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Breast Cancer in men

Radiotherapy for breast cancer in men

Radiotherapy is given, where appropriate, to reduce the risk of a recurrence of breast cancer. Radiotherapy uses high energy rays to destroy cancer cells, while doing as little harm as possible to normal cells. Treatment is given regularly – normally for about fifteen sessions (or fractions) on consecutive days with a break over the weekend. It normally requires you to come to the hospital for each session, and then go home again.
 
Here men talk about their experiences of radiotherapy and its side effects.
 
Radiotherapy is usually given if there is a risk of the cancer coming back in the chest. Some men were recommended radiotherapy because cancer had been detected in their lymph nodes or because of the grade and size of their tumour. A few men had been given radiotherapy as a precaution.
A few men said they knew very little about radiotherapy before their treatment began. They explained that while the treatment itself did not take long, the preparation to set up the treatment before each session often took much longer.
 

HGV King describes his radiotherapy sessions. The set up could take a long time, around twenty...

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Age at interview: 51
Sex: Male
Age at diagnosis: 50
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 But I then went and had three weeks of radiotherapy. Not very nice stuff, but (laugh) it’s got to be done. And I have to take my daughter sometimes so I’d go in to have the treatment. It used to take them ages to set you up but I’d been in there and me daughter would be watching me on the monitor. So, she kept saying daddy’s on telly.

 
Aw. How old was she at the time?
 
She would have been three, yeah, just over three, about three and a half, about three, three years and three or four months, not very old. But she sat there good as gold round the back and as I say, it used to take them ages to set you up, it only takes a couple of seconds or so for… fourteen seconds to zap you. Setting up can take twenty minutes.
 
Right, why did it take so long?
 
Because you’re given the tattoos, tiny little dots, and they line you up and as you’re laying there, you can see… you can see all the lines as... I think green I think the lines that I have and they just set you up on these marks because everybody’s different. Everybody has to have different sizes and everything has to be set up but it can take them quite a while. Obviously, if it’s taking them a long time, at least you know they’re doing their job properly. [laughs]. And the staff, as I say, are fantastic, but some of the people you meet you… you’re sitting in a room with everybody that’s going through it and you used to get some giggles because some of the machines breakdown, they’re not all a hundred percent guaranteed, so you have to sit and wait for your turn which just takes a while sometimes. But, as I say, staff wise, absolutely fantastic.
 

Michael found the equipment used for the radiotherapy a bit intimidating. He felt that people...

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Age at interview: 67
Sex: Male
Age at diagnosis: 57
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 But also there was a feedback about the radiotherapy which was very interesting. They did send a form round and one of the things I actually said to them, that the room… for somebody who’s not used to large pieces of equipment, it was a bit intimidating. It was battleship grey and the only thing when you’re lying down to stare at on the ceiling, is a little red laser light and the sign that says ‘do not look at this light’. And I pointed out to them there was nothing else to stare at and I noticed the second time and a member of staff said, “Oh yes, it was partly because of that what you said”, but they actually now have a TV screen and you’ve got a choice of watching animals or fish or something lying down, which I thought ‘that is an improvement’, so they do listen to people sometimes.

One man had had the relatively unusual experience of having chemotherapy in his own home because he had been having treatment privately. It wasn’t possible for him to also have his radiotherapy at home, and inevitably he experienced some waiting around for his radiotherapy appointments.
 

Stuart describes getting a small tattoo and information about radiotherapy before his first...

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Age at interview: 40
Sex: Male
Age at diagnosis: 36
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 The next step was the radiotherapy which [oncologist] told me about. And again he sort of laid out and gave me a print off of all the dates, cos that, as you probably know, is every day, for me it was over a period of three weeks … three.. two or three weeks. It was three years ago now. So the first one you have to go in and they lay you down and they measure you and they put the little pin prick tattoo on your chest and make sure everything’s sort of mapped out for the radiotherapy machine. So that appointment takes a bit longer than the rest of them, and they give you sort of leaflets on it and tell you what you should do and you should apply sort of aqueous cream every day and there’s… excuse me, your chest could get burnt and, I thought oh, fair enough, I mean, I do all I can to sort of make it as easy as possible throughout the process, so I bought a big tub of aqueous cream and thought well, I’ll slop this on as much as possible and, when it actually came to the radiotherapy it was a case of I had that obviously at the hospital, can’t do that at home, I went in and that was when you started to get the hospital experience, which I hadn’t had with the chemo, sort of waiting around a bit and then waiting for your turn, then going in and this sort of thing. I must say, though, for the radiotherapy I never had to wait an awful long time, to actually get in, although the department was a very busy one they had about three or four machines up there that could be used at any one time, so… I think probably the maximum I had to wait was probably about half an hour at any time, so it wasn’t really too bad.

