Getting radiation therapy? Here’s what you should know

This piece originally appeared on katiecouric.com. 

Radiation therapy has been around since the beginning of the 20th century, when Marie and Pierre Curie began experiments on the impacts of radium on human cells. But if you’re familiar with Marie Curie, you may also know that she died from a condition caused by long-term exposure to radiation. And if you find that confusing, you’re not alone: Radiation damages and destroys cells… but that includes cancer cells.

The concept of using something that could kill you to cure you is a bit unsettling, but not when you understand how radiation works. First and foremost, we’re exposed to small amounts of radiation every day — from things like cell phones, microwaves, and even the sun. If you take a trip down memory lane to high school science class, you might remember that if radiation waves hit a certain frequency, they can cause damage. High doses of radiation break down DNA in cells, eventually causing them to die — which is why radiation exposure is so dangerous. But more than 100 years ago, scientists figured out that by specifically targeting cancer cells in the body, they could treat and even cure cancer. Thus began the birth of targeted radiation treatment  — and since then, we’ve been getting increasingly better at treating cancer while harming as few healthy cells as possible.

If you know someone who had radiation treatment a few decades ago, they may have dealt with difficult side effects like scarring, vitamin deficiencies, and even fertility problems. Technological limits at the time meant that dosing radiation correctly for each patient was difficult, so treatment could have some tough consequences. But thankfully, technology is advancing at a rapid pace. (After all, only 20 years ago, Katie was on the TODAY Show asking, “What is internet?”) To understand what the developments in radiation treatment mean for patients today, we asked Jennifer Racz, MD, Director of Medical Affairs for Oncology at Exact Sciences, to explain how this therapy is used now…and her answers may help put your mind at ease.

The benefits of radiation treatment far outweigh the risks

Every medical procedure has risks, even if they’re uncommon. When it comes to radiation treatment, one of them is the development of secondary cancer. “Although patients treated with radiation are at risk for developing second primary cancers 10 to 25 years after treatment, the risk is very small,” explains Dr. Racz, “and the benefits of treating an active cancer usually far outweigh any risk of a second cancer later.”

A second course of radiation for breast cancer is generally safe and effective

“In the past, it was thought that radiation therapy to the breast could only be given once,” says Dr. Racz. “However, recent studies and clinical trials have shown that re-irradiation [a second course of radiation] can be performed safely and effectively for certain patients.”

The choice to undergo radiation for a second time depends on the type of breast cancer a patient has, and the treatment they first received: “Re-irradiation might be considered for patients who previously experienced a recurrence after radiation for breast-conserving surgery [lumpectomy], for those who have a recurrence in the lymph node area, or with complex recurrences when surgery isn’t an option,” says Dr. Racz.

Complications from radiation are relatively uncommon

One of the most common fears about radiation for breast cancer is that it’ll cause a type of scarring known as radiation fibrosis. This occurs when scar tissue forms in the breast, chest wall, lungs, or bones because healthy tissue is damaged during radiation.

While this painful condition was definitely a concern for patients in the past, today radiation fibrosis is very rare, since doctors can now target tumors with expert precision. At most, some patients may have minor short-term reactions: “The procedure itself is typically painless,” explains Dr. Racz, “but for some it may cause skin discomfort, irritation, or swelling over time. You might also feel tired. These issues  will usually subside within two to four weeks of finishing radiation treatment.” Whether or not you experience side effects varies from person to person and can depend on the area being treated and the length of treatment.

Long-term side effects, which can happen anywhere from months to years after treatment, are significantly less likely these days. “For breast cancer patients, there is the chance of permanent changes in the size or texture of the breast, swelling of the breast or arms, rib fracture, lung injury, toxicity to the heart.” While these may sound scary, Dr. Racz says these issues aren’t something most patients need to worry about: “With modern technology, these risks are becoming increasingly uncommon, especially the risk of heart damage.”

There’s a way to test if radiation for breast cancer might be beneficial

Some breast cancer patients may not need radiation at all. The Oncotype DX Breast DCIS Score can help patients and their healthcare providers personalize treatment decisions and potentially forgo radiation depending on their results and risk of local recurrence. “Using a patient’s DNA from a section of breast tissue removed during surgery,” explains Dr. Racz, “this test provides a result that can predict the 10-year risk of developing a cancer recurrence.” This information can help doctors and patients make informed treatment decisions.

There’s currently another test in development, the Breast Radiation Score test, that’s designed to evaluate the activity of 16 cancer genes — with the goal of determining the benefit of radiation therapy after breast-conserving surgery. “This score,” says Dr. Racz, “has been shown in studies to have the potential to help inform the prognosis of local recurrence for patients following breast-conserving surgery, and prediction of radiation benefit.”

Cancer innovations like these are just some of the advances in treatment on the horizon. And as researchers continue to use ever-advancing technology in the fight against cancer, patients have more options — and more hope — than ever.

The information provided is not clinical, diagnostic, or treatment advice. You should consult with a qualified healthcare provider about any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.