|  Why radiation matters in treating breast cancer
An interview with S. Christopher Hoffelt, MD,
PeaceHealth Southwest Radiation Oncology
Radiation may seem like a drastic approach to fighting breast cancer, but it's fast and effective. Major innovations in radiation therapy are helping physicians to target and defeat cancer. The good news is the body's normal tissues can more effectively be spared harm. And with the only CyberKnife® radiosurgery system in the Portland/Vancouver metropolitan area, PeaceHealth Southwest's Cancer Center offers the most advanced and pain-free treatment options available.
What are the benefits and risks for having radiation treatment?
Radiation therapy is a powerful and highly effective cancer treatment. Malignant cells are more sensitive to radiation treatment than normal cells, so this treatment can dramatically shrink life-threatening tumors.
It's a delicate balance: We want to damage as many cancer cells as possible but limit the harm to normal cells. With some of the latest radiation technology, we are able to precisely target the radiation so that we aim directly at the tumors from different angles, and minimize the risk to your healthier surrounding tissues.
How do you know how much radiation I should receive?
At PeaceHealth Southwest, radiation treatment is a collaborative effort across many specialties: physicians, physicists, therapists, nurses, dosimetrists are all involved. Radiation therapy must be designed for each patient: deciding different treatment energies, directing the precise location and angle of the beam, discovering ways to modify the dosage.
We combine all these considerations to develop a treatment plan, and we run a simulation to test it. In addition, the physicist completes a complex, quality assurance (QA) assessment to ensure that the plan is exact and perfect.
What happens when I receive radiation treatment?
You'll probably be asked to wear comfortable, loose-fitting clothes. Metal can affect the treatment, so don't wear clothes with zippers or snaps. Depending on the part of your body being treated, you may be asked to remove hairpins, jewelry, eyeglasses and hearing aids, and to take out removable dental work.
Typically you will be lying down for radiation treatment. Many patients bring their favorite music, and we may make adjustments to help your body relax while lying still.
How long does it take?
It takes about five to ten minutes to set up the patient and equipment, and then about 35 seconds for each field that receives the dose. Depending on the type of treatment, this may be a longer or shorter period of time.
Radiation also may be given internally, by implanting tiny radioactive substances, such as "seeds," wires or capsules, near the tumors inside the body. If you have this type of radiation, you may need to stay in the hospital for a while.
Radiation therapy can last anywhere from two to eight weeks. Every patient's case is different.
What happens after radiation treatment?
After the treatment is completed, you can go back to your daily routine. Some patients may experience some fatigue, but many simply go home or back to work. Your body is your best indicator for what it will allow you to do.
Radiation does not cause pain, but there may be side effects, such as itchy, red skin. In addition to helping you monitor your physical condition, your nurse navigator will help you with tips for rest, nourishment, exercise, support, and any other concerns that arise.
What types of radiation treatments are available?
We have several treatment options at PeaceHealth Southwest. Based on the exact location and shape of the tumors and target the cancer, we may use:
- CyberKnife® radiosurgery treatment room with precise robotic treatment, cameras and speaker system for image-guided, non-surgical treatment
- Clinac 23X with photon beam similar to CyberKnife
- Linear accelerators using IMRT and IGRT
- Diagnostic PET/CT scans
- Radiography-based simulation room and CT scanners
- Brachytherapy using CS 137
- Customized patient treatment device fabrication
What's in the future for radiation treatment?
Technology will continue to develop radiation treatment machines that treat patients more accurately, quickly, and with more aggressive dose delivery to cancer cells while sparing normal tissues.
The future of radiation therapy treatment uses a model based on diagnostic-quality, stereoscopic x-ray images that, on a daily basis, can target the site the moment before treatment begins. Any changes in a patient's anatomy can be accounted for in real time. Physicians can be even more confident that daily targeting will keep less normal tissue within the treatment area. Physicians currently using this technology can prescribe higher total tumor doses.
Also, PeaceHealth Southwest has been involved in several clinical research studies to fight breast cancer with different treatments, including:
- Effectiveness of Tamoxifen and Roloxifen in prevention of breast cancer
- Use of chemotherapy for breast cancer patients
- Fine needle aspiration (FNA) diagnosis of breast cancer
- Pre-op chemotherapy for breast cancer treatment
- Dose-dense chemo for breast cancer therapy
- Sentinel node breast surgery, resulting in less invasive surgery and decreased surgical side effects
How can I find out more about radiation treatment options?
PeaceHealth Southwest's Radiation Oncology Department is accredited by the American College of Radiology. As the only radiation treatment center accredited in the State of Washington, it is one of only three accredited centers in the Washington, Oregon and Idaho region.
Radiation Oncology is located in the stand-alone Cancer Center building on the PeaceHealth Southwest Medical Center campus, off the 87th Ave. entrance from Mill Plain Blvd. in Vancouver. For more information, go to www.swmedicalcenter.org/cancercenter or call 360.514.1900.
About Dr. Hoffelt
PeaceHealth Southwest's CyberKnife® team is led by radiation oncology expert, S. Christopher Hoffelt, MD. In addition to his role in the Radiation Oncology department, part of PeaceHealth Southwest's Cancer Center, Dr. Hoffelt is also on the faculty at Oregon Health & Sciences University (OHSU). Before joining PeaceHealth Southwest Medical Center, Dr. Hoffelt was part of the team at Baltimore's Sinai Hospital that introduced the CyberKnife technology for tumor treatments.
You can locate a doctor to help you with cancer care (oncology) on our Find a Doctor area.
Published October 2007.
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