Side Effects of Radiation for Breast Cancer

I received five weeks (25 treatments) of radiation therapy after completing chemo in the spring of 2019. The side effects of cancer treatments are so different for everyone, but I found radiation to be MUCH easier than my chemo treatments.

In this post, I will describe my experience with radiation therapy including tips and side effects. As always, please keep in mind that I am not a doctor. The information stated in this post is merely my personal experiences with treatment for breast cancer.

Treatment Timeline

I was diagnosed with breast cancer in September of 2018. After having a bilateral mastectomy, I started six months of chemotherapy.

My medical oncologist wanted me to wait a few weeks before starting radiation to give my body a chance to heal a bit from the AC chemo and Taxol.

I ended up having about a month between the end of chemo and the start of radiation. So, my family and I decided to spend a week at the beach during this break!

Summer was approaching, but I knew it wasn’t going to be a normal summer for me. My skin would need to stay covered during radiation therapy, and I was supposed to stay out of the sun.

If you are looking for a good time to plan a getaway during treatment, this time between chemo and radiation worked out really well for me!

I then began radiation in late spring and completed it at the beginning of July.

My First Radiation Oncology Appointment

At my very first appointment with the radiation oncologist, my doctor wanted to do a physical exam of my chest to see what she was working with.

I had undergone a bilateral mastectomy about eight months prior where I had tissue expanders placed in each breast to stretch my skin.

These tissue expanders were not only incredibly uncomfortable, they were also ridiculously large. I have always been petite and fairly flat chested.

But my plastic surgeon wanted to make sure he would have enough skin to work with when he did my actual implants.

So, he inflated my expanders to a much larger size than I was used to. If you have tissue expanders, you will know that they don’t sag or move at all.

They are like Barbie doll boobs. They’re hard and very perky! So, I had been living with these things for months and commenting to my husband about how silly they looked.

confetti with text overlay Tips for Managing Radiation Side Effects

He would always assure me that they looked fine though. My plastic surgeon and my breast surgeon (both males) had examined me and seen the ridiculousness of my chest as well.

Neither of them ever commented and always kept a straight, professional face during my exams.

So, it got to the point where I thought maybe it was just me who thought my boobs looked outrageous. Well, my radiation oncologist is a female.

When I took off my shirt at that first appointment and she saw my chest, she burst out laughing!

She agreed that my boobs looked hysterical and even said that they were so perky and large that they were going to interfere with the radiation beams!

So, my radiation oncologist called over to my plastic surgeon’s office and told him to remove more than half of what he had put in. Whew!

I would like to note that I adore my plastic surgeon regardless of my giant boobs. I know that he is thinking about the end results, and that the tissue expanders are just a (uncomfortable) means to an end.

So, I trust him completely in his expertise at inflating my boobs. However, I just wanted someone to recognize the fact that they looked completely absurd!

Deflating Tissue Expanders

My plastic surgeon’s office is located right across the street from the radiation oncology office, so I was able to go straight over there to have my tissue expanders deflated.

My plastic surgeon took out about half of the cc’s he had originally put in each breast. While he was doing that, his nurse stood over me with a really sympathetic look on her face.

She started talking about breast cancer patients, all of the physical things we go through, and how it must be so hard. I thought she was just being nice and making small talk, but then I looked in the mirror.

breast cancer quote

I don’t even know how to describe what my boobs looked like. After being deflated, my breasts were sunken in rather than poking out. The skin on them was now folded in places all over.

I couldn’t help but burst out laughing. I wanted to send a picture of them to all of my friends, but I didn’t. I couldn’t wait to show the females at radiation because I knew they would get it.

My radiation oncologist came into the room, looked at the pitiful state of my chest, and apologized to me for making them even worse!

My radiation doctor ended up moving mid-way through my treatments, and I really missed her. I have learned that I really like the candid doctors who will laugh with/at me!

Preventing Heart and Lung Damage

After my breasts were a decent size, one of the radiation therapists made my markings. I laid on my back on the big radiation machine. I had to reach both hands above my head and hold on to handlebar type things.

Since my cancer was in my left breast, my doctors were concerned about my heart being radiated. They had me do deep breathing exercises where I held my breath for different lengths of time.

The longest I ever had to hold it was during this CT scan appointment. The actual radiation sessions went much faster.

The therapist used a sharpie marker to make crosses on my chest and abdomen. I was not supposed to wash these off for the entire five weeks.

Some of them did fade, but the therapists would freshen them up at my appointments. During these five weeks, I made sure to wear shirts that had high collars. Otherwise, you could see a big green “x” near my collarbone.

What To Expect

I went to radiation therapy every day (Monday-Friday) for five weeks. It was a really simple and fast process.

I arrived each day around 9:00 in the morning and went straight back to the changing rooms. I had to wear a gown from the waist up.

