New breast cancer treatment combines surgery, radiation therapy
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Experts at Holden Comprehensive Cancer Center at the University of Iowa are the first in the state to offer intraoperative radiation therapy (IORT) for breast cancer patients. The treatment allows a therapeutic dose of radiation to be delivered immediately following surgery while the patient is still in the operating room. For patients, it means they won’t have to return to the hospital for radiation therapy.
"This is a huge convenience for patients," says Sonia Sugg, M.D., UI associate professor of surgery. "It saves them the time of having to come back to undergo radiation therapy for five days a week for up to three to six weeks after they heal from surgery. It advances them that much further along the road to recovery."
Currently, the standard treatment for early-stage breast cancer is a lumpectomy followed by radiation treatment. A breast cancer patient first sees a surgeon to have the tumor removed and then follows up with a radiation oncologist for the radiation treatments. However, not all patients who choose a lumpectomy follow through with the recommended course of radiation treatments. Factors like time, money, distance, and access to radiation therapy facilities cause some breast cancer patients to neglect the radiation part of their treatment plan. Not completing follow-up radiation can increase the rate of cancer recurrence.
"This will eliminate some of those barriers," says Carol Scott-Conner, M.D., Ph.D., UI professor of surgery. "In Iowa, where access to treatment facilities can be a barrier, this will help patients complete their treatment plan."
With IORT, the radiation oncologist is in the operating room with the surgeon. The radiation is delivered following the surgery to the area where the tumor was removed. A large clinical trial confirmed that delivering radiation at the time of a lumpectomy was as effective in preventing breast cancer recurrence as whole breast radiation therapy in selected patients. Besides the convenience of time, IORT also decreases side effects such as red rashes and skin irritations compared to traditional radiation therapy.
"We hope that this new treatment option will improve the lives of breast cancer patients while reducing side effects of standard radiation therapy, says Wenqing Sun, M.D., Ph.D., UI assistant professor of radiation oncology.
However, UI experts caution that IORT is not for all breast cancer patients. Right now, it is being offered to patients over the age of 50 with small tumors and early-stage breast cancer. Patients interested in the procedure will need to be seen by both a surgeon and radiation oncologist before surgery so that a personalized treatment plan can be recommended. IORT is a procedure that requires teamwork from different specialties. In addition to a surgeon and radiation oncologist, the care team also includes medical physicists and health protection officers to provide technical support.
"This isn’t a replacement for traditional treatments," says Ron Weigel, M.D., Ph.D., UI professor and head of surgery. "But for the right person, we are offering an alternative that will allow a person to get back to their normal life, sooner."