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Concluding part of our review of Breast Cancer post surgical treatment options

Posted by Eamonn Brady on

Breast Cancer Treatment

Part 2


Treatment – post surgery (Continued)

Last week I discussed chemotherapy. This week I discuss radiotherapy and hormone therapy.

  1. Radiotherapy

This therapy uses controlled doses of radiation through high energy X-Rays to kill any residual cancer cells following surgery – especially with lumpectomy (part of breast removed). It’s been shown that lumpectomy plus radiotherapy is as effective as mastectomy (whole breast removed) in the treatment of early-stage breast cancer.

Unlike chemotherapy, radiotherapy only targets the specific area that requires treatment, so, the breast or armpit, or in the case of mastectomy, the chest wall.

The total dose is delivered in small unit daily, 5 days a week over a period of 3 – 6 weeks, each session lasting just a few minutes. Treatment commences within 12 weeks or so following surgery

Radiotherapy is generally painless; common side effects include: -

  • A sunburn type effect on skin
  • Discolouration of the skin
  • Fatigue both during and for a time after treatment has ceased
  • Skin can blister and weep
  • Possible risk of future heart problems


  1. Hormone (endocrine) Therapy

Some types of breast cancer use the naturally present hormones oestrogen and progesterone to grow. Some hormone therapies work by reducing the levels of these hormones or preventing these hormones from getting into the cancer cells. In the majority of cases the therapy will need to be continued for at least five years.

Types of Hormone Therapies:


Tamoxifen prevents oestrogen from getting into the breast cancer cells, stopping them from growing. It is usually given after surgery to prevent cancer from returning in “hormone positive” patients. A typical daily dose is one 20mg tablet. It is suitable for both pre- and post-menopausal women and will need to be taken for 5 – 10 years post-surgery.


For women still experiencing periods, it’s important not to become pregnant whilst still taking tamoxifen due to risk to the baby.


The most common side effects are similar to menopausal symptoms: -

  • Night sweats and sleep disturbance
  • Vaginal irritation such as dryness and itching
  • Loss of sex drive
  • Mood changes
  • Headaches
  • Hot flushes
  • Vaginal discharge
  • Fluid retention
  • Nausea and indigestion

Aromatase inhibitors

Aromatase is an enzyme that helps the continued production of oestrogen in post-menopausal women once the ovaries stop production. Aromatase inhibitors block this enzyme thereby reducing the amount of oestrogen produced and help to minimise the risk of cancer returning.


The most common of these are: -

  • Letrozole
  • Anastrozole
  • Exemestane


No one of these is better than the other and side effects are fairly common to all three; side effects are similar to menopausal symptoms and may include

  • Aching joints and bone pain
  • Hot flushes and sweats
  • Extreme fatigue
  • Vaginal dryness
  • Loss of libido


Ovarian suppression

For women yet to experience the menopause, oestrogen is still produced by the ovaries. If their breast cancer was hormone related – continued oestrogen production could be a catalyst to cancer returning. A drug called Goserlin will “shut down” ovarian activity by interfering with the messaging from the brain to the ovaries.

It is given as a 3.6mg “depot” injection every 28 days and within three weeks from first injection, the oestrogen level will have dropped to that of a post-menopausal woman. Goserlin is often combined with the other hormone therapies covered earlier. As with other related drugs – side effects are similar to menopausal symptoms, in addition, with the reduction in oestrogen, there may be an increased risk of osteoporosis if used long term.


Covid Booster Vaccine

If you are suffering from cancer, you may be at more risk from COVID-19. Ask your doctor if you are eligible for the next Covid 19 booster. Whelehans Pharmacy Pearse St have a weekly walk-in clinic for Covid-19 boosters. Call 0449334591 for more.


Flu Vaccination at Whelehans (starting soon)

In the coming weeks, Whelehans will be offering the flu vaccine at our Pearse St and Clonmore store most days for adults and children. You can book online on the Whelehans Pharmacy website or ring either pharmacy. Flu vaccine is €25 (€20 if you book online) or free with medical or doctor visit card. It is free for older people and those with long term conditions (including cancer) and healthcare workers.

For comprehensive and free health advice and information call in to Whelehans Pharmacies, log on to or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore).


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