A few months ago, I had a lengthy conversation with someone about the radiation that she was about to receive after her lumpectomy. While I had become aware of how radiation can affect reconstruction and have shared out that information with everyone recently, I couldn’t help but reflect about the radiation itself. After all, if the radiation affects the outside of the body in the way that it often does, what must be going on inside the body?
I found a very informative article that addressed the topic of radiation therapy for breast cancer. I suppose that the most amazing thing is that there was a list of 12 different radiation therapies. I thought that radiation was radiation and that the options were whether the radiation was given from outside of the body or inside the body. But, after I started to review the information provided about each different radiation therapy listed, it became a bit clearer about what type of therapy might be selected for a particular patient based upon her unique situation.
For instance, the first treatment (which is listed in alphabetical order) explains the advantages of AccuBoost. The list includes the following:
- The noninvasive procedure can be performed in an outpatient setting.
- The targeted dose is designed to help contain the radiation treatment to the lumpectomy site as much as possible.
- By delivering a measured dose that matches the size, shape and location of the target site, AccuBoost is designed to limit toxicity and overexposure to the breast.
- Because this form of real-time, image-guided radiation therapy (IGRT) is highly focused, it is more likely to affect less of the surrounding healthy tissues and organs, including the heart, lungs, ribs and muscles, by limiting their unintentional exposure to radiation.
- Providing targeted, measured, therapeutic doses is designed to produce fewer radiation-related side effects.
With this first step, it became clear as to why a full medical team needs to be in place when decisions are being made regarding a patient’s course of treatment. Is surgery going to be a part of treatment? If so, will if be before or after radiation? Is reconstruction a part of the equation? If so, what type of radiation is to be administered in order to bring about the best outcome from the reconstruction? Do options exist for radiation being administered at the time of a surgery that affects the amount of radiation to be administered? And how many times will radiation be delivered?
If you or someone you know is diagnosed with breast cancer, your first choice is to decide whether you wish to play an active role in the decision-making processes that are about to occur. Just because you are not a medical professional does not mean that you can’t request a full assessment of the treatment course that your doctors are recommending. Armed with that information, you can make decisions for yourself regarding all aspects of that treatment. If the course outlined matches the steps that you believe works best for you and your concerns have all been addressed, then you can feel free to move forward. For instance, if reconstruction is on your list and your surgeon, oncologist and a plastic surgeon have all reviewed your case and you feel comfortable with their proposals at each stage, then you can feel comfortable in moving ahead, trusting that you have done your research and all questions have been answered to your satisfaction.
If you find that you are not comfortable with any portion of the treatment that has been suggested, then you should definitely seek a second opinion. For example, if you are looking at reconstruction and have found the method/amount of radiation to be administered is not in line with what you believe is appropriate, you should seek other professional input. Or if you want reconstruction using your own tissue rather than implants, you should do your homework if you are told that this is not possible and consult with a plastic surgeon that you have confirmed is certified in that type of procedure in order to get that second opinion. The more that you learn before making a decision, the less likely you are to ever have regrets about how things might have been different. And there is nothing more powerful on a personal basis than to be content that you have done everything that you can do to give yourself the best outcome possible.