'A treatment with an end in sight'

Partial radiation therapy used to treat breast cancer

Partial radiation therapy used to treat breast cancer

October 15, 2007|By JULIE E. GREENE

When Linda Pryor learned she had breast cancer, her first thought about treatment was simply to have the breast removed so she wouldn't have to deal with the constant worry that some cancer remained.

Not only did the Lemasters, Pa., resident not have to have her breast removed, but she also didn't go through traditional, external radiation therapy.

Instead, this past summer, Pryor became one of about 30 women to receive a new, internal radiation therapy known as MammoSite at the John R. Marsh Cancer Center at Robinwood Medical Center, east of Hagerstown.

MammoSite is Cytyc Corp.'s brand name for balloon catheter brachytherapy, a form of partial radiation therapy.

In June, Pryor underwent a lumpectomy to remove a tumor from her breast. The next month, during an outpatient procedure, a balloon was inserted into the cavity from where the tumor was removed. In the third part of the treatment, Pryor received radiation therapy when a tiny pellet of radioactive iridium - as small as a sesame seed - was inserted through a catheter into the balloon.It typically remains in for 5 to 10 minutes per treatment before being removed.


Benefits of partial radiation

Dr. Daniel Cornell, director of radiation oncology at Marsh Cancer Center, said one advantage of MammoSite is convenience. The procedure involves two treatments a day for five days compared with 6 1/2 weeks of external radiation, Cornell said.

Pryor, 65, works two part-time jobs, at J.D. Market and Peters Township (Pa.) Sewer Office, and has a busy life with her husband, two dogs, home, garden and grandchildren.

"For one week, you could tolerate almost anything," she said.

Pryor said there was some discomfort.

"It feels like you have a golf ball in you. It's a little tight," she said.

She used four pillows to sleep in a reclined position to get comfortable. She also wore a special bra with padding to protect the area. She experienced pain when the balloon was removed, and the area was still a bit tender.

Pryor said she was tired that week, but that was partly due to the travel twice a day from Lemasters, northwest of Greencastle, Pa., to Hagerstown.

The Marsh Cancer Center has been offering MammoSite for a year, Cornell said.

MammoSite has been performed through Summit Health at Summit Cancer Services, on the campus of Chambersburg Hospital, since May 2006, according to Sheran White, director of public relations.

Recurrence and side effects

MammoSite was approved by the U.S. Food and Drug Administration in May 2002, whereas external radiation for breast cancer has been in use for much longer. While there isn't long-term data on MammoSite, so far the results have been similar to the results of external radiation, said Dr. Victor Zannis, medical director of the Breast Care Center of the Southwest in Phoenix.

Following a lumpectomy and MammoSite, the recurrence rate of cancer, in the entire breast, is 1 to 3 percent, which is equivalent to the recurrence rate with external radiation, Zannis said.

More data is being gathered.

A controlled randomized study is being conducted by the National Surgical Adjuvant Breast and Bowel Project to compare partial radiation, including MammoSite, to external radiation for breast cancer that will eventually involve 4,000 women in the United States, Zannis said. To learn more about this, go to and click on "Protocol B-39."

In addition to the rate of cancer recurrence, other factors to consider are toxicity and side effects, and how the breast looks, Zannis said.

Cosmetically, 9 out of 10 women have responded well to how their breast looks after it healed following the MammoSite procedure, he said. He said side effects, which are uncommon, include redness, spider veins and thickening of the skin, the same side effects of external radiation.

Cornell said he thinks MammoSite results in fewer side effects and better cosmetic outcomes than external radiation.

Costs and eligibility

MammoSite is more expensive than external radiation, but insurance has covered both.

Facility charges and professional fees for the doctor total approximately $43,000, said John Attaya, financial counselor for the Marsh Cancer Center, compared to about $20,000 for 6 1/2 weeks of external radiation.

Washington County Hospital does have a program to help uninsured patients, Attaya said.

To be eligible for MammoSite treatment, the cavity the tumor was removed from needs to be at least 1/3 inch from the skin, Zannis and Cornell said.

Making sure the tumor, and therefore the treatment, are deep into the tissue minimizes the toxicity to the skin and reduces chances for skin redness, Zannis said.

Other criteria for women to be eligible include the size of the tumor - it must be 3 centimeters in diameter or smaller, and must be an isolated tumor, Zannis and Cornell said.

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