 
That’s quite good.
 
And, the actual radiotherapy experience, I mean, some people I’ve read and heard have hated it and didn’t like it, but I mean, to me it was nothing really compared to the chemo or anything else that I’ve had, cos you’re just laying there, and you know, it happens and you get up and you go away and then you come back for your next one. I suppose it’s the actual fact that the area is getting treated and then progressively over the period of time it gets redder and redder and you can see the actual, you know, patch that they’re treating, and that it can get quite sore for some people, but as I said, the aqueous cream did help an awful lot with me cos it didn’t really… and the oncologist said it could peel and things like that, but it didn’t happen at all with me, [small laugh] so it was excellent. 
A few men had to travel considerable distances for their radiotherapy and some found it difficult or frustrating to make changes to their daily lives in order to attend their radiotherapy sessions. A few men felt well enough to travel to the hospital on public transport. John was taken to the hospital by ambulance car so that he could be there for 7am. Tom had said it could be difficult to make plans for later in the morning because quite often the equipment needed attention and appointments could be delayed.
 

Robert describes what it was like to have the treatment and fit things around his daily...

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Age at interview: 70
Sex: Male
Age at diagnosis: 70
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 Did you take precautions like, did you rest and just be quite sensible round that time, or did you not change much in your normal routine?

 
Well, I had to change my routine because I was going every day, you know, and I found that a bit of a discipline, you know, coz I’m quite busy. Aye, and I found that a bit of a discipline, and I didn’t change my routine any more than I had to, quite frankly, you know?
 
Was it the same time of day you went every time?
 
No it wasn’t, actually – it was a bit of a nuisance. Sometimes they had to change it, and then one day they phoned up in the morning and say their machine had broken down and I couldn’t come that day – and then they phoned up at lunch time and said, “Oh, you can come in the afternoon, they’ve fixed it.” Then there was another time that I wanted a day off to go to a funeral. Oh no they were quite, “Oh, I see. Oh alright then.” But they were quite, you know? I said we would add on the other end, you know, but they were a wee bit kinda iffy about that, you know?
 
So it wasn’t very flexible, then?
 
No. You’ve got your twenty treatments and that’s it, you know? They’re quite, you’ve got to go every day. And then you met the same people coz they were going too.
 
Was there people with all different types of cancer?
 
Yes, aye.
 
Did you feel any sort of camaraderie with them?
 
Yes I did. And also the radiologists or the girls that did the machine, they were good as well. It’s very precise – you probably know it’s very precise – they put it up in the computer and get you in the exact position and so on. The first time I was really surprised, you know, how short it was – of course, it’s so powerful. But you’re in it for such a short time. But I got used to it alright you know.
 
Had you to wait once you were there, or were you taken in…
 
Ah yes, but most of the time, not unduly. Not unduly – their appointments worked pretty well.
Several men described having very positive experiences of radiotherapy and they were surprised that they had not suffered any side effects. A few men continued to work throughout their treatment. Dan said that work had been a helpful distraction during his treatment. Tom changed his working hours to start earlier in the day so that he could attend his daily radiotherapy treatment in the afternoon.
 

Tom felt few ill effects from his chemotherapy and radiotherapy and he was able to carry on...

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Age at interview: 65
Sex: Male
Age at diagnosis: 60
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 Can you tell me a wee bit how you felt about the treatment you were given?

 
What, the radiotherapy and all that?
 
Yeah.
 
Oh, it was alright, yeah. Like I say, it affected my wife really bad.
 
Your wife did?
 
Yeah, and I’ve heard a lot of people, it affects them real bad, like, knocks ten bells out of their bottom, you know what I mean?
 
When she got her treatment?
 
Yeah, it’s pure poison they put in your body and it makes them really poorly, but me, never. I can’t understand it, can’t explain it, and I can’t even, and even the doctors can’t understand it but it never affected me, and when I used to go back to work he’d say, “Are you sure?” I’d say, “Yeah, positive.” Cos I feel alright, and I went back to work. When I was having me radiotherapy. It was for three weeks every day, five days, for three weeks.
 
So how did you work in going for your radiotherapy with work?
 
I used to start early and finish… used to start at five in the morning, finish at one, with the agreement with the company, and go for the treatment at two. Or half past two, whatever time it were.
 
