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Intraoperative Radiation Therapy a New Step in Breast Cancer Treatment

Canada-A step forward for breast Cancer treatment comes in the form of Intraoperative radiation therapy. This involves a one time dose of radiation during surgery . Thus the patient can avoid repeat visits to the hospital.

On May 17, the Princess Margaret Hospital team combined the expertise of surgeons, radiation medicine specialists (radiation oncologists, physicists and therapists) and nurses to perform its first procedure. It marked the first time that the portable intrabeam radiotherapy machine that makes this procedure possible has been used in Canada. The PMH team has since treated two more patients.

"The potential benefits to patients are huge," says lead surgeon Dr. David McCready, who also heads the PMH Breast Cancer Program. "Treating the specific area of cancer with this kind of precision protects the skin, heart and lungs from unnecessary radiation, minimizes side effects, and saves the patient a lot of time."

This procedure allays the fear, of many patients going in for lumpectomy surgery to remove the small tumour, of weeks of radiation treatment that would follow. Now all the extra pain, side effects, discomfort and stress could be done away with.

Using a probe attached to the portable intrabeam radiotherapy machine, a single, concentrated dose is inserted directly into the affected area inside the breast during surgery. Dr. McCready says the one-time dose is, biologically equivalent, to conventional radiation treatments for breast cancer that typically require, on average, a minimum of 16 treatments over three weeks.

Dr. Anthony Fyles, the radiation oncologist who leads the Breast Radiation Oncology Program and treated the first patient in the operating room that day, says: "This procedure is helping us understand more about the biology of how breast tissue responds to treatment. That knowledge, in turn, will help us further customize and select the best treatment options for individu als with early breast cancer.

It is hoped that this one time dose will prevent a recurrence of the cancer. The new approach has the advantage of being less time-consuming, more efficient and more patient-friendly.

The localized treatment is suited for a limited group of women with small, low-rise breast cancers. It seems to work best for postmenopausal women (whose breast tissue is less dense) with tumours less than two centimetres in diameter.

Gabriella Di Donato is the first woman in Canada to be treated under the procedure. She is very happy to be back on her feet and going to work instead of going to the hospital for repeat radiation under the traditional method.

The procedure is still experimental, and the Toronto team is participating in an international trial involving more than 800 women.


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