Radiation therapy is a simple, painless, and generally well-tolerated tool for treating and even curing breast cancer. One of the most common side effects of radiation therapy to the breast (after a lumpectomy) or to the chest wall (after a mastectomy) is skin irritation. The reaction and its extent differ for every woman. Because radiation therapy is often such an important part of breast cancer treatment, it is important to know how to mitigate its side effects in order to gain the greatest benefit from the therapy.

Coping with Skin Irritation

Radiation-induced skin reactions are more likely to occur in people who received chemotherapy shortly before or during radiation therapy and in women who have a prominent fold under the crease of the breast. In fact, this area and the underarm are the most common areas of the breast to sustain a skin reaction. Most skin reactions resolve within a few weeks of completing radiation therapy.

Skin reactions are almost inevitable for women receiving radiation to the chest wall after a mastectomy. As a result, many radiation oncology facilities give such women a one-week prophylactic break halfway through the course of treatment, to reduce the severity of skin reactions.

The severity of a skin reaction varies from person to person. It can become more noticeable as the course of treatment progresses. Faint pinkness of the skin, brisk redness, sun burnt sensation, dryness, itching, peeling, darkening like a suntan, blistering, and moist oozing can occur.

When the reaction is severe, such as a brisk redness that evolves into blistering and moist weeping of the skin, women receive a treatment break, usually lasting a week or two. This rest is usually sufficient to alleviate the worst symptoms. When necessary, doctors can prescribe therapeutic creams. Radiation can be resumed once the reaction resolves.

Treating the Reaction

During radiation therapy, women can avoid chafing the irradiated skin by going braless or by wearing a cotton sports bra without an underwire that fits well below the crease of the breast or the irradiated skin of the chest wall. Women who can go braless altogether, should. If that is not a comfortable solution, women should wear a bra as infrequently as possible to reduce the likelihood and/or the degree of a skin reaction. Also, aerating the irradiated skin helps minimize skin reactions.

Over-the-counter moisturizing creams without alcohol and fragrance can reduce the extent of a skin reaction. Often, radiation oncology teams prescribe these creams at the beginning of radiation therapy.

Women should also try to be kind to the irradiated skin, which can be easily inflamed. Radiation oncologists suggest:

• Do not rub, scrub, or scratch the skin in the treatment area; instead, pat the skin dry and massage physician-prescribed anti-itch creams or ointments onto the affected area.
• Avoid sun exposure to the irradiated skin. When going outdoors, wear protective opaque clothing such as a cotton tee shirt.
• Steer clear of tight-fitting blouses and bras over the area unless instructed otherwise.
• Use only lukewarm water and mild soap recommended by the radiation oncology team on the treated area.
• Avoid using ice packs or heating pads on the treated skin.
• Steer clear of commercial deodorants and skin care products not endorsed by the treatment team.
• Do not shave the underarm on the treated side with a non-electric razor.
• Avoid skin care products for at least two hours before radiation treatment.

Although a number of people who undergo radiation therapy do experience skin reactions, most get past this temporary side effect. By working with their radiation oncology teams, people pass the metaphorical finish line of the course of radiation therapy, usually victoriously. Most importantly, they derive substantial benefits from radiation therapy and move on to leading productive, cancer-free lives.

Copyright 2006 by Carol L. Kornmehl. All rights reserved. No part of this article may be copied without express written permission of the author.