Radiotherapy for breast cancer: Classic technology, modern advances

August 1, 2017 | by City of Hope

Radiation therapy has long been a treatment for breast cancer.

“For the most part, radiation is the same radiation that we’ve been using for decades,” said Daniel Kim, M.D., an assistant clinical professor and radiation oncologist in the Department of Radiation Oncology at City of Hope Arcadia.

But in recent years, there have been major advances in the ways that Kim and his colleagues plan for and administer that therapy. Those advances equal big benefits for patients.

  • Advanced planning. One of the biggest developments in radiation treatment has been in the planning phase, Kim said. Thanks to modern imaging tools and other technologies, radiation therapy teams can better visualize the radiation targets and design ways to avoid other parts of the body, such as the heart and lungs.

  • Shorter courses. Modern technology has also shrunk the length of radiation treatment for many breast cancer patients. With hypofractionated radiation treatment, patients receive a full dose of radiation in three or four weeks instead of the standard six. “Because of our improved planning techniques and the greater safety of our treatment, we can deliver a higher dose per day to get things done sooner,” Kim said.

  • One-stop-shopping. Another exciting development is intraoperative radiation therapy (IORT). With this method, doctors deliver a single dose of radiation in the operating room. After a breast tumor is removed, radiation oncologists apply a very concentrated dose of radiation to the surgical site before surgeons close the wound, Kim explained. “Certainly, there are major advantages of a ‘one-stop-shop,’ getting all your treatments done on the same day,” he said. However, he cautions, IORT is still considered experimental, since it hasn’t been around long enough to know how long-term outcomes compare to more traditional treatments.


Tailor-made treatments

Like all cancer treatments, radiation comes with some side effects. People being treated for breast cancer might experience mild burns on the skin of the breast, on par with a sunburn, Kim said. Fatigue is also common during treatment.

The good news is that the modern developments in imaging and planning have made radiation therapy more targeted than ever, reducing the risks and side effects.

And radiation therapy is poised to become even more tailor-made, Kim said. With the advent of genetic testing, he expects that future medical teams will be able to determine ahead of time which patients are more likely to benefit from radiation therapy, and which might not need radiation at all. “This is going into the realm of personalized medicine,” he said.

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