They also made me take off my wig and hat during my sessions. Since I was just in the beginning stages of hair growing out after chemo, my head was still pretty bald.

I was a bit overcome with emotion during my first treatment. You lay on the machine in a room by yourself. I felt really exposed with my arms above my head, my breasts out in the open, and my head coverings removed.

My mind couldn’t help but wander since there was nothing else I could really do. They played music into the room, so I eventually tried to just focus on that.

During the treatments, I laid perfectly still and held my breath or breathed whenever the therapists asked over the intercom. The machine moved to different spots over my body. I didn’t feel any pain or anything during this process.

My left arm did get pretty numb a few times. This is the arm where four lymph nodes had been removed. My circulation wasn’t the greatest in this arm so it fell asleep really easily. I can’t imagine what it must be like for people who have way more than four nodes removed!

The numbness got a bit worse with radiation treatment, but it is normal now that it’s over. So, if you are dealing with a tight arm, know that there is an end in sight!

I ended up laying on the machine for about fifteen minutes during each session. Then, I was able to get dressed and leave. So, I was usually only there for about thirty minutes total.

I met with my radiation oncologist once a week during my five week radiation schedule. My doctor would check my skin and talk to me about side effects to make sure I was doing okay.

Radiation Burns and Other Side Effects

I try not to think about the long term side effects of the radiation; although, they are always in the back of my mind.

I did experience a few side effects during radiation treatment though. Thankfully, they all went away within three weeks of treatment ending.

Numb Arm

I mentioned this above, but the circulation in my left arm was worse during radiation therapy. My arm fell asleep really easily when I laid down and raised it above my head. It was also harder to do certain movements with this arm during that time.

Sunburned Skin

The skin on my breasts didn’t really get that red; however, my upper chest looked really sunburned starting about two weeks into treatment. Also, my neck and upper back (just over the treated shoulder) got really red.

My doctor prescribed a steroid cream to rub on my skin. She also had me spray it with green tea. I found that Aquaphor worked really well too. Just know that the steroid cream and Aquaphor tend to stain clothing.

Itchy Skin

This was the most annoying side effect for me!! My skin, particularly my upper back, itched so badly off and on every day.

Fatigue

I’m going to be honest here and say that I don’t really know if radiation caused me to feel tired. I have a one year old who is a terrible sleeper so I was tired long before radiation started. Ha!

Radiation vs Chemo

If you are wondering how chemotherapy and radiation compare, I thought radiation was a breeze! The sunburn and the itchy skin weren’t fun. However, each appointment was super fast, and I felt fine throughout the whole five weeks.

I was still able to take care of my kids and live my regular life, which was not the case with chemo.

In fact, on my last day of treatment, my dad asked me which was more exciting: the last radiation treatment or the last day of school before summer break- (I used to teach elementary school.).

I jokingly told him that nothing beats the last day of school! After really thinking about it though, radiation wasn’t that bad, so summer break probably was a bigger relief!

Moving On

Overall, I’m thankful that my radiation oncologist is so optimistic that the radiation treatment will help prevent my cancer from returning.

I’m hopeful that the benefits of radiation for breast cancer will far exceed any negative side effects that I did experience or may experience in the future.

If you or a friend are facing treatment for breast cancer, check out my breast cancer gift ideas I found super useful during my journey!

You can also read my favorite positive breast cancer quotes that provide strength and inspiration during this difficult time.

What side effects did you have while receiving radiation therapy? And how did you feel it compared to chemo?

Comment below and let me know!

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26 Comments

  1. Love to all. I am about to embark on proton therapy x 25 treatments. Does anyone have any information they can share in regard to PT? Ty! 🙂

  2. I too have experienced all of this. Mine was so high up there was no tissue besides skin and muscle so lumpectomy was the best option, and chemotherapy beforehand was the only option to “have a decent aesthetic outcome”. It took almost 2 years between 2 types of chemotherapy, surgery, radiation, and then oral chemotherapy. I finished treatment in late September and since then everything seems much harder. Work can’t understand why i still can’t travel, friends can’t understand why I don’t have the energy to attend all the events, It’s been questioned whether I’m just not pushing myself hard enough, and if “chemo brain” is really a thing or just psychosomatic, etc. it’s almost worse physically and mentally after you finish treatment

    1. Hi KG,

      Congratulations on completing treatment in September! I’m sure that was a huge relief for you! The first year after treatment definitely has its ups and downs. Chemo brain was a real side effect for me, but I found that it got A LOT better with time. My family and friends had a difficult time understanding it too. And I sometimes felt silly in front of strangers when I couldn’t find the right words. But it gradually got better with time, so hang in there! I wish you all the best in your continued recovery!

