Radioactive Seeds May Offer Treatment Option for Breast Cancer
Jan. 16, 2000 -- Although it has been a common treatment for men with prostate cancer, including New York City Mayor Rudolph Giuliani, a type of radiation therapy in which radioactive seeds are implanted near the tumor also may be a treatment option for certain women with breast cancer.
When Andrea Mulrain, a music scout from Stonybrook, Long Island, was first diagnosed with breast cancer at age 33, her doctors laid out various treatment options. When faced with the choice of undergoing a mastectomy, the surgical removal of a breast, she felt that she was too young to lose a breast.
She then sought out the advice of a respected oncologist, James F. Holland, MD, of Mount Sinai Hospital in New York City. He suggested that she may be an appropriate candidate for an experimental treatment being done in France using brachytherapy.
Brachytherapy is a general term for radiation delivered from implants inside the body rather than from a machine outside the body (external beam radiation). In brachytherapy, radiation oncologists implant tiny silver-colored tubes into the body near the tumor. The tubes, called "seeds," contain a radioactive element that delivers a uniform and continuous supply of radiation to the tumor. Although brachytherapy already is being used to treat other types of cancer, it is only in experimental stages with breast cancer.
Interested in the procedure, Mulrain threw herself into research and soon thereafter got on the plane to Paris, where doctors at the Pitie-Salpetriere Hospital could assess whether she was a good candidate for the treatment.
Soon after meeting with several doctors who felt it would be a good choice for her, Mulrain received four cycles of chemotherapy, or anticancer drugs, followed by five weeks of external beam radiation. Then she was hospitalized for three days to receive the seeds.
"When the seeds are implanted, you are highly radioactive. You basically have to be quarantined," she tells WebMD.
After the brachytherapy was completed and she had healed, she underwent two more cycles of follow-up chemotherapy.
Now, about eight months later, tests show that there is virtually no sign of the tumor left.
"I'm ecstatic and would certainly recommend this protocol to certain people," she says. "Some women, on an emotional and psychological level, may feel more comfortable going for the whole hog," she notes, referring to the current standard of care of mastectomy or lumpectomy (surgical removal of the tumor), followed by radiation.
Aside from the experimental treatment protocol that Mulrain chose and received, there are two ways that brachytherapy can be incorporated into breast cancer care in the U.S. In one case, breast tumors are often treated with a combination of lumpectomy followed by external radiotherapy to the whole breast, and in some cases, this radiation can be given via brachytherapy. Some women whose cancer recurs after initial treatment may then try brachytherapy to avoid undergoing a mastectomy.