So were you just doing work locally, then?
 
Yeah.
 
Were you always doing that or did you do…?
 
Long distance. I was a distance driver.
 
Right, but for those three weeks they gave you sort of shorter routes to do?
 
That’s right, yeah. They were very good.
Most men, however, experienced some side effects from the treatment. A few described ‘minor’ side effects, such as redness and a burning sensation on their skin. Some experienced multiple and more severe side effects, such as tiredness and burns. Michael said he found it tiring and felt a ‘bit microwaved’. He said his chest hair look ‘a bit like a moth-eaten rug’. Most men talked about being advised to apply aqueous cream to the affected area of skin, which they said had helped. One man hadn’t known that he should apply the cream from the first day of his treatment and his skin had become very red. A few men talked about the longer term effects of radiotherapy, such as not being able to expose the affected area of their skin to the sun.
 

Tim was very tired after his treatment finished and got an infection in his chest. His wife’s...

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Age at interview: 73
Sex: Male
Age at diagnosis: 60
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 So how did you feel after your radiotherapy, in comparison?

 
Well I didn’t feel very well actually. Funnily enough I got an infection and I had a great explosion out of my chest of something, I don’t know what it was, towards the last few days, I was really feeling quite ill. And I remember that we went on a quick trip to Paris, after we’d finished the radiotherapy, and I remember going down to the Tuileries Gardens to look at my favourite statues there by, Aristide Maillol, who was a famous French sculptor, and I was so tired I just sat on a bench by one of them, and I went to sleep for a bit. And, we flew home, and then I think it was in the morning, or the night. I had this- I had dressings on you know, for the skin, and then suddenly boof, all this stuff came out of my chest. And I’d obviously, they said, you know I had to them have quite some- type of what do you call it? Forgotten the word for the moment, anyhow, treatment.
 
Antibiotics?
 
Antibiotics yeah. Antibiotics. To clear it up.
 
Just oral antibiotics or- Were you in hospital for that?
 
No, I just had a set of pills, yeah. And there wasn’t a clear link, saying you know the radiotherapy did that, but obviously somehow I got an infection in my chest, and I had these sore places, and then suddenly one of them just whoosh, you know and lots of sort of stuff came out. It was quite surprising actually. And I felt quickly better actually, so I was obviously sort of feverish in a way.
 
Yeah. So, so actually her radiotherapy went a lot better than mine. And she didn’t get so badly burnt either. I really got quite, you know the skin was coming off, it was like a very bad sunburn, and I had some special cream to put on and dressings which we used to put on every day. So it was twenty five days I think, yeah.
One man who had had a bilateral mastectomy only needed to have radiotherapy on one side of his chest. This side was still darker and he had been told that he would always need to be careful about exposing the affected area to the sun.
 

Roy now keeps his arms covered even in the summer to protect himself from the sun after his...

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Age at interview: 67
Sex: Male
Age at diagnosis: 65
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Basically – it’s like going in the microwave, really. But it darkened all this side of me chest.

 
And is that still darkened, or…
 
It’s still slightly a different colour. It’s not… I’ll show it to you if you want to see it.
 
Yeah.
 
It’s gone slightly darker. This side, they didn’t do any radio – didn’t need radiation, coz it was the crystals and they got it very, very early. Yeah, they got it very early. Yeah, and it’s…
 
And do you have to now be careful with exposing it to the sun?
 
Yeah, I mustn’t expose it, yeah, yeah, yeah, yeah. I have, as I say, even in the summer, I keep me arms covered. I don’t, you know, I’ve been – what it is, although I’m sort of fairly easy going and everything, I will do what I’m told, you know?
 
You sound like the ideal patient!
 
Yeah – whatever they tell me, you know, whatever they say, I will do it, regardless, you know what I mean? You know, I do exactly what I’m told, you know? You know, they said, you know, “Try not to get sunburn. Don’t let your arms get too sunburnt.”
 
And so they’ve told you to be careful about that for the rest of your life?
 
For the rest of me life, yeah.

 

Mike C had experienced a third degree burn from his radiotherapy. The burn itself had been like a dry scald and painful. Unfortunately, the burn made him more susceptible to infection and he picked up an MRSA infection which continued to cause him problems. Two men experienced more serious complications between radiotherapy treatments (a severe urine infection and a heart attack), but these were not directly caused by the radiotherapy.
 
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Mike C suffered a severe burn as a result of radiotherapy and subsequently picked up an MRSA...

