New 5-day therapy treats breast cancer

When Helen Draper was diagnosed with breast cancer in April, doctors recommended she have a lumpectomy, removal of her sentinel lymph nodes and a 6 1/2-week course of radiation.

After looking at her options, the Salt Lake woman decided to go instead with an increasingly popular but not completely studied cancer treatment called brachytherapy that delivers episodes of high-dose radiation in a course of treatment that lasts five days rather than weeks and targets specific tissue instead of the entire breast.

Radiation oncologists at Salt Lake Regional Medical Center's GammaWest Brachytherapy have been offering the treatment for some time, and that's where Draper went. Ogden Regional Medical Center also offers brachytherapy, according to GammaWest radiation oncologist Dr. Roger Hansen. Most other hospitals in the area do not offer brachytherapy for breast cancer, some because they lack high-dose radiation capability and others because they consider it investigational.

University Hospital and Huntsman Cancer Institute are teaming up for a study that should begin using brachytherapy to treat breast cancer patients in a couple of months, said U. radiation oncologist Dr. Cherie Hayostek. The early data, she said, are promising, but the U. considers it investigational.

Earlier this week, brachytherapy for breast cancer made headlines with announcement that the National Cancer Institute is launching a huge study to see if brachytherapy keeps women cancer-free as long as traditional radiation therapy and to help identify its best candidates.

For brachytherapy, cancer must be small, the primary tumor 3 centimeters or less, said Dr. John Hayes, GammaWest radiation oncologist. It must be removed completely in surgery, along with a margin of normal cells. (Dr. Steve Mintz removed Draper's tumor.) The patient's lymph nodes must be removed and tested. If cancer cells are found in four or more lymph nodes, then external beam radiation is appropriate, rather than brachytherapy.

The most common type of breast brachytherapy — and the kind Draper, 55, had — uses multiple small plastic catheters that are threaded through the breast and remain in place for the five days of brachytherapy. They are placed in and around the area where the tumor was removed so that radiation covers the tumor site and extends about 2 centimeters beyond it. External radiation treats the entire breast.

Also called accelerated partial-breast irradiation, brachytherapy delivers a more potent dose of radiation with each treatment than standard radiation does. But it's a much shorter course of treatment, Hayes said.