||Advanced therapies and novel approaches to breast cancer treatment are yielding better results and new hope for women with the disease. Offered at Holy Name Medical Center's Regional Cancer Center, these exciting advances in radiation and medical oncology address the need to eradicate cancer by targeting tumor cells as precisely as possible, while minimizing unpleasant or dangerous side effects that can result from exposing healthy tissue to radiation and/or chemotherapeutic drugs.
Turning breast cancer radiation upside-down
Benjamin D. Rosenbluth, M.D., a Harvard-educated, Sloan-Kettering Cancer Center-trained radiation oncologist who recently joined Holy Name's team, names "CT-guided prone-breast radiation therapy" as one of the most exciting innovations in his field.
Traditionally, he explains, a breast patient receiving radiation lies on her back. While that position enables the entire breast to be treated, some radiation may skirt below the breast, hitting the ribs, muscles, and more importantly, the heart and lungs. Skin-on-skin contact during treatment can produce some irritation and, depending on the angle of the beam, the healthy breast might also catch some radiation. Prone-breast radiation therapy calls for the patient to lie on her stomach, with her breast projecting downward, isolating only the tissue targeted for treatment. This allows more radiation to be delivered only where needed.
Smart meds attack the abnormal, preserve the healthy
Yadyra Rivera, M.D., a Holy Name medical oncologist , notes the latest generation in cancer medicine, called "targeted therapies," also aims to maximize dosage to the malignancy, with minimal toxicity to healthy cells. The tumor cells of certain patients express a particular molecule, explains Dr. Rivera.
Targeted therapies work by identifying and attaching themselves only to those molecules, killing cancer cells and bypassing the normal cells.
Another novel approach, "dose dense chemotherapy," calls for administering the same amount of chemotherapeutic drugs at more frequent intervals. "Studies have shown," says Dr. Rivera, "that this more intense way of delivering chemotherapy has proven more beneficial, actually improving patient response rate." The compressed schedule also allows patients to complete their course of therapy faster.
Predicting recurrence risk will eliminate over-treating
"For many years," says Dr. Rivera, "we have had to over-treat many patients, since we didn't know who would benefit from additional chemotherapy."
But now there's a kind of genetic testing, called Oncotype DX, that can predict the risk of breast cancer recurrence. Pathologists conduct a series of tests on a patient tissue sample and the resulting "score" gives physicians information about how the disease will behave in ten years.
"Oncotyping is helping us better personalize treatment to each patient," according to Dr. Rivera.
Lumpectomy for breast cancer is usually followed by six to eight weeks of daily radiation therapy, a major inconvenience for many patients. Holy Name Medical Center provides an alternative called MammoSite® which requires only five days of twice-daily, five-minute therapy sessions.
MammoSite® provides high-dose radiation internally, from within the tumor bed, the likeliest site for a local recurrence. It also delivers radiation through a balloon catheter that is place the time of surgery. Following the final treatment, the balloon is deflated in the radiation oncologist's office and the catheter slips out easily. MammoSite® is typically used for women in their sixties, seventies or older who have early-stage, localized breast cancer.
Treating the whole person
These advances join Holy Name's other cutting-edge diagnostic and treatment capabilities, which include breast MRI, combined PET/CT scanning, IMRT (intensity modulated radiation therapy), respiratory-gated radiation therapy, stereotactic radiosurgery, and interventional oncology.
Dr. Rivera says the treatments offered at Holy Name represent "the standard of care."
"That means they are comparable to those of an academic teaching center." She emphasizes, "When you're treated here, you become part of a community, part of a family. And our commitment to patients doesn't end when you complete your treatment. We follow you very closely for several years."
Patients facing cancer have treatment options. To learn more, or to make an appointment with an oncologist from the Regional Cancer Center at Holy Name Medical Center, call 201-541-5900.
The Breast Center
The earlier that breast cancer is detected, the higher the chance that treatment will be successful. Patients can address all of their breast imaging needs at one location, during a single appointment at Holy Name's on-site Breast Center. Highly trained staff guides the patient through her tests with efficiency and sensitivity. Images are read by Holy Name's own Board-certified radiologists who have special expertise in mammography. Holy Name's Breast Center is certified by the American College of Radiology. Comprehensive services include:
- State-of-the-art, all digital mammography
- Breast ultrasound
- Ultrasound-guided fine needle aspiration, core needle biopsy and the ATEC Breast Biopsy and Excision System
- Advanced bone density testing
The Breast Center
At Holy Name Medical Center