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.
Dr. Kornmehl is a board certified radiation oncologist and author of the
critically acclaimed consumer health book, “The Best News About Radiation
Therapy” (M. Evans, 2004). Her website is
http://www.RTSupportDoc.com .