Side Effects of Radiation Therapy
Radiation therapy to the breast can cause some side effects. Some begin during treatment. Others may occur months or even years later.
Easing worries about radiation therapy
It’s normal to worry about possible side effects of radiation therapy.
Talk with your health care provider about your concerns.
Your provider may be able to suggest a hospital social worker, patient navigator, psychologist or support group to help ease anxiety related to radiation therapy (or breast cancer).
With any standard radiation therapy, you will not be radioactive when you leave the radiation treatment center. You will not pose any radiation risk to your family, including your pets.
Learn more about support groups.
Short-term side effects
Let your radiation oncologist or nurse know how the sessions are making you feel. They may be able to treat or prevent many side effects, or change your treatment plan slightly to reduce them. For example, they might delay your next treatment a few days.
Pain and skin changes
During and just after treatment, your treated breast may be sore. Talk with your health care provider about using mild pain relievers such as ibuprofen, naproxen or acetaminophen to ease breast tenderness.
The treated breast may also be rough to the touch, red (like a sunburn), swollen and itchy. Sometimes the skin may peel, as if sunburned. Your provider may suggest special creams to ease this discomfort.
Sometimes the skin peels further and the area may become tender and sensitive (called a moist reaction). This is most common in the skin folds and the underside of the breast.
If a moist reaction occurs, let your provider know. Your provider can give you creams and pads to make the area more comfortable until it heals.
Learn more about easing pain related to radiation therapy.
Learn about long-term skin changes due to radiation therapy.
Fatigue is common during radiation therapy and may last for several weeks after treatment ends.
Fatigue is mainly a short-term problem, but for some, it can persist [24,36].
You may feel like you don’t have any energy and may feel tired all of the time. Resting may not help.
Regular exercise, even just walking for 20 minutes every day, may help reduce fatigue [22-24,37]. Getting a good night’s sleep is also important.
Talk with your health care provider if you are fatigued or have problems sleeping (insomnia).
Learn more about fatigue and insomnia.
Long-term side effects
Breast and skin changes
Over time, your breast may become firmer or smaller.
You may also have mild tanning of the skin where the breast was treated or red discoloration, especially around the surgical scar(s). These changes may be permanent. Ask your provider what products might help reduce discoloration.
People who have radiation therapy to the lymph nodes in the underarm area (axillary nodes) or who have axillary nodes removed may develop lymphedema.
Lymphedema is a condition in which fluid collects in the arm, causing it to swell. Swelling may also occur in the breast, chest or back.
The chances of getting lymphedema are greater if your treatment includes both [4,9]:
- Removal of axillary nodes during breast cancer surgery (the more nodes removed, the greater the risk)
- Radiation therapy to the axillary or supraclavicular (above the collarbone) lymph nodes
Being overweight also increases the risk of lymphedema [4,9].
Learn more about lymphedema.
Rare short-term side effects
Nausea and hair loss
Nausea is rare with radiation therapy to the breast.
You won’t lose the hair on your head. However, you may lose some hair under your arm or on the breast or chest area getting radiation (this may be a concern for some men with breast cancer).
Rare short- or long-term side effects
Although rare with modern treatment, the side effects below may occur a few months or years after radiation therapy.
Rib fracture can occur when the radiation weakens the rib cage near the treatment area. This is rare with modern treatment.
If radiation therapy is given to the left side of the chest, heart problems may develop years later.
Many techniques are now used to limit this risk. With modern radiation therapy, the risk of heart problems is usually very small .
Radiation pneumonitis is an inflammation of the lungs that can cause shortness of breath, a dry cough and low-grade fever. It’s rare with modern treatment and almost always goes away with time.
Anti-inflammatory drugs can often relieve symptoms.
Brachial plexopathy can happen when radiation damages nerves in the upper chest. It may cause permanent tingling, pain and weakness in the affected hand and arm.
Nerve problems are very rare with modern treatment.
Radiation therapy and risk of a second cancer
In rare cases, radiation therapy to the breast can cause a second cancer.
The most common cancers linked to radiation therapy are sarcomas (cancers of the connective tissue) [11-13]. For women who are long-term smokers, radiation therapy may also increase the risk of lung cancer .
The risk of a second cancer is small. If your radiation oncologist recommends radiation therapy, the benefits of radiation therapy almost always outweigh this risk.
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