It’s time to cut back on radiation treatments for breast cancer
Submitted by Dr.Kattlove’s Cancer Blog
It must be frustrating for a woman with breast cancer to learn that after she has had surgery, she is only part way through her treatment. Often there will be hormone treatment or chemotherapy or both; and, if she has had a lumpectomy (about half of all women), she will also need radiation to the breast.
Why do we give radiation to the breast if the cancer has been removed? It’s because the cancer often will come back in the breast and radiation cuts the chances of this happening by half. Clearly, in some women – about 5-10%, some cancer cells have dodged the surgeon’s knife.
So traditionally, radiation oncologists have treated the breast with radiation 5 days a week for 5 to 6 weeks. That’s a lot of time out of a woman’s life and many doctors have wondered whether the radiation could be given over a shorter time with fewer treatments.
There have been a few studies that show that this can be done and now a really good study has come out of England that proves it. Several radiation centers participated in treating a little over 2000 women after their lumpectomies for breast cancer. Half the women received the usual 25 treatments over 5 weeks and another half got a slightly higher dose of radiation each time but only 15 treatments in 3 weeks.
Five years later, the women who got the shorter treatment had no more recurrences in the breast than did those who received the traditional 25 treatments over 5 weeks. In fact, their recurrence numbers (2.2%) were lower than the women with the longer treatment schedule (3.3%). And the concern that slightly higher doses over a shorter period would damage the breast (the breast can become scarred and hard) turned out to be unfounded. Actually the women with the shorter treatment tended to end up with better looking breasts. The researchers actually took pictures of all the women for comparison.
So why are we in the U.S. still using the older longer regimen? One reason is that there are a lot of radiation facilities in the U.S. and we don’t want them to stand idle. Treatment schedules tend to conform to capacity. That’s why most of the studies of shorter treatments come from Canada and Great Britain where the supply of radiation facilities is limited.
Still, that doesn’t mean a woman should spend her time going to radiation treatments if it isn’t necessary. Nor should they (or their insurance companies) have to pay more than necessary – 15 treatments are cheaper than 25).
It’s time for radiation oncologists to discard their traditional approach and give these women a break.
Visit 1800blogger to see all of our industry leading blogs.
