An NCI-designated Comprehensive Cancer Center
By Kevin Chesley | April 18, 2018
Daniel H Kim bio Daniel H. Kim, M.D.
For breast cancer patients seeking breast-conserving therapy, or with high-risk disease following mastectomy, radiation is a vital part of treatment.
City of Hope’s radiation oncologists are highly qualified to use computed tomography (CT) or magnetic resonance imaging (MRI) scans to target tumor sites and customize care, all while minimizing exposure to normal surrounding tissue.
Daniel H. Kim, M.D., is an assistant clinical professor in the Department of Radiation Oncology at City of Hope. He’s familiar with the various methods available and explains the pros and cons of each kind.

Radiation’s Recent Advancements

Many of the latest innovations in radiation therapy deal with the planning aspects of treatment, he says. “It’s the same radiation that we’ve used for decades. The major advances have been better ways to visualize the radiation targets and plan the treatment to avoid organs that don’t need it, like the heart and lung.”

Standard Versus Hypofractionated Radiotherapy

One new method of using radiation involves a shorter, more effective rate of delivery. “Rather than treatment over the standard six-week course, hypofractionated radiation treatment prescribes shorter courses of three to four weeks,” Kim says. “Overall, the total dose is the same, but because of improved planning and greater safety, we can get things done faster.”

Intraoperative Radiation Therapy

There is also a new way to deliver radiation while the patient is still being operated on, known as IORT. “Intraoperative radiation therapy is a one-stop-shop, getting all your treatments done on the same day,” Kim explains.
This method is currently experimental, with researchers analyzing IORT’s long-term safety and efficacy. But Kim finds its potential exciting. “After the lumpectomy, a radiation applicator is placed in the cavity where the tumor used to be. Then, a focused node of condensed radiation is delivered — the equivalent of a six-week course. The treatment takes no more than a few minutes, then the rest of the surgery proceeds like it normally would.”

Radiation’s Future

Personalized medicine and imaging techniques are both focuses for the near future in Kim’s field. “A lot of our advances are in the fields of molecular diagnostics and genetic testing. Improvements there will help drive us to an improved way to select patients, localize tumors and identify nontarget areas. Those arenas will push our field forward.”

The Fear of Radiation

For many women, the idea of using radiation is rife with concerns about complications. “Get your information from a cancer specialist. This is what we do and it’s our job to counsel patients appropriately,” Kim says. “With the delivery of radiation, it’s something we control because we, ourselves, know it is dangerous in the wrong hands.”
Discussing the use of radiation can be very sensitive, “What I tell all patients is, first of all, radiation is not something that you feel. It’s not painful and, as far as most types of external radiation go, there’s no radiation left inside the body. There’s no danger to the people around you or the surrounding areas.”
Side effects, however, are a prevalent concern. “The skin reaction can progress along the lines of a mild sunburn over the course of your three, four or six-week treatment,” Kim says. “The long-term risks we minimize with improved imaging and planning techniques and learning to better target the area that needs radiation while avoiding the heart, lungs or anywhere that doesn’t need it.”
Kim is proud of City of Hope’s ability to help and innovate. “We’re a multispecialty cancer center that works well in teams. Surgeons, pathologists, medical and radiation oncologists, radiologists and reconstructive surgery colleagues are all found under one roof to coordinate together and provide the best patient experience possible.”


If you are looking for a second opinion about your breast cancer diagnosis or consultation about your treatment, request an appointment online or contact us at 800-826-4673. Please visit Making Your First Appointment for more information.


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