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Radiation 101: Your Guide to Radiation

Jacki Donaldson, who has been through radiation for breast cancer treatment, explains what you need to know before, during, and after radiation.

Meet Jacki Donaldson

When it comes to breast cancer treatment, radiation can seem like a walk in the park compared to major surgery and months of chemotherapy. For me, it was a breeze. I had already survived a lumpectomy and chemotherapy before my turn at radiation. I’d endured hair loss, nausea, low blood counts, fever, two hospitalizations, and a blood transfusion. Radiation couldn’t – and didn’t – even compare. But it’s still quite a process, and what follows will shed some light on how you might breeze through radiation. It’s all quite do-able – if you know what to expect.

Preparation for Radiation

If your doctor has prescribed radiation as part of your treatment plan, preparation is key. Radiation is a detailed, precise process that aims to kill cancer cells in the breast while sparing healthy cells in the same area. It’s administered by a machine that accelerates charged particles and shoots them at a target that generates photons. Photons travel directly to the breast, in the form of a beam, where they kill the cancer cells.

Radiation is used in combination with lumpectomy primarily to reduce the chance of local recurrence in the breast or on the chest wall. Radiation after lumpectomy is considered the standard of care for all women and is part and parcel of the treatment plan. For women whose breast cancer has gone to the lymph nodes radiation may also increase the cure rate after lumpectomy. For women who have had a mastectomy there are still clinical situations where a patient benefits from post-mastectomy radiation – if the tumor is in multiple lymph nodes or is a very large tumor (5 cm. or more).

To ensure the proper delivery of this treatment, you will visit your radiation team several times prior to your first session. Your first visit with a radiation oncologist will include a review of your history, pathology reports, and x-ray films, as well as a physical examination. After the exam, your doctor will discuss recommendations, review side effects, and prepare a plan.

Next, you will attend two planning sessions called simulations. During these sessions, a mold is created to ensure that you lie in the same position for each treatment. X-rays and CT scans are performed to identify the specific delivery of radiation from a variety of machines, temporary markings are drawn on the skin, and small permanent tattoos (little blue dots) are placed around the breast so machines line up without any variation during each radiation session. You may attend additional appointments to fine-tune this process. Behind the scenes, your medical professionals will craft the perfect scenario for your individualized treatment.

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