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Age at interview: 70
Sex: Male
Age at diagnosis: 66
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And, that was the problem I got burnt with the, that’s what caused the infection to start with because it opened it, and the, the radiotherapy burnt it quite badly.

 
And did that start immediately, that you started on the radiotherapy or did that kind of build up as…?
 
No towards the end of it and so it was, that was why it was, you know the first bout of it was the summer, basically yeah, it was the end of the… I’d finished the treatment when I had the first bout, the infection, about that. Obviously I’d had the infection when I was in hospital and things and stuff, and they dressed it and everything. But the recur…, the first recurrence was July/August 2009. ‘Cos I remember we were supposed to be going out to lunch ironically with the head of the, the doctor was one of the guests, that one, that house there was the old head doctor, but he’s retired and this lady has taken over and she was going to be a guest at this lunch and I’d had to cry off.. before I went, I’d had to cry off I didn’t have, because I was running round trying to get dressings and things for this, well – what do they call it?... These em, out of hours hospital things, so.
 
NHS 24 or … NHS Direct or...
 
It wasn’t NHS 24 it was a funny name.
 
Yeah, yeah.
 
And they’ve lost the contract now, somebody else has got it now apparently. But so, anyway, to cut again a long story short – that was when it recurred in that July after, at the end of the radiotherapy, which again, I didn’t have any side effect from radiotherapy and I’d taken, taken [name] and she’d not many either, she got a bit tired, but it was just the infection that was it, from the burning, because they did burn it quite badly.
 
And could they see that that burn was building up as they were, as they were doing it or…?
 
No, no.
 
No.
 
No I don’t think so, no, no, it was a sort of, well [name] saw it better than I did, wasn’t it… it was a sort of third degree burn almost, wasn’t it, you couldn’t.
While describing their radiotherapy treatment, a number of men praised the hospital staff.
 

Michael praised the staff for taking good care of him and explaining the radiotherapy well. He...

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Age at interview: 67
Sex: Male
Age at diagnosis: 57
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 And you talked as well about your experience of radio therapy, so you had that twice. You had fifteen sessions the first time?

 
Yes.
 
And then a similar number the second time.
 
Yes.
 
And did you have a similar experience of the radiotherapy both times? You said the first time was very tiring.
 
I think with hindsight, because I was working in the hospital, I just went along, had my radio therapy… at the end of it, I have to admit I suddenly realised how tired I was and they said, you know, “well you really ought to have had some time off”. But the thing is there’s only two of us in the department and we are on demand all the time to fix pieces of equipment for you know, wards and we’re needed. And being off… I don’t like being off sick anyway and so I think perhaps I found that more tiring than I did the second time, although the second time of course I’d retired and I was a bit older obviously as well, and I didn’t have the pressure of going back to work. It was… no it was fairly run of the mill really. As I say, it was uncomfortable. It made the skin red, it made it a little bit sore, they recommended a cream to rub on it which helped, cooled it down a little bit and there’s no lasting effects you know, apart from the fact that you know, the hair on my chest has disappeared.
 
And has that happened on both sides?
 
On both sides, yes.
 
So, I don’t know if you feel evened up or whether that’s…
 
Well, yes, yeah as I said earlier, sort of at my age I really don’t tend to be so vain about your appearance.
 
And did they warn you about that hair loss the first time round or was that something that surprised you?
 
Do you know, I can’t remember actually. They probably did, they were very, very good. They went through… in the,,, you don’t just appear one day and they sort of give you the treatment. You have the first stage you go and they tattoo you, they put a little tattoo in the middle of your chest and… on whichever side it is they’re going to… they put one on the side so they can sight the laser accurately every time so it hits the right spot. And so you go along and have that done and they talk through and explain to you, and then before you start the treatment, usually the first treatment, it’s… instead of being a half hour, it’s about an hour appointment and somebody takes you into a very cosy little room you know, with a nice sofa, you know chair and cups of coffee and that and talks you through it. I can’t remember what they said about hair loss, they probably did because as I say, they were very, very thorough.
 
That’s nice, so they gave you a really good idea about what to expect.
 
Yes. At no time did I not feel involved in my treatment.
Often when people go to the hospital for a course of radiotherapy they may see the same patients on many occasions. A few men talked about seeing the same people every time in the waiting room who were also having treatment and they were able to support each other. David C said he became friendly with other patients that were there at the same time. They could have ‘pleasant chat’ and encourage each other.

Several of the other cancer sites on Healthtalk, including the site on ‘Breast Cancer in Women’, also describe people’s experiences of having radiotherapy.

Last reviewed June 2017.
Last updated October 2013.

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