Most common side effects?

Etnasgrl, I agree with Ruth. My routine was to get up and immediately put on lotion that I was given at the center, get dressed in loose fitting clothes, have a good, protein filled breakfast, go for a walk, home to shower to wash off any lotion and sweat (especially since deodorant was not used) then go to radiation. I also put on lotion again immediately after rads and again during the afternoon plus before bed. It worked for me as I had little reaction to the radiation even after 30 sessions. There were a couple of days that I needed a short, 20 minute nap but other than that rads were easy. Truthfully the worst part was getting the tattoos!

your RO will watch your skin carefully, mine saw a red spot on my armpit before I did. I did have some raw skin which I bandaged and slathered with Aquaphor. I had just finished chemo prior to starting rads, so I didn't notice any unusual fatigue, I certainly didn't feel worse than I did while on chemo

I agree with Ruthgru. Many people breeze right through. I found a cooling cloth to be very helpful after the 2nd week to cool my breast down. I hit a fatigue wall at the end of the 3rd week. Was wiped out for about 3 days but kept right on working after resting for those 3 days. I did accelerated radiation so is was done a week later. As for skin. I got a pink area and a rash which I treated with cortisone. No skin break down. I have a tan area now which is fading. Use whatever creams they recommend it helps a lot. Check out the winter rads group. I was in the fall group and the information I learned there was very helpful.

I never got the fatigue--probably because I’ve been a high-protein low-carb (well, I let the carb discipline slip a bit) eater since early 2013. I started getting pink after the second treatment, and the RO noticed both that and a little bit of flaking/dry skin right away. I began applying the Aquaphor they gave me starting right after that second treatment--always had a couple of small sample tubes in my purse, and would apply some immediately afterwards in the dressing cubicle before putting my bra back on. At bedtime, I experimented with Aquaphor, Boiron calendula cream, Jason’s Aloe Vera Cream and finally Fruit of the Earth 100% Aloe gel (no alcohol, fragrance or dyes--figured if that’s what the cancer center’s outpatient pharmacy sold, they knew best). Settled on the aloe gel and then a layer of Aquaphor or calendula at bedtime. In the morning, showered it all off but didn’t reapply before treatments (which were 3pm). Since I had the partial-breast short protocol, my armpit and SNB incision site were outside the beam field. Never got ANY irritation, not even in the crease beneath my breast. Was able to wear my underwire bras throughout--though my cleavage did distort and skew leftward (see infra). Felt comfier wearing soft bras for sleep rather than going braless. (My instincts were correct--also see infra).

Eventually, though, the irradiated part of my breast tanned (the only suntan I’ve ever gotten). Also, my breast tumor-cavity seroma enlarged considerably (the RO pointed it out on the mapping CT and did observe how it inexorably grew with each treatment. By the end of treatments it developed some scar encapsulation (radiation fibrosis) beneath the skin. As a result, even though my doctors and LE therapist don’t consider it true LE, they are treating it as such to promote drainage of some of the fluid and possibly speed reduction of its size. Nevertheless, I found myself having to order bras a band size larger (which automatically means a larger cup even though the letter size remains the same). The new bras came today. I’m finding 40 I fits better than my old 38 I or even J--my cleavage is centered and vertical again, rather than skewed to the left. I have also been advised to wear some sort of support--bra, sleep bra, or supportive camisole--at all times and never go braless except in the shower or during sex.

Because of preexisting obesity and the enlarged breast seroma (and perhaps the rupture before rads of my SNB seroma), I have developed mild intermittent axillary web syndrome (palpable knots rather than visible cords). Had I known before rads what I know now, I’d have started stricter low-carb eating and ramping up exercise IMMEDIATELY after my biopsy came back, even before getting a surgery date; and would have bought those larger bras right away. (For post-op, I ordered and wore soft cup versions of the same--or “sister,” aka larger band/smaller cup--size as those underwires I refrained from wearing until the SNB seroma sutures were removed before my rads). I certainly wouldn’t have comforted myself with those little “reward” visits to Hoosier Mama Pies or Cafe Descartes for pie or pastry en route home from Evanston Hospital after every treatment. I now have a tougher road to hoe, because the letrozole I’m taking is increasing my appetite (beyond even the increase from the Medrol I had to take for the New Year’s bronchitis) and I am not just having trouble losing beyond the 2 lbs I shed after my cruise but also desperately trying not to gain any more--the letrozole also slows metabolism. Fortunately, not getting any bone or joint pain to hinder exercise.

Fatigue for me (didn't have chemo). Also reddening in the field of the radiation treatments.