BREAST CANCER/NONSURGICAL TREATMENTS: RADIATION THERAPY

Radiation therapy, following lumpectomy, is given five days a week for approximately six and a half weeks. The specific schedule of your treatment will be discussed with your radiation oncologist and nurse. If you are also getting chemotherapy, radiation may be administered at various points:

* Prior to chemotherapy

* Following chemotherapy

* “Sandwiched” in the middle of chemotherapy

* Concurrently with chemotherapy

* Recent studies have indicated the value of radiation for some women who have had mastectomies. If this is suggested to you, it will probably be at the end of your other treatments. You may have more trouble with skin burning when the radiation is directed at your chest wall rather than at a breast.

Most women find their radiation treatments to be relatively uneventful. It can be tiring to make a daily trip to the hospital, and it certainly is a daily reminder of what has happened to you. It may also require a major psychological shift to think of radiation as life-giving, instead of as an encounter to be avoided whenever possible.

In Hester’s clinical practice, she has encountered some women who have a very difficult time psychologically during radiation therapy. Again, for most women, these treatments are quite manageable and sometimes more of an inconvenience than anything else. However, Hester believes that two groups of women may have real trouble during these weeks:

* Women who have a childhood history of sexual abuse

* Women whose primary coping mechanism is avoidance

Women in the first group may have a strong reaction to having to lie prone and still while a large and powerful object is suspended over them. These feelings may be intense but confusing, as they come from semiconscious or unconscious memory. If you know that you have a history of sexual abuse, it would be wise to talk over these feelings and your planned treatment with an experienced oncology social worker or other mental heath clinician. Unless you choose to do so, you do not need to tell your medical team of your history. You can simply say that this treatment is difficult for you and that, therefore, you will require a little extra time and attention.

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