Radiotherapy

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Hi,  I have had surgery to remove a large tumour from my breast, triple negative BC. The NHS suggest chemotherapy first however I feel so scared. I am considering radiotherapy hoping for less side effects.

My question is: as the surgeon has removed the tumour how do we know that I still have cancer?  Wouldn't it make sense to test  bloods/scan to see if the cancer is still there or not. Why radiate someone who may no longer have cancer?

Thanks

  • Good Morning, Doobie.

     

    Thank you for getting in touch, and welcome to our online community.  My name is Lisa, and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line.  

     

    It’s completely understandable that you’re feeling confused as to why your team are recommending further treatment when the breast tumour has been removed.  Any treatment post surgery is called adjuvant treatment and is preventative, to give you the best chance that the cancer does not come back. 

     

    Triple negative breast cancer is sometimes described as a faster-growing type of breast cancer.  Your doctor may have given you more information about the stage and grade of the cancer to understand more about this. Recommended treatment is usually a combination of surgery, radiotherapy, and chemotherapy because they have been shown to work well together to treat this type of breast cancer.    

     

    Chemotherapy is given for triple negative breast cancer as this part of treatment is effective at travelling through the blood stream to target and destroy faster growing cancer cells wherever they are.  However, even if the cancer were low grade (slower growing) or hadn’t spread to the lymph nodes in the underarm, it is still usually offered. 

     

    Radiotherapy, on the other hand, is a localised treatment.  It helps prevent the breast cancer from coming back in the breast if you had a lumpectomy, as it uses high-energy x-rays to destroy cancer cells that could be in the remaining breast tissue.  This reduces the risk of the cancer coming back in that area.  Even in the case of a mastectomy, depending on the size of the tumour and if it were in the lymph nodes, the team may still want to treat the area with radiotherapy.  Radiotherapy is especially important if there is a higher risk of a local recurrence, like in the lymph nodes or the breast tissue.

     

    It can be scary to think that you may need chemotherapy and/or radiotherapy.  It’s common to have many different emotions when you have cancer and need treatment. While chemotherapy treatment can cause different side effects, these side effects depend on the drugs that you would have.  Some side effects are more common than others, but it is unlikely that you would have them all.

     

    You also mentioned having a blood test or scan.  However, there isn’t a reliable blood test or scan that can show definitively if all the cancer cells are gone.  Tumour markers or scans might not detect microscopic or even early-stage disease that could lead to a recurrence of the cancer, so even if scans or blood tests don’t show any cancer, there may still be tiny cancer cells that are not detectable but that could grow into new tumours.  Therefore, chemotherapy works systemically, ‘targeting’ these potentially hidden cells throughout your body.

     

    It’s understandable that you have a lot of concerns and worries about your recommended treatment plan. Therefore, we would encourage you to get back in touch with your consultant and breast cancer nurse at the hospital as they will have access to your medical records and are best placed to discuss this in more detail with you.  There is always a lot to think about when making treatment decisions.  However, your team can help you to understand your treatment options. Here are some questions to ask your healthcare team that may be helpful when you speak to them.  

     

    Many people find it can be helpful to talk about their diagnosis and how it may be affecting them.  It’s good that you have joined our online community.  We also have a triple negative breast cancer forum, which is a place to share experiences, get support, discuss treatment options, and more.  We also offer free counselling for people who may be struggling emotionally because they are living with cancer. 

     

    I hope you find this information helpful, Doobie.  However, we often find that we can help more by exploring your concerns over the phone.  You can also speak with the Macmillan Support Line team of experts.  Phone free on 0808 808 00 00 (7 days a week, from 8am to 8pm), or you can send us an email, too.

    Take care and best wishes

    Lisa R, Cancer Information Nurse Specialist

    Ref/KA/LiR