Radiotherapy is a doddle compared to chemotherapy. It zaps any stray cells that might be left after surgery. Whether or not you need it, how many sessions you have and the strength of the zapping will all be down to your individual pathology.
Planning and Tattoos. The radiotherapy planning is very painless. They take what seems like forever to manipulate you into a very specific and rather weird position (only uncomfortable if you haven’t kept up with your post surgery exercises – you MUST be able to lift your arm in the air or it will be delayed). They then give you a couple of teeny weeny tattoos (that look like you’ve been prodded with a biro), take a quick CT scan (all open-plan and easy – not like an MRI – see X is for… X-Rays and Scans) of your chest area. The CT scan is just for the planning – they are not looking for baddies and it is done without contrast. You then toddle off home while they do the planning part of the angles and height and strength for the zapping machine.
The Treatment. The most painful part for me was travelling to the hospital every day, followed by massive queues for the car park and then the inevitable delay for the machines. Once I was actually inside the process was quick and easy. At my hospital the room is rather large and cold and there is nowhere to change (just preparing those of you who may be struggling with your post-surgery body. I found it a bit weird but knew that they’d seen it all before a million times). So, you whip off your top half, lie down on the bed where they manipulate you into EXACTLY the same position you were lying in for the planning which can take a few minutes. When the position is finally exactly right, YOU MUST NOT MOVE! Otherwise the whole process will begin again! They then leave the room and then this massive space-age, robot-like machine twiddles and twirls around you until it is in the right spot. It then makes a zapping, buzzing, whirring noise for a few seconds while it zaps the correct spot. You cannot feel anything and there are no beams or anything like that – whatever it does is painless and invisible. I had 2 radiotherapy sessions of about 15 seconds each for 15 dose dense sessions. My skin was slightly tender and pink after the first week, but didn’t get too sore, even with the remaining radiotherapy blasts. The number of angles they radiate you from, the number of treatments and the strength will vary depending on your pathology.
A few tips and reminders:
1) Washing. Advice varies hugely on what to use. You’ll want to use something unperfumed that is kind and gentle to your skin. I used Simple shower gel and had no problems.
2) Moisturising. I moisturised the area frequently with E45 and Organic Aloe Vera Gel. My skin got quite hot and sore – like sunburn, but luckily didn’t break. I lathered the gel on all day and used E45 at night. There’s no harm in moisturising lots in advance too.
3) Deodorant. My hospital advised against any deodorant on the affected side, so I followed their advice. However, others have been told then can use unperfumed, parabens-free deodorant.
4) Clothing. I wore loose fitting cotton clothing and didn’t bother with a bra, but if you need a bra then a soft, cotton crop top would probably be best.
5) Take a good book! Sometimes you will be in and out – other times you might have quite alot of time to kill!
6) Dealing with fatigue. I was working part time from home and had the luxury of being able to listen to my body and have a nap if needed. I realise if you’re working full time or have a family you might not be able to do that, but make sure that you take it easy and get a few early nights at least! There is also good evidence that changes in your diet and keeping up exercise helps combat fatigue. See Y is for… YAAAAAWN – Dealing with Fatigue.
7) Protect yourself from the sun. Your skin is having to deal with enough without having to cope with a bout of sunburn too! Either keep the area covered or use a high SPF with as few chemicals in as possible. Be aware that the actual area being zapped can be quite large – but after a few sessions you should be able to make out the areas as they change colour.
8) Long-term side effects. Your oncologist will take you through the most serious side effect before you sign your consent form – this being that there is a risk that the radiotherapy can cause a new cancer – but the benefit will outweigh the risk. Other side effects that MIGHT happen, include skin discolouration like a little permanent tan in that area, capsular contraction – where the healthy tissue kind of contracts and hardens (which is why most surgeons prefer to delay reconstruction rather than risk their masterpiece being ravaged by radiotherapy!) and ongoing fatigue. According to Macmillan the fatigue can continue up to a year after treatment, but once your active treatment is done you will start to feel better and stronger in yourself.
Chemo For Beginners - an A to Z of all things "C" 
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