Radiation therapy involves treatment of the tumour using a machine that beams high-energy rays or particles onto an area of the body to destroy the cancer cells. The amount of radiation given during treatment, the number and frequency of treatments, as well as how it is delivered will be determined by the care team for each woman. Not every woman we interviewed underwent radiation therapy. Christa, for example, couldn’t have radiation because she was pregnant.
The women we spoke to all had different experiences with radiation. Some found it easier than chemotherapy or not as bad as they had initially anticipated. It was still challenging though for most to deal with the side effects and fatigue associated with this treatment.
I took my daughter in to see it, the (radiation) machine, I said to her “It looks like Star Wars because it’s all these lights and everything. This big round thing and all these lights”. She walked in and the girl was showing her the machine, and I said, “Yeah and when it starts up it all lights up with all these different lights and everything.” My daughter says to me, “I’ll wait outside mum.” but I was fascinated by it. It’s almost like a CAT scan (Computerized Axial Tomography Scan) but bigger and it goes over like this and back and forth and they have to put little tattoos and then I guess they put the radiation in there. It probably goes right though that kind of thing. I think with the breast, or anything like that, you’re not going to get a problem, at least I never had, I just felt tired. And after the, I think it was the 5th one, I can’t remember how many I had. I know I had eight chemo; no pardon me I had um 15 radiation, because then after about 6 or 7 of them it was like you had a sunburn and it hurt, like it was burning, but it was burning from the inside out. Really a strange feeling but they give you cream, of course and then after you’re finished you keep putting the cream on but it takes about 6 months before it’s really out of your system and that you feel it’s out of your system. Strange and scary what it’s doing to you.
*CT scan: Body scan that produces cross section images of the body’s internal structures.
Care and treatment plan
Most women received radiation after finishing chemotherapy, and generally as daily sessions (Monday-Friday) for 10 - 15 minutes, lasting 15 - 25 days. However, there were exceptions, such as for Annie. Because of the nature of her diagnosis and the size of the area needing radiation, she received radiation for up to 30 minutes each time. Melissa and Annie received brachytherapy and Tomotherapy, respectively, two less common forms of radiation. Brachytherapy is the application of high doses of radiation on or near the tumour itself, in order to minimize radiation to the surrounding tissues. Tomotherapy divides a single beam of radiation into multiple beams to allow for continuous radiation from more angles. Sirkka's radiation area was covered with a wet towel to increase the intensity of the radiation to the skin. Isla described it as an unnerving experience to be in a cold room with the machine but it was quick.
Then because I was feeling fine after chemo, I delved right into radiation and that was a bit trickier, only because you’re at the hospital every day so it was, really challenging to try and be motivated to go there for your 15 minutes and then leave and then know that you had to go back and do it the next day.
Surprises or changes during the treatment plan
May-Lie and Donna didn't remember having radiation therapy in their treatment plan, so hearing that they had to undergo radiation later on was a big surprise. Donna felt that she was not offered a choice about her treatments and didn't feel that she received adequate care and information from her oncologist and nurses.
For some women it was a surprise to learn that their skin had to be marked in ink like a tattoo or permanent pen mark, as they had never been told about this detail until they were being marked.
And Annie decided to change doctors after she felt discouraged after the first meeting with the radio-oncologist. You can read more about changing doctors in Relating to health care professionals.
Other women had more positive experiences with their providers, saying that their radiation team was great and that they were very helpful and supportive throughout their treatments. Some, like Laurie, were able to take a more active decision-making role in their treatments, which they appreciated.
And then we had to decide about the radiation. They said that I should have radiation both in the breast area and up here but I wasn’t very keen about this and I wasn’t very keen about going for 5 weeks every day.
When you’re finished your chemotherapy you ring a little bell on your last day when you’re leaving. So when I went downstairs to do my radiation one of the radiation technicians was a male and he was there every day for my 20 treatments except my very last day.
Some women had only a few side-effects from radiation, whereas others had more. Red, dark skin, accompanied by some burning were more common skin side-effects reported by women we interviewed, and some likened it to a sunburn. Nurses often suggested creams to help alleviate the burning and irritation of the skin caused by the radiation, and to prevent the skin from drying out. Nadia A's nurse suggested Polysporin cream or specific ointments, and she found them very helpful in reducing irritation and keeping her skin soft. Other side-effects included stiffness due to changes in muscle tissue and scar tissue build up, blistering, tenderness, pain, sensitivity, and peeling skin. Almost all of the women said that they experienced fatigue during and after the end of their treatments. Less commonly mentioned side-effects included severe burns, vomiting, stomach problems, changes in breast tissue, and difficulty lifting an arm. Some women described a skin colouration like a sun tan that lasted long after the radiation.
It does, yeah it does and they know it’s a long-term effect. Oncologists know it’s a long-term effect. Researchers are now really looking into it. We’ve discussed this quite often on the Symptom Management Committees for Cancer Care Ontario and that’s a huge topic right now for long-term survivors. Why do I still have this?
Suggestions and coping
Annie had quite a bit of pain during her first few radiation sessions, so her physiotherapist suggested that she take Advil every 4-6 hours. She said that this helped to alleviate the pain and reduced the dosage over time as the radiation became less painful. Some forms of therapy that some women found helpful included; massage therapy, healing work, naturopathy, specialized creams, essential oils, moisturizers and vitamin C treatment. A handful of women said that napping during the day was an effective way for them to fight off fatigue.
And she (volunteer through cancer connections) would tell me about her experience, what helped her and that was really awesome. By the time I arrived in (city in British Columbia) at the cancer lodge, there was a note and a card on the bed and it was from her and that was my inspiration and I taped it to the wall.
By that time I had thought, I’m pulling in some of my alternative care, so for skin care I made all of my own blends. I made all my own moisturizers and I used essential oils and did healing work. I went to a number of providers and did healing work.
I found radiation was tough and I am so proud of myself that I started working right away and my boss says I could come back part-time because during the chemo time I got very depressed. It was during the Christmas time and it got me very depressed and I couldn’t I told my husband I can’t stay at home during radiation.
And then I thought well that’s not great because where I live in (city in QC) the swimming pool is more or less in my back yard and in the summer I always go for a swim before going to sleep because then I sleep better because I’m cooled off. And even more so if they stick you on Tamoxifen, which makes you have hot flashes and they’re radiating you so you’re hot, so swimming feels even better.
It must be said though that swimming is not a good idea when the skin is broken.
Services and accommodation
Some women found that commuting to and from their treatment facility was hard and that it contributed to their fatigue. Some cities and communities had driving services to help patients get to and from their treatment facility, which is especially helpful for patients who live far away; daily transportation costs by car or taxi, for instance, can be expensive. Other women were able to stay in 'hotels' designed for patients going through cancer treatment for the duration of their radiation treatment when farther from home – some staying the week, returning home on weekends, while others remained for their entire treatment. Despite being far away from home and missing their usual social support, all of the women who used this service had positive experiences during their stay.
Well there’s a group, I’m actually the secretary and I’m on the Board for a charity group, that we have here called Road to Hope and they drive patients or clients, I guess we call them, to their cancer treatments and back for free and I actually just drove a lady last Friday to a radiation treatment. It’s the first time I ever drove because I work full-time.