For external radiation to the breast and lymph node areas, you will receive treatment once a day, 5 days a week, for 5 to 7 weeks. Internal, or partial-breast radiation, is usually given twice a day for 1 week. External partial-breast radiation, when used, is given twice a day for 1 week. For treatment to areas where the cancer has spread, daily treatments for 2 to 3 weeks are typical.
Scheduling can be one of the challenges of radiation treatment, but treatment centers try to help you keep to your normal day-to-day routine during radiation therapy. Appointments are generally short — although there are individual differences, the daily treatment process usually takes between 15 and 30 minutes.
The radiation staff will try to give you a daily appointment time that is as convenient as possible for you. Most treatment centers open by 7:30 or 8 a.m. and stay open until the end of the workday, Monday through Friday. Some centers provide earlier or later hours, but you may need to ask.
Since your doctor worked out most of the technical considerations of your therapy during the planning stage, your treatment sessions should run quite smoothly. Once a week you might have a longer appointment so your doctor and nurse can talk with you, examine you, and make various recommendations to ease your way through the process. Each week, X-rays of the treatment field are taken to verify that everything is going properly. Your blood counts might be checked in some situations.
To give you some time off during therapy and to allow your healthy tissue time to recover, treatment centers are not open on weekends. Most doctors try to start the first treatment by Wednesday to make sure you get at least 3 doses in the first week.
Why does a course of radiation take so long?
Radiation works best when cells are growing and making new cells. Giving the treatments over time maximizes the chances that the radiation will hit cancer cells when they're growing.
Additionally, getting radiation in small daily amounts (fractions of the total prescribed amount) helps protect your normal cells. Because you receive many small doses of radiation, rather than a few large ones, your healthy cells in the area being treated suffer less damage and have more time to repair themselves.
Radiation therapy is most effective when it is continuous and a full course is completed. To get the full benefit of radiation therapy, it's important for you to keep all of your scheduled appointments. If you have a significant skin reaction, your doctor might suggest a few days off from treatment. Also, if there is an emergency or you are unable to make a treatment, it's OK to miss a session. In these cases, missed sessions will be added to the end of treatment.
Special schedule requests
Keeping to a 5-day-a-week schedule of appointments for radiation can become a burden, especially during holidays and vacation time. One way to ease the demands of this routine is to ask your treatment center to schedule sessions early on Fridays and late on Mondays. These extra hours give you an extended weekend and might make the rigors of treatment more bearable. Many treatment centers are willing to be flexible, especially if it helps you keep each scheduled appointment.
You might have a vacation planned that seems to conflict with the start or completion of treatment. Work with your doctor to coordinate the treatment schedule with your vacation.
"Normal might not feel so normal after the diagnosis of breast cancer turns your life upside down! But the members of your radiation team will work with you to try to minimize the disruption caused by this 5- to 7-week treatment process."
-- Marisa Weiss, M.D., chief medical officer, Breastcancer.org