It is natural for anyone beginning a new medical treatment to be a little fearful. For people beginning radiation therapy, this fear seems to be heightened by some common misunderstandings about the treatment.
Radiation therapy is painful.
Not really. Most patients have no sensation of radiation when the machine is delivering the daily treatment. A few patients report a slight warming or tingling sensation in the area while the radiation machine is on. Over time, the skin in the area being treated will gradually become dry, sore, itchy, or burning. These feelings can be uncomfortable, but usually not enough for a person to stop or interrupt her treatment. Read more on coping with skin reactions.
Radiation therapy will cause me to be radioactive.
Only in certain cases. If you are treated with external radiation, you will not be radioactive at any time. The radiation you receive delivers its dose to your tissues within an instant — there is no lingering radiation once the treatment machine is turned off. As you try to keep to the normal rhythms of your life, it is important to remind friends, family, and co-workers that you will not expose them to radiation. If you receive internal radiation as a "boost" at the end of treatment, you will be radioactive while the radioactive material is in you. While you receive this internal treatment, you will be secluded in the hospital in a private room.
Radiation therapy will cause me to lose my hair.
No. Not on your head, anyway. If you are undergoing just radiation treatment, you won't lose the hair on your head (the hair on your nipple or in your lower armpit next to the breast might come out during radiation, but will grow back). The misperception that radiation makes you lose your hair comes from the confusion of radiation and chemotherapy. Since many patients begin radiation treatment right after their chemotherapy, it's understandable that the side effects of the two therapies are confused. Because chemotherapy is a "systemic" treatment, meaning it affects the whole body, you will likely lose your hair during this treatment. Radiation therapy is a "local" treatment, which means it is directly focused on the tissue of the breast area, and possibly nearby lymph nodes. Unless radiation is targeted at your head, you will not lose your hair from radiation.
Radiation therapy will cause nausea and vomiting.
Not usually. Radiation treatment to the breast area and lymph nodes for early-stage breast cancer usually doesn't cause nausea or vomiting.
Still, if radiation is used to treat advanced-stage breast cancer that has spread to other parts of the body away from the breast, it may cause nausea and vomiting, especially if radiation is given to the liver, brain, or gastrointestinal tract. The risk for nausea goes up as the dose of radiation and the size of the area being treated increase. Also, if you’re having chemotherapy at the same time as radiation, know that certain chemotherapy medicines may cause nausea and vomiting.
Radiation therapy will increase my chance of getting more breast cancer.
No. The purpose of having breast radiation therapy is to reduce the risk of recurrence in that breast. Radiation to one breast does not increase your chance of getting cancer in the other breast. It's true that there is a relationship between radiation and cancer: Adolescent girls receiving chest radiation for Hodgkin's disease have a higher risk of getting breast cancer because the newly developing breast is especially vulnerable to radiation damage. And a small percentage of women who were exposed to the atomic bomb blast at Hiroshima during World War II suffered from higher levels of breast cancer later in life. We now understand that this occurred because women were exposed to low levels of radiation over their entire body. The therapeutic radiation you will receive, however, is targeted precisely to the breast area, with almost no "scatter" to other areas of your body.
After years of practicing radiation oncology, I've found that when I address these misperceptions directly, patients enter radiation therapy with more realistic expectations and a better frame of mind.