, they can help you to manage them.

Breast aches and pains

  • You may get aches, pains and some swelling in the breast area.
  • Tell your doctor or nurse if you get any of these symptoms.

Tiredness and lack of energy (fatigue)

  • You may feel very tired, have no energy, sleep a lot, and not be able to do normal activities or things you enjoy.
  • Do not drive or operate machinery if you are feeling tired.
  • Nap for short periods (only 1 hour at a time).
  • Prioritise your tasks to ensure the best use of your energy.
  • Eat a well balanced diet and drink plenty of fluids (unless you are fluid restricted).
  • Try some gentle exercise daily. Rest when you feel you need to.
  • Allow your friends and family to help.
  • Tell your doctor or nurse if you have problems managing any of the symptoms listed above.

Hair loss

  • In the area of treatment your hair may fall out.
  • This can happen 2 to 3 weeks after starting treatment.
  • This is usually temporary, but for some people it can be permanent. 

Mid term side effects: May occur weeks to months after radiotherapy has finished

Lung changes (pneumonitis)

  • After radiotherapy to the chest area, you may get inflammation of the lungs.
  • Contact your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you have any difficulty breathing, chest pain or a temperature of 38°C or higher.

Long term side effects: May develop months after radiotherapy has finished and may be permanent

Breast tissue changes

  • Radiotherapy to the breast area may cause changes in the appearance and feel of your breast. This can include tenderness, persistent firmness, swelling or shrinkage.
  • Tell your doctor or nurse if you get any of these symptoms.

Tiredness and lack of energy (fatigue)

  • Feeling tired or fatigue may continue for some time after the radiotherapy has finished.
  • Tell your doctor if you have ongoing tiredness and lack of energy.

Rib fracture

  • You may be at risk of breaking a rib. The risk can depend on the type of treatment you have.
  • Tell your doctor or nurse if you have ongoing sharp pains or soreness in your chest.

Heart problems

  • Radiotherapy can increase your risk of developing heart problems in the future.
  • This is uncommon and may not happen until at least 10 years after treatment.
  • Talk to your doctor if you have any concerns about the benefits and risks of radiotherapy.

Developing a second cancer

  • There is a very small risk that you may develop a second cancer as a result of having radiotherapy.
  • This is uncommon and may not happen until at least 10 years after treatment.
  • Talk to your doctor if you have any concerns about the benefits and risks of radiotherapy.

If you are having your lymph nodes treated (around the collarbone and/or in the armpit), you may also have these side effects:
Sore throat or difficulty swallowing
  • You may have some pain or difficulty when eating and swallowing.
  • This can occur if you are having treatment to your lymph nodes around your collarbone.
  • Tell your doctor or nurse if you get any of these symptoms.
Swelling (lymphoedema)
  • You may get swelling in your arms.
  • Your arms may feel heavy or tight and you may have aches and pains.
  • This is caused by a build up of fluid in body tissues.
  • This can start months to years following cancer treatment.
  • Tell your doctor or nurse if you notice any swelling in your limbs, they can help you to manage it.
  • Early treatment can reduce the risk and severity of swelling.

Will I be radioactive?

You will NOT be radioactive during and after external beam radiotherapy treatment. You can safely mix with other people, including children and pregnant women, at any time during and after your treatment.

Will treatment affect my sex life?

The desire to have sex may decrease because you may become tired, anxious or unwell during treatment. It may help to discuss your worries with your partner and/or your radiation oncologist or nurse. The radiation itself will not affect it.

Do I still need to use contraception?

Yes, you should use contraception during and after radiotherapy. Pregnancy should be avoided as radiation therapy can have a harmful effect on an unborn baby. Ask your doctor or nurse about what type of contraception you should use and for how long.

Will this treatment affect my fertility? 

Some cancer treatments can reduce your fertility. This can make it difficult or impossible to get pregnant. Talk to your doctor or nurse before you start any treatment. Depending on your situation there may be fertility sparing options available to you, discuss these with your doctor or nurse. See our patient information sheets – Fertility for women during cancer treatment.

Should I be on a special diet while having treatment?

It is recommended that you enjoy a balanced diet (eat lots of grains, fruit, vegetables and dairy products) while you are on treatment. Eating should remain an enjoyable experience. If you have any concerns or questions about your diet ask to see a dietitian.

Will I lose my hair?

You will not lose the hair on your head unless it is in the treatment area. You may lose some body hair if it is in the treatment field and this can begin to happen during or after treatment.

What does the x-ray taken during treatment tell me?

The x-­ray or images that the radiation therapists take during your treatments are used to confirm that you are in the correct position for your treatment. These x­-rays cannot be used to tell if your tumour is responding to the radiotherapy treatment.

Can I drive during treatment?

In general, most patients will be well enough to drive whilst they are receiving radiotherapy treatment. If you are unwell or on strong pain killers discuss with your radiation oncologist prior to driving a motor vehicle.

Can I have a flu or tetanus vaccination?

Vaccination such as flu and tetanus are safe to receive while you are having treatment. Their efficacy may be slightly diminished if given within 3 months of starting a course of treatment

Is it safe to take vitamin tablets and herbal medicines?

Before starting any medicines which includes prescription, over­-the­-counter medicines, vitamins and alternative, natural or herbal medicines tell your doctor, radiation therapist or nurse. Some medications can interact with your treatment.

Who can I talk to if I am not coping?

It is not uncommon for you to feel anxious or depressed during and after treatment. Let your treating team know and they will arrange for you to talk to someone. You can also call the Cancer Council on 13 11 20 for cancer information and support.

How do you know if the treatment is successful?

It is not possible to know if your treatment has been successful immediately after treatment. Your doctor will see you after treatment is complete and will discuss your progress.

What is the follow-up?

Once your treatment has finished, you will be advised by your doctor as to what follow up appointments are needed.

Telephone support

  • Call Cancer Council on 13 11 20 for cancer information and support

Breast cancer information

General cancer information and support

Quit smoking information and support

Quitting smoking is helpful even after you have been diagnosed with cancer. The following resources provide useful information and support to help you quit smoking. Talk to your doctor, nurse or pharmacist about any other questions you may have.

This document is a guide only and cannot cover every possible situation. The health professionals caring for you should always consider your individual situation when making decisions about your care. Contact your cancer clinic staff or doctor if you have any questions or concerns about your treatment, or you are having problems coping with side effects. Use of this document is subject to eviQ’s disclaimer available at www.eviQ.org.au

The currency of this information is guaranteed only up until the date of printing, for any updates please check:

https://www.eviq.org.au/pi/1922

21 Oct 2018