Radiotherapy

Radiotherapy is the use of x-rays to treat cancer. These high-energy rays damage cancer cells. External beam radiation is given as a series of small pulses of energy over four to five weeks. This allows a large dose of energy to be aimed at the cancer while minimising effects on normal surrounding tissues. Radiotherapy is used in different ways for treating breast cancer.

1.After partial mastectomy - radiotherapy is given to the rest of the affected breast to reduce the risk of cancer cells re-growing and causing a local recurrence. Radiotherapy reduces the risk from about 30 - 40% down to 10%.

2.Radiotherapy is usually not necessary after mastectomy. However, if the cancer is very large, or if the margins of clearance from the chest wall are small radiotherapy may be recommended to reduce risk of recurrence. There is also evidence that when four or more axillary lymph nodes are involved with cancer then radiotherapy to the chest wall can actually improve survival.

3.Radiotherapy is sometimes used as the primary treatment for a large or advanced cancer where surgery is not possible.

4.Radiotherapy is also used to treat localised metastatic disease such as bone metastases.

The radiation oncologist will discuss risks and benefits in your specific situation. You will be able to ask any questions that you have and will also have time to think about your decision to go ahead with treatment. The next step is to attend the radiotherapy department for simulation. This is a planning visit at which the radiation technician will set up the radiotherapy machine specifically for your treatment. A plan will be devised including how you will be positioned to ensure maximum radiation reaches the cancer. It also gives you an opportunity to find your way around the unit and to meet your treatment team. You will then return to start actual treatment a few days later. Radiotherapy will start about 6 - 8 weeks after surgery to give the tissue time to heal adequately after the operation. You will have a treatment session 5 days a week for 4 weeks. Each session only takes a few minutes.

Radiotherapy is given at Auckland Public Hospital or in Private practice through the newly established Auckland Radiation Oncology

There have been widely publicised delays in radiotherapy treatment in Auckland due to staff shortages and strikes. On a number of occasions patients have been flown to Australia for treatment.

Possible side effects:

• Skin may become dry, flaky, red, itchy and sore.
• Radiated tissue may be swollen and tender initially and may remain firm and lumpy for many months
• Hair loss over the radiated area
• Tiredness
• There is a small risk of damage to normal tissue in the area such as the lung, heart and ribs. The radiation oncologist will discuss these issues with you