About Cancer Radiation Therapy
A radiation oncologist is a doctor who has specialized in the use of radiation will always be an M.D. Generally, you should see a radiation oncologist soon after your positive biopsy so that he or she can get an idea of the size and location of the lump. This visit does not mean that you will be getting radiation. It gives the radiation oncologist a chance to evaluate you and help your medical doctor, surgeon, and medical oncologist make a treatment plan.
Radiation works best when there are smaller numbers of cancer cells to attack. For this reason it is usually done after surgery (usually lumpectomy, but occasionally mastectomy as well). While radiation is in and of itself a cause of cancer, today's use of radiation therapy is highly specialized and localized. This localization and the improvements in technology allow radiation oncologists to pinpoint precisely the area that is being treated.
Usually administered by a machine called a linear accelerator, the radiation is aimed at a very specific area of the breast and affects only that area. Other parts of the body are shielded from radiation, and by using tangents (angles), the radiation passes through the breast and into the air rather than into other parts of the body. The treatments are generally scheduled once a day for a given number of weeks. This is to prevent skin reactions that excess radiation could cause.
To begin with, your whole breast area will be radiated (from collarbone to ribs and breastbone to side). If necessary, your lymph nodes will also be included in this treatment. This is the major part of the treatment and will last about five weeks.
Once the main treatment is finished, most people will be given a "boost," which is an extra amount of radiation where the tumor was located. This can either be done with an electron beam (if the tumor was not very deep) or with radioactive implants.
The electron beam radiation is done with a machine and does not require hospitalization. For radioactive implants, thin plastic tubing is drawn through the area where the biopsy was done while you are under general or local anesthetic or some other kind of sedation. Small radioactive pellets called iridium seeds are placed in the tubes. This whole process takes about 36 hours and you are usually in the hospital for the duration. The main reason for this is that you will be "radioactive" and unable to be in crowds during this time. Once the tubes are removed (no anesthesia is required for this), you may go home if there is no other reason for hospitalization.
If you are not having chemotherapy your treatments could start anywhere from two weeks after surgery up to a month later. For women who have had chemotherapy first, radiation is generally started about a month after chemotherapy ends.