Radiotherapy for breast cancer in men

Radiotherapy| treats cancer by using high-energy rays to destroy cancer cells, while doing as little harm as possible to normal cells.

After breast surgery, radiotherapy may be given to the chest area if there is a risk that cancer may come back there. Your specialist will look at a range of factors to help them assess this risk including:

• the size of the tumour
• if there was cancer in the lymph nodes (and how many were affected)
• whether the tumour was growing close to the chest wall
• whether there were clear margins
• the grade of the cancer.

If all the lymph nodes have been removed from under the arm, radiotherapy to the armpit is not usually needed. 

Treatment overview Back to top

The treatment is normally given in the hospital radiotherapy department as a series of short, daily sessions. The treatments are usually given from Monday to Friday, with a rest at the weekend. Each treatment takes 10-15 minutes. Your doctor will discuss the treatment and possible side effects with you.

A course of radiotherapy for breast cancer typically lasts for three weeks. It is usually given as an outpatient.

External radiotherapy doesn’t make you radioactive and it’s perfectly safe for you to be around other people, including children, after your treatment.

Planning radiotherapy Back to top

Radiotherapy has to be carefully planned to make sure that your treatment is as effective as possible. A doctor, called a clinical oncologist, will plan and supervise your treatment.

Before beginning treatment you will go to the radiotherapy department for one or more planning sessions. A CT scanner will take a series of x-rays; the clinical oncologist will use these to make a map of the area to be treated.

Marks are usually drawn on your skin to help the radiographer (who gives you your treatment) to position you accurately and show where the rays will be directed. These marks must stay throughout your treatment, and permanent marks (like tattoos) may be used. These are tiny, and will only be done with your permission. You may feel a little discomfort while it is being done.

The radiotherapy is normally given to the whole area where the breast was. You may also have radiotherapy to nearby lymph nodes. These are in the armpit, the area around the collar bone and at the top of the chest by the breast bone (sternum). Some men are given an extra dose to the exact area where the cancer was. This is known as a booster dose.

Treatment sessions Back to top

Before each session of radiotherapy, the radiographer will position you carefully on the couch and make sure you are comfortable. During your treatment you’ll be left alone in the room but you can talk to the radiographer who will watch you from the next room. Radiotherapy is painless, but you do have to be still for a few minutes while the treatment is being given.

Positioning Back to top

You’ll need to be able to position your arm so that the radiotherapy machine can give the treatment effectively. Sometimes your muscles and shoulder joint may feel stiff. If you can’t move your shoulder normally, it may be painful or difficult to give the treatment.

A physiotherapist may teach you some exercises to make the position for treatment feel easier.

Side effects of radiotherapy Back to top

You won’t have any side effects from radiotherapy to begin with. Any side effects that do occur with radiotherapy develop gradually over the course of treatment.

Common side effects include:

Tiredness You will probably feel more tired than usual during radiotherapy and for a month or two afterwards.

Skin irritation You may develop redness, dryness and itching of the skin in the treatment area. Scented soaps, creams or deodorants may irritate your skin and should not be used during treatment. At the beginning of treatment you’ll be given advice on how to look after your skin in the area being treated.

Other skin changes There may be hair loss in the area of your chest that is being treated. This is usually temporary and hair grows back after treatment is over. There may be some darkening of the skin on your chest. If this develops it will usually fade within 6-12 months.

Aches and pains You may notice a dull ache or shooting pains in the muscles of the chest lasting for a few seconds or minutes. Some people continue to have occasional aches and pains in the chest area after radiotherapy has finished.

Less common side effects include:

Rarely, breathlessness may develop a few months after treatment. This is due to the effect of radiotherapy on the lung. It usually gets better within 2-4 weeks without any treatment or it may be treated with a short course of steroid medicines.

Occasionally the ribs in the treated area may be weakened, making them more likely to fracture than normal.

Radiotherapy to the armpit can sometimes lead to long-term side effects such as pain, tingling and weakness or numbness in the arm and hand.

These long-term effects are rare. If you are worried about the risk of developing particular side effects from radiotherapy, you can speak to your clinical oncologist or radiotherapist.

Radiotherapy for secondary breast cancer Back to top

Radiotherapy can also be used to treat secondary breast cancer. This is called palliative radiotherapy and it can often be given in one or two doses. It’s most often used to treat secondary breast cancer in the bone or skin. It can help to shrink the cancer and relieve pain.

When radiotherapy is given to treat a bone affected by cancer it usually takes about 7-10 days to start relieving the pain. It may take up to six weeks before the full effect is felt. Sometimes the pain becomes slightly worse before getting better. This type of radiotherapy causes very few side effects.