Radiotherapy for breast cancer in men
Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells.
Radiotherapy is directed at specific parts of the body. In breast cancer, it’s most often used to decrease the risk of breast cancer coming back in the breast or chest area(local recurrence). You’ll usually start radiotherapy about four weeks after your surgery unless you’re having chemotherapy.
Radiotherapy after a mastectomy
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If there’s an increased risk of the cancer coming back in the same area after a mastectomy, your cancer specialist will advise you to have radiotherapy to the chest. They may advise this if:
the cancer was large
the cancer was high-grade
there were cancer cells in the lymph nodes in the armpit (depending on how many nodes were affected)
there were cancer cells close to the edge of the removed breast tissue.
If you’ve had a lumpectomy, you will be advised to have radiotherapy to the remaining tissue afterwards.
Radiotherapy to lymph nodes in the armpit
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If you had some (but not all) of the lymph nodes in your armpit removed and it was found they contained cancer cells, you’ll usually have radiotherapy to the remaining nodes. If you had all the lymph nodes in your armpit removed, you won’t need to have radiotherapy as well.
Radiotherapy is normally given in the hospital radiotherapy department as a series of short, daily sessions. The treatments are usually given from Monday-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 your radiotherapy
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Radiotherapy has to be carefully planned to make sure it’s 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.
On your first visit to the radiotherapy department you’ll be asked to have a CT scan. This will take a series of x-rays, which the clinical oncologist will use 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) position you accurately and to show where the rays will be directed. These marks must stay throughout your treatment, so 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.
At the start of 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 alone in the room, but you can talk to the radiographer who will watch you from the next room. Radiotherapy is not painful, but you will have to lie still for a few minutes during the treatment.
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
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You may develop side effects over the course of your treatment. These usually disappear gradually over a few weeks or months after treatment finishes. Your doctor, nurse or radiographer will discuss this with you so you know what to expect. Let them know about any side effects you have during or after treatment, as there are often things that can be done to help.
You may develop redness, dryness and itching of the skin in the treatment area. If you have dark skin it may get darker or have a blue or black tinge. Your doctor can prescribe creams to soothe your skin if it becomes sore and flaky. Usually, any skin reaction settles down 2-4 weeks after radiotherapy. You’ll be given advice on how to look after your skin.
Here are some tips that may help ease skin irritation:
Don’t use perfumed soaps, deodorants/antiperspirants or any creams unless they are prescribed by your cancer specialist.
Have showers rather than baths but turn away from the spray to protect your chest. If you do have a bath, avoid soaking the affected area for too long.
Pat the area dry gently with a soft towel - don’t rub.
Wear loose clothing as this may be more comfortable and less likely to irritate your skin.
You’ll need to avoid exposing the treated area to sunshine for at least a year after treatment finishes. Use suncream with a high sun protection factor (SPF) of at least 30, to protect your skin if it’s exposed.
Some men also experience hair loss in the area of their chest that is being treated. This is usually temporary and hair grows back after treatment is over.
You’re likely to feel tired during treatment, and this may continue for a month or two after it finishes. Pace yourself and save energy for the things you have to do, and that you enjoy.
Get plenty of rest but balance this with some physical activity, such as short walks, which will give you more energy.
Watch Denton's story
Denton talks about how he coped with fatigue after treatment for prostate cancer.
Aches and swelling
You may notice a dull ache or shooting pains in the chest that last for a few seconds or minutes. You may also find that your chest area becomes swollen, but this usually improves quickly after treatment finishes.
Long-term side effects
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Radiotherapy to the chest can sometimes lead to long-term side effects, but most of these are rare.
How the chest looks
After radiotherapy, small blood vessels in the skin can be damaged causing red ‘spidery’ marks (telangiectasia). These affect how the skin on the chest looks but are harmless. Your skin may also have a slightly darker tone.
Rarely, a few months after radiotherapy some men develop breathlessness 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 steroids. Radiotherapy rarely causes any long-term damage to the lungs.
Changes to the heart
People sometimes worry about the effects of radiotherapy on the heart. Radiotherapy is very carefully planned to avoid including the heart in the treatment area. It very rarely causes heart problems and only people who have cancer in their left side are at risk.
Weakening of the ribs
Rarely, radiotherapy weakens the ribs in the treated area, making them more likely to fracture (break) than normal.
These side effects are generally rare. If you’re worried about the risk of developing particular side effects from radiotherapy, talk to your cancer specialist.
Radiotherapy for secondary breast cancer
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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.