    2. Thank you for this. I am in awe of those of you who have had to have full mastectomies and or chemo with your journey. I had a lumpectomy in Nov. Stage-O DCIS in Situ. Margins clear. I walked into my follow-up happy, thinking “I’m done, thank goodness.” No!!! I walked out sobbing with 3 new oncologists in my life! I was scared; REALLY SCARED! I am now on treatment 13 of 20. I’ve been panicked every day thinking “is this that day I’ll feel so burned I can’t wear clothes or go to work?” So far I’ve turned slightly pinker and have a very small spot in my cleavage that might be blistered. 7 treatments left – the ‘blast’ treatments. I seriously think the fatigue is more from my body being on constant flight or fight just waiting for it to get so bad. Reading your post gives me hope that it may not get bad!!! THANK YOU FOR THAT!!! I am a fair skin, blonde hair, blue eye lady whose had her share (and probably many others shares) of awful sunburns since I was a kid. I have lived in fear since my post op appmt that I was in for a horrible journey. Thank you for telling it like it is! I know I may still have a few weeks of pain (and I may not) but I wish I would have seen this 6 weeks ago! Good luck to everyone who will now have this diagnosis and the “what if” in the back of our minds forever. Be positive, be thankful, and be grateful every day!

  3. Hi. I am stage two and halfway through chemo. My doctors are recommending switching the expanders for the implants before I have radiation. Has anyone else done it this way? And if so how did it go? I had a bilateral mastectomy however I will be getting radiation.only to the left side (where the cancer was).

  4. I am glad your side effects were minimal. My experience was much different. I don’t say any of this to put fear in them but to let others knows that you are not alone or weak if your radiation is difficult. I had 35 rounds of radiation on my breast and clavical. I have stage 3 b hormone positive breast cancer. Around round 23, my already red skin became blistered and very dark. I had open ulcers. I had to pause treatment for the risk of infection and had 2nd and 3rd degree burns. I used aquaphor starting day 1 and then a burn cream once I was prescribed that. The last two weeks of radiation were so painful and depressing. I felt like I was not being a strong patient because I had heard how radiation wasn’t difficult for so many. I had to take a two week medical leave to give my body time to heal and rest. My last few treatments have been boosts and my body is already healing so quickly. Tomorrow I ring the bell!

    1. Hi Elora,

      Oh gosh your experience with radiation sounds so difficult! I’m so sorry to hear that you had such a tough time. It’s crazy how these cancer treatments affect us all so differently. My skin started to get irritated by Round 25, but thankfully that was the end of my treatment. 35 rounds of radiation is significantly longer than what I experienced, and I’m sure your poor skin was just over it! Thank you so much for sharing your story so others with similar treatment plans can feel prepared. I hope you are feeling better, and congratulations on ringing the bell!!! I’m sure you feel so relieved!

  5. Thank you all for expressing your feelings on the table during treatment. I have my mock run and first treatment in the same day, came home and cried (I am not a crier) next day same thing, and on the third day, finally on the 4th day I didn’t cry, still very sad, but at least I have stopped crying. today was the 5th treatment, 20 more whole breast and 5 days of boost. I am having breast pain (left breast) and my shoulder and neck are really stiff and hurting. I am Stage II Grade 3 ER/PR+ HER2-. I am fortunate that I have a remarkable team, but the feeling of exposure and vulnerability during treatment was overwhelming! I was also fortunate that I needed a breast reduction and that allowed them to take more tissue around the tumor and then they reduced the right side to somewhat match, they left the left breast bigger to account for shrinkage, but this added to my emotional issues lying on that table with new boobs that I really haven’t adjusted to yet.

    1. Hi Ruthann,

      Thanks so much for sharing your story. I’m so sorry to hear that radiation has been difficult for you, but I know so many other readers completely relate. Hopefully each session will get easier for you. I wish you all the best as you complete your treatment!

    1. Hi Merrulee,

      I did not experience indigestion that I remember. It may have been one of the side effects my doctor mentioned though. Maybe another reader will be able to provide better feedback for you. I wish you all the best as you complete treatment.

  6. Thanks for sharing your radiation experience. I’m currently undergoing it myself…2 rounds down, 23 to go!!
    I also have tissue expanders (and had left breast cancer) and I’m concerned about getting bad burns, as well as capsular contracture. My plastic surgeon was very anti -radiation and clearly disappointed that I chose to have it. He warned of infection, ulceration, exposed tissue expander, tissue necrosis, explantation, and possible loss of breast (what’s left of it..I had nipple sparing mastectomy).
    I have very thin, tissue paper skin to start with so I’m dreading what may come. I’ve read accounts of women having blisters after the radiation is over, having them burst and drain fluid, exposing the expander.
    It’s hard not to worry. How was your experience following radiation? Did the expander/implant exchange surgery go well?
    Thanks for helping others to have a better understanding of what’s ahead.

