Anticipate Concerns About Radiotherapy For Breast Cancer

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A study examining the patient’s perspective on breast radiotherapy found that 68% of the patients surveyed responded that they had little or no prior knowledge of radiotherapy at the time of breast cancer diagnosis, making that an excellent time for physicians and other health-care professionals to introduce accurate information about radiotherapy and its possible side effects,1 the study’s lead author, Susan A. McCloskey, MD, MSHS, said in an interview with The ASCO Post. Dr. McCloskey is Assistant Professor of Radiation Oncology at the University of California, Los Angeles.

Providing that information upfront could also help counter frightening stories of serious radiation side effects, which 47% of the patients surveyed reported reading or hearing about, although only 2% reported that the negative stories they heard were true. “There are many scary word-of-mouth stories out there and many unfounded concerns or concerns from another era,” Dr. McCloskey noted in an article about the study in Reuters.2

“The majority of women do understand the benefit and value” of radiation therapy in reducing the risk of locoregional recurrences and death, although “some patients think the downstream consequences may outweigh the benefits,” Dr. McCloskey said. “One of the things that has been distressing to me as a treating physician is that even those women who say, ‘I understand the importance of this. I have read about it. I know it is necessary for my treatment’—they, too, despite knowing the effectiveness of radiotherapy, come in with these fears.”

Top Three Fears

The study involved 327 patients with nonmetastatic, noninflammatory invasive, or preinvasive breast cancer; 82% were treated for an invasive breast cancer and 83% were treated with breast-conserving therapy. Patients were free of disease recurrence and at least 6 months out from the completion of radiotherapy. 

The top three ranked initial fears were of radiation damage to internal organs (cited by 40% of patients), skin burning (reported by 24%), and being radioactive (cited by 7%). In reality, Dr. McCloskey said, organ damage is a rarity, technologic advances have greatly reduced skin reactions, and with external-beam radiotherapy, the possibility of becoming radioactive is simply a misconception. 

The study found that 92% of patients treated with breast conservation and 81% who underwent mastectomy agreed with the statement, “If future patients knew the real truth about radiotherapy, they would be less scared about treatment.” Trying to dispel some of those fears by giving more realistic information at the outset is critically important, Dr. McCloskey stressed. ■

DISCLOSURE: Dr. McCloskey reported no conflicts of interest.


1. Shaverdian N, Wang X, Hegde JV, et al: The patient’s perspective on breast radiotherapy: Initial fears and expectations versus reality. Cancer 124:1673-1681, 2018.

2. Rapaport L: Many women fear and misunderstand breast cancer radiation. Reuters Health News, February 26, 2018.

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