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Radiation Therapy Treatment for Breast Cancer in Just 5 days

HealthReach, Fall 2013 | Page 7

Virginia Hospital Center has the most experience with APBI of any hospital in the Washington metro area.

For more information about APBI, call 703.558.6284.

A busy executive, Gail daMota of Alexandria wasn’t sure how she would manage treatment when she was diagnosed with breast cancer in 2012. After her lumpectomy, she was facing six to seven weeks of radiation therapy five days a week — tough to fit into her already-full calendar.

But, because her cancer was detected at an early stage, Gail was eligible for accelerated partial breast irradiation, or APBI. That reduced her treatment time to just five days.

Robert Hong, MDwith Gail daMota

Robert Hong, MD with Gail daMota

“I’m very analytical; I want to know what I’m getting into before making a decision,” Gail says. “Both my breast surgeon and radiation oncologist spent a great deal of time discussing my options and the pros and cons of each. I was fully informed, which made me feel very comfortable.”

Gail had her radiation therapy treatment at Virginia Hospital Center, which has been designated as the region’s only Center of Excellence for APBI. Since 2008, the radiation oncology program has treated nearly 500 patients with APBI, mostly with an applicator called a strut-adjusted volume implant, or SAVI, and has been recognized nationally for its success with the technique.

Patients are eligible for APBI with SAVI if they have early-stage breast cancer without lymph node involvement, if their tumors are no more than 3 centimeters, and they have not had a mastectomy.

Here is how it works: A tiny applicator is implanted into the tumor cavity. Once the applicator is in place, it is rotated to deploy catheters that conform to the size and shape of the cavity. Twice a day for five days, the catheters are connected to the radiation source. When treatment is done, the applicator is collapsed and removed.

Aside from the speed of the treatment, the most important benefit of APBI with SAVI is that it delivers radiation just to the areas that need to be treated, avoiding unnecessary radiation to normal breast tissue and surrounding organs.

“When explaining APBI to my patients, I refer to the Goldilocks principle,” says Robert Hong, MD, Department Chief, Radiation Oncology. “We have to determine whether their treatment is too much, too little or just right. For many women who undergo breast-conserving surgery, APBI is just right. It maximizes getting rid of cancer cells and there is no dose to the heart or lung. Plus, because we are radiating a smaller area, patients tend to experience less fatigue.”

Gail’s breast surgeon, Stephanie Akbari, MD, FACS, implanted the catheter in a brief office procedure. In fact, Gail left a board meeting to have the catheter put in and went to a business dinner that night. The next morning, she changed the dressing herself and hosted a conference.

“It was really nothing to have the catheter put in,” Gail says. “There was an open incision, which required dressing changes, but this was a much better option for me than prolonging my treatments over many weeks.”

Radiation oncology nurses spend a lot of time educating patients and families about the treatment and answering their questions. “We do a hands-on demonstration to show how to care for the incision,” says Cecilia Brizuela, RN, MSN, OCN.

One of the most common questions patients have is whether the catheter will expose their family members to radiation. The catheter is only radioactive during the actual treatment.

Gail says that the staff was “very friendly and supportive” during her treatment. “The environment is very upbeat,” she says. “It was easy to go in and have my treatments done.”

Overwhelmingly, patients share Gail’s feelings and are happy with the results, Dr. Hong says. In his most recent research, more than 90 percent of women said that their cosmetic outcome was good to excellent.

“APBI is amazing in terms of the impact on quality of life and selfesteem for our patients,” he says.

FIGHTING BREAST CANCER
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