• Cancer Prevention

    The best time to beat cancer is before you even get it!

    read more
  • Second Opinions

    You have options and the final decision is yours to make.

    read more
  • Navigation

    You should never find yourself wondering what the next step is.

    read more
  • Education and Support

    We will guide you through this life changing event.

    read more
  • About Dr. Hart

    Board Certified Radiation Oncologist

    read more

Potential Delays in Beginning Radiation Treatments

What potential issues may cause a delay in beginning radiation treatments for breast cancer patients?

The three common treatment modalities in treatment of breast cancer can be given in different sequences. The most common sequence is to start with surgery, continue with chemotherapy if indicated and finish with radiation therapy. But in some cases chemotherapy is delivered before surgery and is followed by radiation therapy. There is one exception to this general rule of radiation therapy being the last modality in the sequence of treatments and that is when Accelerated Partial Breast Irradiation (APBI) using brachytherapy balloons such as Mammosite, Contura or Savi applicator is the form of radiation utilized. In APBI, radiation is delivered immediately after surgery and chemotherapy, if recommended, would follow radiation.

Therefore a “delay” in beginning of radiation treatment can be a planned or an unplanned one. For example we often recommend 4-6 weeks between surgery and beginning of radiation in order to make sure that all the surgical incisions are completely healed. One of the potential side effects of radiation is delay in healing of wounds and that is the reason behind that planned delay. We also recommend about 2-4 weeks of gap between last chemotherapy administered and beginning of radiation therapy. This form of planned delay in beginning of radiation is due to the fact that some chemotherapy agents are radiosensitizers and may potentially increase the risk of side effects from radiation therapy.

The unplanned or undesired delays in beginning of radiation therapy may be due to an unhealed surgical incision or persistent seroma or a hematoma in the lumpectomy cavity or in soft tissue pouches after a mastectomy. Radiation therapy is based on very accurate measurements and calculations of the volumes of tissue irradiated and the doses delivered. If the calculations and radiation plan is based on a certain size of breast and certain size of lumpectomy cavity and this volume is changed due to an enlarging seroma or hematoma, our calculations and therefore radiation doses would be off. Therefore we would await resolution of a seroma or a hemtoma either by giving it some time to absorb or by aspirating it before planning the radiation treatment.

With increase in the use of tumor genetic assay tests such as Oncotype DX, often there is a delay in determining whether a patient requires chemotherapy or not. In this scenario, the radiation oncologist would need to await the test result before starting patient’s radiation because if the Oncotype DX result indicates benefit from chemotherapy, this treatment should be delivered before beginning of radiation therapy.

Leave a Reply

Message

Hart to Heart Cancer Consultants | Copyright 2012 | Website by ASK Designs

Disclaimer
All health and health-related information contained within this website is intended to be general in nature and should not be used as a substitute for a visit with a health care professional. The advice is intended to offer only a general basis for individuals to discuss their medical condition with their health care provider. Your health care provider should be consulted regarding matters concerning the medical condition, treatment and needs of you and your family. Although every effort is made to ensure that the material within this website is accurate and timely, it is provided for the convenience of the website user and should not be considered official. Users of this website are advised to refer to and rely upon the official version of information when making significant decisions.