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  • Preparation for your first visit:
  • Is radiation treatment painful and how many visits needed?
  • Can I drive and work while receiving radiation treatment?
  • Will I be radioactive and danger to my family?
  • What staff will I meet regarding my treatment?
  • How can I make sure proper dose is being given?



What to Expect in Radiation Therapy


What Happens Before, During and After Treatment

After a diagnosis has been made, you will likely discuss your treatment options with a primary care physician and cancer specialists, such as a surgeon, medical oncologist, and radiation oncologist. Cancer specialists work together to provide breast cancer treatment that is best for you. Often more than one type of treatment is required, such as surgery to remove the tumor followed by radiation or chemotherapy.

Before Treatment

Prior to treatment, you will meet with a radiation oncologist to determine if breast cancer radiation treatment is the right treatment option for you. Your doctor will evaluate your need for radiation therapy and the likely results in your case. During the initial visit, your doctor will review your current medical problems, past medical and surgical history, family history, medications, allergies and lifestyle and perform a physical exam to assess your disease and general physical condition and review medical tests, including CT, MRI and PET scans.

Based on this assessment, your radiation oncologist will advise you if breast cancer radiation is appropriate for your situation and disease stage. If cancer radiation treatment is indicated, the doctor will discuss benefits, risks and side effects and answer your questions. We encourage you to ask questions to give you peace of mind and greater understanding of the process. We are aware that breast cancer treatment is frightening and causes anxiety and we want to ease your concerns throughout the process.

During Treatment

Simulation is a process in which the radiation therapist makes an immobilization device and marks the skin to help with treatment planning. These immobilization devices are molds, casts and other devices that keep the body in one position throughout the treatment session. The skin is marketed with India ink to create tiny permanent tattoos and plastic catheters are placed on the skin.

CT Verification Image – A CT scan is performed after the Simulation. This CT scan is used for treatment planning purposes. You are placed in the same position as during simulation and the tattoos and plastic are used to develop a radiation plan.

Treatment Planning is done by members of your treatment team by reviewing information from the simulation, CT scans and previous tests to develop an individualized treatment plan. A 3 Dimensional representation of your anatomy allows for careful examination of the organs, structures and tissue density of your internal anatomy. Sophisticated computers are used to optimize the shape and angles of the radiation beams using sophisticated mathematical computations. The goal is to create a precise modeling of the plan that will be used to deliver radiation to the areas needing treatment, while avoiding surrounding tissues and organs.

Confirmation Simulation is performed suing the treatment planning data, prior to starting actual cancer radiation treatment. During this simulation, a dry run of the treatment is performed to verify the precision of planning. The radiation therapist runs through each step of the actual treatment, but takes films, rather than giving the treatment. The films are reviewed by the radiation oncologist and any fine tuning can be performed prior to beginning treatment. At this time, a schedule is made for your appointments for the treatment.

External Beam Radiation Therapy Treatments – This breast cancer radiation treatment is painless, like getting an x ray. During the treatment, radiation is directed at the tumor in a non-invasive process in a series of outpatient treatments. The treatments are scheduled five days a week, Monday through Friday. The length of time can vary from two to ten weeks, depending on the location, size of the tumor and type of cancer. The external beam treatment is given according to your doctor’s instructions.

You are positioned during the treatments in the same immobilization device that was created for you to ensure you are in the same position each day of the treatment process. During treatment, the therapist will be in a control room monitoring you on a television screen and communicating with you through a microphone. Daily imaging is done to localize the treatment field for precision treatment. This IGRT technology is an advanced technology offered at our center and a handful of other radiation oncology centers. A set of CT scans or low energy x-rays are taken proper to treatment and used to target the radiation beam to the exact tumor area.

The treatment is designed to reduce the radiation dose to the normal tissue surrounding the tumor, but the radiation will still affect some healthy cells. Time between treatments allows healthy cells to repair, while cancer cells die. In some cases, a course of treatment may have to be interrupted for a day or more, if side effects develop. The missed treatments may be added to the end of the treatment course. The radiation oncologist monitors daily treatments and alters the radiation dose based on the observations. In addition, blood tests, x-rays, and other tests may be performed to determine how your body is responding.

Weekly Status Checks are performed by your radiation oncologist to evaluate side effects and recommend treatment for the side effects. As treatment progresses, changes in the schedule or treatment plan may be made depending on your response to the treatment. The radiation therapy team gathers with other healthcare professionals on a regular basis to ensure the treatment is proceeding according to plan.

Weekly Beam Films may be performed to verify the correct position of the treatment using the treatment beam.

After Treatment

Follow up care is provided to ensure that your recovery is proceeding normally and appointments are scheduled to monitor your health status. Additional diagnostic tests may be performed and reports sent to other doctors on your team. The frequency of the visits decreases over time, but your radiation oncology team is always available to discuss your treatment, address your concerns, and answer your questions about breast cancer radiation.

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