Radiation therapy is a simple, painless, and generally well-tolerated tool for treating and even curing breast cancer. One of the most common side effects of radiation therapy to the breast (after lumpectomy) or chest wall (after mastectomy) is skin irritation. The reaction and its extent differ for each woman. Because radiation therapy is often such an important part of breast cancer treatment, it’s important to know how to mitigate its side effects to get the most benefit from therapy.
Dealing with skin irritation
Radiation-induced skin reactions are more likely to occur in people who received chemotherapy shortly before or during radiation therapy and in women who have a prominent crease below the breast crease. In fact, this area and the armpit are the most common areas of the breast to experience a skin reaction. Most skin reactions resolve within a few weeks of completing radiation therapy.
Skin reactions are almost unavoidable for women who receive radiation to the chest wall after a mastectomy. As a result, many radiation oncology centers offer these women a one-week prophylactic break midway through treatment to reduce the severity of skin reactions.
The severity of a skin reaction varies from person to person. It may become more noticeable as the course of treatment progresses. Slight reddening of the skin, intense redness, sunburned sensation, dryness, itching, flaking, darkening like a tan, blisters, and moist oozing may occur.
When the reaction is severe, such as intense redness that turns into blisters and wet weeping on the skin, women are given a break from treatment, which usually lasts a week or two. This rest is usually enough to alleviate the worst symptoms. When necessary, doctors can prescribe therapeutic creams. Radiation can be resumed once the reaction resolves.
Treatment of the reaction
During radiation therapy, women can avoid chafing the irradiated skin without a bra or by wearing a non-wired cotton sports bra that fits well below the crease of the breast or irradiated skin on the chest wall. Women who can go completely braless should do so. If that is not a comfortable solution, women should wear a bra as infrequently as possible to reduce the likelihood and/or degree of a skin reaction. In addition, airing irradiated skin helps minimize skin reactions.
Over-the-counter alcohol- and fragrance-free moisturizers may reduce the extent of a skin reaction. Radiation oncology teams often prescribe these creams at the start of radiation therapy.
Women should also try to be kind to irradiated skin, which can easily become inflamed. Radiation oncologists suggest:
o Do not rub, rub, or scratch the skin in the treatment area; instead, pat the skin dry and massage doctor-prescribed anti-itch creams or ointments into the affected area.
o Avoid sun exposure of irradiated skin. When you go outdoors, wear opaque protective clothing, such as a cotton T-shirt.
o Stay away from tight-fitting tops and bras in the area unless otherwise directed.
o Use only warm water and mild soap recommended by the radiation oncology team on the treated area.
o Avoid using ice packs or heating pads on treated skin.
o Stay away from commercial deodorants and skin care products that are not endorsed by the treatment team.
o Do not shave the armpit on the treated side with a non-electric razor.
o Avoid skin care products for at least two hours before radiation treatment.
Although many people who undergo radiation therapy experience skin reactions, most outgrow this temporary side effect. By working with their radiation oncology teams, people exceed the metaphorical goal of the radiation therapy course, often victoriously. Most importantly, they derive substantial benefits from radiation therapy and go on to lead productive, cancer-free lives.