Radiation.
While it certainly doesn’t pack the same emotional kick in the gut as chemotherapy, radiation conjures up visions of burned skin, fatigue, and fear of the unknown: are those high-dose X-rays, administered day after day for weeks, doing me more long-term harm than good?
Thankfully, traditional radiation therapy for breast cancer has improved greatly over the past 20 years. More targeted than ever, the chance that radiation will result in serious long-term issues – e.g., a secondary cancer – is pretty much a non-issue these days.
Still, the treatment can take up to 6 weeks: 5 days a week, Monday through Friday. That can stretch to 7 weeks if you’re getting “the boost:” an additional course of focused radiation delivered directly to the site of the tumor.
While the actual radiation takes just 10 to 15 minutes, driving to the hospital, waiting, and driving home takes a chunk of your day: especially if you live a long way from the hospital. Thus for many women, the biggest challenge of radiation is the schedule, rather than the treatment itself.
Luckily, there are a number of new therapies that are radically altering the manner in which radiation is delivered. Many are still in the trial stage, and generally unavailable to the public. But a few are gradually making their way into the mainstream – and if you’ve learned your treatment plan includes radiation, they’re worth checking out.
Accelerated whole breast radiation therapy (AWBRT), a.k.a. hypofractionated radiation therapy
AWBRT uses slightly elevated doses of radiation to shorten the course of treatment to 3 to 4 weeks. Yes, it still involves weeks vs. days (or even hours) of treatment; but it’s a start.
This treatment is in the final stages of testing, with patient guidelines – which women might benefit most, and on what exact schedule – being determined. Scattered facilities are offering the treatment, as data-gathering continues; ask your oncologist if your hospital is one of them, and if it might be right for you.
Whole-breast vs. partial-breast radiation
Breast cancer treatment is becoming more and more targeted, and radiation is no exception. Some newer forms of radiation treat just the area where the tumor was removed (partial-breast radiation), vs. the entire breast (whole-breast radiation).
Studies so far indicate that there’s no difference in survival rate between these two types of treatment, though there are more local recurrences (return of cancer to the same breast) with partial-breast radiation.
The two treatments described below involve partial-breast radiation. As such, only certain women are good candidates for them; before you research their availability, find out if you qualify. And this could be confusing, as the two main advisory bodies for radiation protocols disagree on the standards.
The American Society for Radiation Oncology advises partial-breast radiation might be a choice for women over the age of 60 who are ER/PR-positive; with no lymph node involvement; and whose tumors are under 2cm. They advise women with DCIS or other non-invasive cancers, and women with multiple tumors, NOT to use partial-breast radiation.
