Radiotherapy Tips

Radiotherapy is often used after surgery to reduce the risk of breast cancer returning. You’ll usually have a planning appointment (CT scan) to prepare for treatment and ensure the radiation is delivered as accurately and safely as possible.

Here are some tips to help you prepare:

Physiotherapy and Arm Mobility

• Keep Doing Your Exercises: It's important to continue your post-surgery physiotherapy exercises. You’ll need to be able to raise your arm above your head and stay still during radiotherapy sessions.

• If you’re unable to do this comfortably, your radiotherapy may be delayed. If you’re struggling with movement, ask your care team for a physiotherapy referral—even a short course can make a big difference.

Radiotherapy Planning Appointment

• At your planning session, your team will:

  • Perform a CT scan while you lie in the treatment position.

  • Make small permanent tattoo dots and/or pen markings on your skin to help precisely target the radiotherapy. These markings are essential for accurate daily treatment.

  • The pen ink may remain wet after your appointment—wear an old top or dark clothing to avoid staining.

  • You'll be asked to stay in the same position throughout the session to ensure accurate planning.

Deep Inspiration Breath Hold (DIBH)

• If you are having radiotherapy on the left side of your chest, you may be asked to perform a deep inspiration breath hold during treatment. This technique helps to move the heart away from the chest wall, reducing radiation exposure to the heart and lungs.

• Your radiotherapy team will guide you through this process during the planning scan.

• To prepare, you can practise at home:

  • Lie down flat, take a deep breath in, and hold it for several seconds.

  • Slowly release and repeat. This can help you feel more confident and relaxed when asked to do it during treatment.

Each radiotherapy session is usually quick—just a few minutes of treatment—but positioning and preparation can take longer. The experience is different from surgery or chemotherapy and often feels more routine once it begins. These tips may help you feel more prepared.

What to Expect in the Room

• Staying Still: You’ll be asked to lie very still in a specific position. If you feel a sneeze or cough coming on, don’t panic—radiographers will advise you to turn your head and sneeze or cough into the air, then they’ll help reposition you if needed.

• Temporary Markings: Some centres may reapply pen marks to your skin or undergarments to help with positioning. If this happens, it can stain clothing. Consider wearing older items, and if needed, a non-toxic stain remover like diluted bleach (e.g. Ace) can help—but follow safety instructions carefully and test on fabric first.

• Alarms and Beeping: An alarm will sound when the radiographers leave the room—this is completely normal. They’ll monitor you on a screen and speak to you via intercom if needed.

• Imaging During Treatment: Sometimes, an X-ray or scan is taken before treatment starts to confirm correct positioning. This may add a little extra time to your session.

What to Wear and Bring

• Avoid Wearing Your Lymphoedema Sleeve: If you use a compression sleeve for lymphoedema, don’t wear it during your session—it may be affected by friction from the treatment table or develop fuzziness.

• Dress in Layers: Radiotherapy rooms can be cool, especially if you’re waiting between set-up and treatment. Wear layers or a shawl you can easily remove when needed.

• Clothing Tips:

  • Opt for dark or older underwear in case of ink marking.

  • Avoid talcum powder, perfumes, or deodorants on your chest area unless approved by your radiotherapy team, as some products can irritate the skin or interfere with treatment.

Although individual sessions are short, the effects of radiotherapy build gradually. You may feel relatively well at first, but fatigue and skin reactions can develop toward the end of treatment and peak 1–2 weeks after it finishes.

These self-care tips may help support your comfort and recovery:

Rest and Skin Care

• Allow Time to Rest After Each Session: If possible, take time to lie down and relax after your session. Resting helps with fatigue, and letting the treatment area be exposed to air (where privacy allows) may help reduce irritation or soreness.

• Keep the Area Cool and Dry: Avoid tight clothing over the treated area. Where possible, wear loose, breathable fabrics like cotton.

• Avoid Perfumed Products: Use unperfumed soap or shower gel and avoid applying deodorant, creams, or lotions to the treated area unless advised by your radiotherapy team.

Skin Reactions and Creams

• Skin Reactions Are Common: Many people experience redness, dryness, peeling, or soreness. These symptoms often become more noticeable in the final week of treatment and may continue briefly after.

• Ask About Creams: Some radiotherapy units provide prescription creams or dressings to help with blistering or skin breakdown, especially at your final session. You may need to ask specifically, as these are sometimes not offered unless requested.

• If your skin becomes painful, cracked, or weepy, contact your team—they can advise on appropriate products or arrange a review.

Fatigue and Planning Ahead

• Plan for Tiredness: Fatigue may increase over the course of treatment and last for a few weeks afterward. If you're thinking of planning a holiday, family event, or return to work, try not to schedule anything too strenuous for at least 2–3 weeks post-treatment.

• Allow yourself plenty of rest breaks, and try to build quiet time into your day.

Nutrition and Healing

• Protein Intake for Recovery: A healthy, balanced diet with sufficient protein can support tissue repair and help reduce fatigue. While needs vary by individual, some research suggests aiming for about 1–1.2g of protein per kg of body weight per day (e.g. ~75–90g daily for an average adult) during and after radiotherapy. Speak to your oncology dietitian if you're unsure.

• Stay Hydrated: Drinking plenty of water can support your energy levels and skin health.

Many people find that radiotherapy causes dryness, redness, or irritation of the skin. Your treatment team may provide or recommend specific creams to use during and after radiotherapy. In addition to this, members of our support group have shared some creams and gels they found helpful in soothing the treatment area.

Important: You do not need to use all of these products—this is a list of peer suggestions, not clinical recommendations. Always check with your radiotherapy team before applying any cream, especially before treatment sessions.

Support Group–Recommended Products

• E45 Cream – A gentle, unperfumed moisturiser for dry skin.

• Aloe Vera Cream – Some people find this soothing for warm, irritated skin.

• Aqueous Cream – Widely used as a basic moisturiser; can be applied gently to the treatment area.

• Flamazine – A silver-based antibacterial cream, sometimes used for blistering or broken skin (usually on prescription).

• Intrasite Gel – Used for wound care and soothing damaged or broken skin (must be prescribed).

• MooGoo – A natural skincare range that some people use for radiotherapy-related skin irritation.

• Radiaderm R1 Cooling Gel and R2 Soothing Lotion – A specialised radiotherapy skincare system. Some people use this from day 1 of radiotherapy up to 14 days post-treatment.

Application Tips

• Apply creams only after treatment, unless told otherwise by your radiographer.

• Gently apply to the entire treatment area, including the exit point on your back (where the beam leaves the body).

• Allow any cream to fully absorb before dressing.

• Stop using any product if your skin becomes more irritated and let your team know.

• Avoid applying creams immediately before treatment, as this may affect the delivery of radiation.