What is radiation therapy?

Radiation therapy is a critical component of breast cancer treatment in Singapore and is used to target and destroy cancer cells in the breast area. It is commonly employed as adjuvant therapy after breast-conserving surgery (lumpectomy) or as a post-mastectomy treatment, depending on the individual’s specific circumstances.

Treatment goal. The primary goal of radiation therapy is to eliminate any remaining cancer cells that may be present in the breast or surrounding tissues after surgery. By delivering high-energy X-rays or other forms of radiation to the affected area, radiation therapy helps reduce the risk of local recurrence and improves long-term outcomes.

Before therapy. The process of radiation therapy begins with careful planning. This involves a detailed evaluation of the patient’s medical history, surgical reports, and imaging results to develop a personalized treatment plan. The radiation oncologist, in collaboration with a team of specialists, determines the appropriate radiation dose, treatment duration, and the specific areas that need to be targeted.

Administration. During treatment sessions, the patient lies on a treatment table, while a machine called a linear accelerator delivers the radiation beams. The machine rotates around the body, precisely directing the radiation to the predetermined areas. Each session is usually short, lasting only a few minutes, and is typically scheduled on consecutive weekdays over several weeks.

Side effects. While radiation therapy is a generally well-tolerated treatment, it may cause temporary side effects. These can include fatigue, skin changes such as redness, itching, or dryness in the treated area, breast swelling, and breast discomfort. These side effects typically resolve over time after treatment completion.

In some cases, long-term side effects may occur, although they are relatively rare. These can include changes in breast appearance, such as texture or size differences, breast fibrosis (thickening or hardening of breast tissue), or rare instances of radiation-induced damage to surrounding organs, such as the heart or lungs. The healthcare team carefully monitors patients during and after treatment to manage and minimize any potential long-term effects.

What is chemotherapy?

Chemotherapy is a crucial part of breast cancer treatment in Singapore and is used to target cancer cells throughout the body. It is a systemic treatment, meaning it travels through the bloodstream to reach cancer cells in different parts of the body, even those that may not be visible on imaging tests. 

Treatment goal. The main purpose of chemotherapy is to eliminate cancer cells and reduce the risk of cancer recurrence. It can be used in different settings:

• Adjuvant Therapy: After surgery, chemotherapy may be given as adjuvant therapy. This means it is used to kill any remaining cancer cells that cannot be detected by imaging tests. Adjuvant chemotherapy aims to lower the risk of cancer recurrence and improve overall survival rates.

• Neoadjuvant Therapy: In some cases, chemotherapy is administered before surgery (neoadjuvant therapy). The goal is to shrink tumors, making them easier to remove surgically. Neoadjuvant chemotherapy may be recommended for larger tumors or when surgical removal is initially challenging.

Administration. The selection of chemotherapy drugs depends on various factors, including the type and stage of breast cancer, the patient’s overall health, and individual treatment goals. Chemotherapy drugs can be given orally in the form of pills or administered intravenously (IV) through a vein.

Side effects. Chemotherapy does come with potential side effects, as it affects both cancer cells and healthy cells in the body. Common temporary side effects may include fatigue, nausea, vomiting, hair loss, loss of appetite, and increased susceptibility to infections. However, it’s important to note that not all patients experience the same side effects, and there are effective strategies to manage and minimize these effects.

In some cases, chemotherapy may have long-term effects. For example, certain chemotherapy drugs may impact fertility in both women and men. Additionally, some individuals may have a higher risk of developing certain health conditions later in life. The healthcare team carefully considers these potential risks and side effects when designing a personalized treatment plan and discusses them with the patient.

A Multidisciplinary and Collaborative Approach

Both radiation therapy and chemotherapy are part of a multidisciplinary approach to breast cancer treatment, with close collaboration between surgical oncologists, radiation oncologists, medical oncologists, and other healthcare professionals. This multidisciplinary approach ensures that treatment decisions are individualized and based on factors such as the stage of breast cancer, tumor characteristics, overall health, and patient preferences.

Patients are encouraged to have open and thorough discussions with their healthcare team to understand the role of radiation therapy and chemotherapy in their treatment plans. The healthcare team will provide detailed information, address any concerns, and provide ongoing support throughout the radiation therapy process, ensuring that patients receive the most effective and personalized care for their specific breast cancer diagnosis.

It’s important to remember that every individual’s experience with any treatment is unique, and the healthcare team will provide personalized guidance and support to ensure the best possible outcomes in breast cancer treatment.