Radioactive Seeds May Offer Treatment Option for Breast Cancer
Most radiation oncologists stress that using brachytherapy instead of external beam radiation for breast cancer is a new idea. Because of this, they are still not sure if the results will be better, the same, or worse than the results seen after whole external beam radiation.
However, even if the results are approximately the same, brachytherapy is a shorter treatment and has the potential for irradiating less of the healthy tissues.
"It's an alternative to external beam radiation to the breast," says Douglas Kelly, MD, a radiation oncologist at Cancer Treatment Centers of America in Tulsa, Okla. "When women are newly diagnosed with breast cancer, they have an option of mastectomy or lumpectomy followed by radiation. Historically, breast radiation is done with external beam radiation to breast over six or seven weeks, but brachytherapy offers an alternative to whole-breast radiation."
The most widely used type of radiation therapy for people with cancer, external beam radiation is similar to getting an X-ray, but for a longer period of time. It is typically given in daily fractions over several weeks.
One of the main advantages of brachytherapy is that it only takes five days, whereas external beam radiation takes much longer, Kelly tells WebMD.
In addition, "Not a lot of radiation reaches the skin," he says, "so there is less skin reaction and less radiation reaching the ribs, lungs, and heart, where it can cause adverse effects.
"Here, we have been doing it for three years, and the cancer has not recurred in the breast of any women that we have treated," Kelly says. "The side effects have been minimal, and I think most of the women have been happy that they choose it." Kelly has used this procedure on about 25 women in the past three years.
While it is not yet considered a standard of care for breast cancer in any way, Kelly says, "I think it's almost at a point where it may be offered as a routine option. There still are ongoing trials and still will be future trials, but we are getting to a point where it can be done off-trial."
There are some side effects of brachytherapy, including risk of infection and breast swelling, but they are generally not significant, says Michael Zelefsky, MD, chief of brachytherapy in the department of radiation oncology at Memorial Sloan-Kettering Cancer Center in New York City.
Zelefsky also has been using brachytherapy for selected women with breast cancer. "There have been substantial experiences from France where brachytherapy has been used for recurrent cancers after standard treatment has been tried," he tells WebMD. "In these situations, it is used for a further attempt at breast preservation.
"The results have been very good," he says. "If the treatments don't work, mastectomy can always be used as a salvage procedure after brachytherapy.