    1. Hi Diane,

      Like you, I read all the horror stories of women who had terrible side effects from radiation. My plastic surgeon was against radiation as well. I chose to follow the advice of my medical oncologist and my radiation oncologist and have the treatment anyway. Luckily, I did not experience ANY of those side effects you mentioned. My plastic surgeon did want to wait a while after radiation before attempting the exchange surgery. We scheduled the surgery for eight months after I completed radiation. However, the pandemic hit and my “elective” surgery was canceled. So, I ended up waiting almost a full year before the surgery. I have not had any issues at all. I used Aquaphor on my skin after each treatment, and I really only started to get sunburned the last two weeks of treatment. I wish you all the best as you complete your treatment!

  7. It is interesting to me to read comments from other women who also felt very emotional during radiation treatment. By the time I got to radiation I expected it to be a breeze compared to the treatment I’d been through so far. So I was totally unprepared with the emotional melt down I had on the table during my setup appointment. Up to that point my dignity as a patient had always been a priority to my care team but at the radiation center I felt horribly exposed and alone. The setup took quite a while and I was lying there exposed the entire time while the male technician did his calculations. For the greater part of what he had to do I could have been covered. Even if it was a small cover would have been better then nothing! It was degrading and humiliating and I couldn’t stop the tears rolling down my face. I was surprised by the intensity of my reaction to all of this. The radiation treatments themselves were a little better and I got used to it, kind of. But I was so relieved when all of that was over!

    1. Hey Sherri,

      Thanks so much for sharing your story. I think it will really resonate with others who have been through this. Like you, I didn’t expect to have any type of emotional reaction to radiation. However, being physically exposed and alone with only my own thoughts certainly caused deep feelings of loneliness and sadness. I am grateful that the radiation sessions went fairly quickly. It was definitely a relief once they were over though! I hope you are doing well, and I wish you all the best in your recovery!

  8. Hi, I had my radiotherapy in April 20. Because of Covid my onocologist wanted to do an intense course of radiotherapy. Again like you I had to do the breathing as my cancer was also left sided. I did okay with this but for some reason everytime I was having the treatment I felt really alone and emotional. I also had 4 lymph nodes removed so had no feeling in my upper arm still had itching. But time is a healer!

    1. Hi Jean,
      Thank you for taking the time to share your story. I’m glad you got through your radiation treatments, and I wish you a continued recovery. I completely agree with you on the treatment being a really lonely and emotional time. I wasn’t really prepared to feel so emotional during radiotherapy, but focusing on the music they had playing really helped. I’m glad you were able to manage the itching and other side effects. Time truly is a healer!

  9. I developed lymph edema four months after my radiation treatments. I had fifteen OT sessions, wear a compression sleeve and a recovery bra. It helps. I also do stretches several times a day. The good news – I’m sticking here and getting healthier everyday.

    1. Dotty,

      I am so sorry to hear about your lymphedema, but I’m glad to hear you have found ways to help it. Hopefully it will continue to improve for you! Good luck in your continued recovery and thank you for sharing your story!

  10. Thank you this is a very honest explanation of my radiation treatment also. I didn’t have the burn that I heard about I also used the steroid cream that was prescribed for me. At the end of my 5 weeks the radiation oncologist said since I didn’t have any skin issues I could quit using the cream even though the radiation remains in you for two weeks after treatments. Three days later I got a really bad burn it took me 6 weeks to get it healed. So even if they tell you it is alright to stop using the cream don’t! My experience with radiation wasn’t bad at all.

    1. Hi Laurie,

      Thank you SO MUCH for your advice! I have heard that you can still have side effects from radiation therapy weeks later. I’m sure anyone reading this greatly appreciated you giving your experience. Better safe than sorry! Good luck to you in your breast cancer journey and thanks again for sharing!

  11. Hello,
    I’m curious where you were itchy compared to where the radiation was? And did you get any type of rash or small bumps where you felt itchy? I too am going through left breast radiation and feel itching on back, both of upper arms and of course breast. I get tiny bumps that itch so bad on arms and back but when I brought up to the radiologist nurse, she had no clue and told me to get some Benadryl cream. Thanks for all your info! Helps a lot!

    1. Hey Stephanie,

      I’m sorry to hear you are dealing with itching during radiation. Mine was mainly on my back just over my shoulder. Did you do chemo before radiation? I had really bumpy skin that was prone to rashes/hives for MONTHS after chemotherapy ended. It ended up going away eventually though. I hope yours gets better soon! Good luck with everything!

  12. Thank you so much for your honest and humorous article about radiation. I have triple positive breast cancer but stage 1 and will be doing radiation in a few months after I finish chemo and it helped me to know what radiation will be like. Though breast cancer sucks, it gives me so much strength to have support and knowledge from those that have experienced this already.

    1. Hey Natalie,

      Thank you for sharing! I’m so glad you found my post about radiation useful! I know you are SO READY to finish chemo and move on to your next treatment. I wish you all the best!!

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