For patients with early stage breast cancer, radiation therapy combined with lumpectomy is an alternative to mastectomy that many women prefer. However, the traditional external beam radiation therapy is a long, tedious process. Daily visits to the hospital or cancer center, usually for four to six weeks, are a nuisance at best and often wreak havoc in the the patient's life.
In addition to the logistical nightmare of receiving daily treatments, external radiation therapy poses the drawback of unintended radiation exposure to the heart, lungs and other healthy tissue nearby. In an attempt to alleviate these concerns, several new methods of delivering radiation therapy have been developed.
While still considered experimental, three have been approved by the FDA. Known collectively as “accelerated partial breast irradiation,” the new methods are designed to deliver more focused and more intense radiation over a shorter period of time. In addition to the benefit of a shorter therapy schedule, the side effects caused by radiation may be diminished as well. Let's take a look at them:
Multi-catheter Internal Radiation Therapy
Technically known as interstitial needle-catheter brachytherapy, this method delivers radiation directly to the area where the cancer was by way of radioactive “seeds.” The seeds are delivered to the cancer site through a small tube called a catheter. The catheter is placed under the skin and then stitched in place. The end of the catheter comes out of the skin. Over a period of time the radioactive seeds are fed into the catheter and deliver radiation to the tissues in the area surrounding the catheter. Depending on dosage, the treatment can last for a few hours up to a few days. During the therapy, the patient must remain in the hospital.
Balloon Internal Radiation (MammoSite)
Similar to brachytherapy described above, this method uses a catheter with a small balloon attached to deliver radiation. The catheter and balloon are placed in the breast where the cancer was either during lumpectomy surgery or in the surgeon's office afterward. Again, the end of the catheter comes out of the skin. During each treatment, a radioactive seed is placed in the catheter and then rests inside the balloon. Radiation is then disbursed to the surrounding tissue. The radioactive seed is removed after each treatment. Lasting only about ten minutes, most patients receive two treatments per day for five days. Once the final treatment is administered, the catheter and balloon are removed. The patient is free to leave the hospital or cancer center in between treatments.
3-D Conformal External Beam Radiation
This method relies on either a 3-dimensional CAT scan or MRI to plan the most precise delivery of intense radiation. The difference between this form of external radiation and the standard external radiation is that each treatment is delivering radiation in a more focused way. The use of 3-D imaging beforehand allows the radiation to be delivered directly to the area where the breast cancer was, as opposed to irradiating the entire breast. Because of this accuracy, radiation treatment can be completed in approximately one week (as opposed to the usual four to six weeks).
These are viable and appealing alternatives for many breast cancer patients. Further, they show great promise for an even larger number of those diagnosed with early stage breast cancer in the future. However, doctors caution that these treatments need to be studied for a longer period of time in order to be completely certain that they are as effective as conventional external radiation therapy. Therefore, it is important to discuss the pros and cons at length with your doctor.