Guidance for Breast Cancer Patients During Radiation Therapy

This note provides information for breast cancer patients undergoing radiation therapy on precautions, prevention, home remedies, dietary changes, protection, support-related counseling, medications used by oncologists, and lymphedema prevention strategies.

This information is based on international standards (such as NCCN, ASTRO) and was kindly provided by Dr. Narendra Rathore (MB Hospital, Udaipur).

1. Possible Effects During Radiation Therapy

Radiation therapy can affect the chest, underarms, and the surrounding skin.

2. Prevention

Preventive measures can reduce the severity of these side effects:

• Skincare: Keep the radiation-exposed area clean, soft, and moisturized. Use moisturizers recommended by your doctor (like Bepaxan or Anophore).

• Hydration: Drink 2–3 liters of water daily to keep the skin and body well-hydrated.

• Lymphedema Prevention: Avoid pressure on the arm, do not lift heavy weights, and perform light exercises to prevent lymphedema.

• Nutrition: Maintain strength during treatment by consuming adequate calories and protein.

• Sun Protection: Protect the radiation-exposed area from sunlight; wear loose-fitting clothes or apply sunscreen (as advised by your doctor).

• Fatigue Management: Balance work and rest, and engage in light physical activity like walking.

3. Dos and Don’ts

✔ Do:

• Wash the affected area gently using mild soap (like Dove, Cetaphil) while keeping it moisturized.

• Apply moisturizer 2–3 times a day.

• Wear soft, stretchable clothing.

• Drink water frequently (water, coconut water, diluted fruit juice).

• To prevent lymphedema, avoid tight clothing or jewelry and do exercises (deep breathing, arm movements, wall climbing).

• Report any irritation, swelling, pain, or fever to your doctor immediately.

• Take balanced rest and engage in light activities throughout the day without strain.

✖ Don’t:

• Do not use harsh products (fragranced soaps, lotions, deodorants).

• Avoid spicy, hot, or overly sour foods.

• Do not rub or scratch the affected area.

• Do not smoke or drink alcohol—these increase side effects and risks (NCI, 2020).

• Avoid lifting heavy weights, as it increases the risk of lymphedema.

4. Home Remedies

• For skin irritation and dryness:

  • Apply aloe vera gel: it soothes and hydrates the skin.

  • Apply coconut oil to the outer skin (consult doctor if blisters are present).

  • Gently cleanse the skin with lukewarm water mixed with rose water.

• For swelling and pain:

  • Use light anti-inflammatory medications (with doctor's advice).

  • Apply a cold compress (wrapped in a soft cloth or towel) to the affected area for 10–15 minutes.

• For fatigue:

  • Drink ginger tea to boost energy.

  • Drink tulsi (holy basil) tea to reduce stress and fatigue.

⚠️ Caution: Do not apply any remedy to open wounds or skin without your doctor’s permission.

5. Dietary Changes and Nutrition

To maintain energy during treatment:

• Nutritious soft foods:

  • Light soups made with carrot/bottle gourd/pumpkin.

  • Mashed potatoes, buttermilk, or plain yogurt.

  • Eat 5–6 small meals to improve digestion.

  • High-protein, high-calorie diet: Meal shakes, protein shakes (like KABIPRO), calorie-dense foods that dissolve easily in water.

  • Hydration: 8–10 glasses of water, coconut water, or fruit juices daily.

  • Avoid: Spicy, fried, heavy, or very sour foods.

Supplement Suggestions (under doctor’s supervision):

• Protein powders

• Omega-3 fatty acids (to reduce inflammation)

• Vitamins and minerals like Zinc

• Probiotics (to aid digestion)

6. Regular Consultation with Oncologist and Physiotherapist

• Follow-up visits and monitoring of symptoms are essential (NCCN, 2023).

• Maintain a skin health log during treatment and share observations with your care team.

7. Commonly Used Medications

To be used strictly under the doctor’s guidance:

• General Use:

  • Hydrocortisone cream (1%) for skin irritation

  • Anti-inflammatory creams

  • Moisturizers (Anophore, Bepaxan)

  • Pain management: Paracetamol (500–1000 mg), Tramadol/Morphine for severe pain

  • Docon patch for localized pain

• For Lymphedema:

  • Diuretic medications (under supervision)

  • Compression therapy: Malaysia sleeve or bandages (under physiotherapist guidance)

• For Infections:

  • Antibiotic creams (e.g., Amoxicillin/Lincomycin)

  • Antifungal creams

• For gas or nausea-like symptoms:

  • Ondansetron

  • Methoxime (Methoxisalen, if intended)

• Nutritional Support:

  • Enteral nutrition formulas (e.g., Ensure/BO) when dietary intake is insufficient

⚠️ Note: All medications should be prescribed by an oncologist.

8. Lymphedema Prevention Strategies and Exercises

Lymphedema—accumulation of lymph fluid in the arm or chest—can occur especially if underarm lymph nodes are removed or radiation is given. To prevent:

Strategies:

• Avoid pressure on the arm: Do not wear tight jewelry or clothes.

• Prevent cuts, scratches, or insect bites: Keep skin clean and moist.

• Do not lift heavy weights (over 5 kg), especially during the first few months of treatment.

• Wear compression garments (medical sleeves) only after consultation.

• Perform light exercises that promote lymphatic drainage.

Exercises (under physiotherapist supervision):

• Deep Breathing: Take slow breaths for 5–10 seconds using the abdomen. Repeat several times.

• Shoulder Rolls: Roll shoulders forward and backward 10 times, 2–3 times a day.

• Arm Stretching: Slowly raise the arm overhead, hold for 10 seconds, and lower it slowly. Repeat 5–10 times.

• Fist Clenching: Make a fist and open repeatedly—10–15 times.

• Wall Climbing: Walk fingers up a wall and back down, 5–10 times.

• Yoga: Gentle stretching or flexibility exercises.

⚠️ Caution: Always consult a physiotherapist or oncologist before starting any exercise. If you experience swelling, pain, or heaviness—consult immediately.

🌟 Additional Tips

• Stay in regular touch with your medical team: Share concerns and symptoms regularly.

• Seek help from family or counselors.

• Monitor symptoms closely: Record any skin changes, arm swelling, or pain.

• Mental health: Practice breathing or mindfulness exercises to manage stress.

📝 Important Note

Proper care during radiation therapy and lymphedema prevention strategies, if followed diligently, can help maintain the effectiveness of treatment.

Stay in regular contact with your oncologist and physiotherapist, follow their advice, and carefully practice any home remedies.

You are not alone on this journey. ❤️