Tissue-Sparing Brachytherapy Available to Wide Range of Cancer Patients
Brachytherapy, a highly specialized treatment that places radiation sources into or around tumors, significantly reduces the amount of radiation exposure to healthy tissue.
Experts at the University of Wisconsin Carbone Cancer Center offer this minimally invasive option to a spectrum of patients with breast, gynecologic, lung or prostate cancer.
Radiation oncologists use either permanent "low-dose rate" seeds for prostate or lung cancer, or temporary "high-dose rate" (HDR) Iridum sources for breast, cervical, endometrial or lung tumors. At UWCCC, the only NCI-designated comprehensive cancer center in Wisconsin, specialists have pioneered optmial use and delivery of HDR brachytherapy to treat breast and gynecologic cancers.
According to Bethany Anderson, MD, a UWCCC radiation oncologist, brachytherapy is an appealing option for patients who meet the eligibility criteria and who wish to have treatment completed within one week.
Brachytherapy is a standard component of cervical cancer treatment. Cervical cancer patients receive five to six weeks of daily external beam radiation and five brachytherapy treatments.
The brachytherapy begins once the tumor has shrunk sufficiently from the external beam radiation, allowing proper placement of the brachytherapy instruments. The instruments are placed directly into the uterus and vagina, thus allowing the radiation to be delivered internally and minimizing exposure to surrounding normal tissues.
Traditionally, brachytherapy procedures used X-rays to help plan the radiation treatments. According to radiation oncologist Kristin Bradley, the radiation oncology department at UWCCC works jointly with the radiology department to incorporate MRI into the planning process to better target the tumor and further reduce radiation exposure to the nearby bladder and rectum.
Brachytherapy treatment is also a valuable tool in the multidisciplinary approach to treating patients with early-stage lung cancer.
Radiation oncologists use mesh brachytherapy in conjunction with thoracic surgery for patients who are not candidates for a more extensive surgical resection.
At UWCCC, radiation oncologist George Cannon, MD and thoracic surgeon Tracey Weigel, MD, chief of thoracic surgery, collaborate in providing lung brachytherapy.
Typically, Dr. Weigel performs a resection to remove the primary tumor and a segment of the lung. The mesh brachytherapy is then placed along the high-risk surgical incision to diminish the likelihood of local cancer recurrence. Because the radiation seeds are placed at the time of surgery, patients do not need to return to the hospital for additional treatments. The procedure is minimally invasive, and the average length of hospital stay is two days.
According to Dr. Cannon, "Patients with marginal lung function may be more suited for this procedure rather than a traditional lobectomy, and studies show equivalent cancer outcomes."
Prostate brachytherapy is a highly effective option for men with prostate cancer, particularly those whose cancer is confined to the prostate gland, who have a PSA level of less than or equal to 10 and a Gleason score not greater than 6. Patients with slightly less favorable cancer characteristics may also be candidates for brachytherapy alone or in conjunction with external beam radiation.
The three typical treatment options for these patients include prostatectomy, external beam radiation or brachytherapy. All provide equivalent cancer control in low-risk patients. Greg Richards, MD, a UW radiation oncologist explains, "We discuss all of the treatment options, including possible side effects and convenience of each option, with our patients so they can make a decision that incorporates their personal needs." Prostate brachytherapy, a minimally invasive treatment performed in one day, is generally less disruptive to patient lifestyle than external beam radiation therapy or surgery, which includes a hospital stay and longer recovery.
Brachytherapy is a highly effective and convenient treatment for many cancer patients. The UW Carbone Cancer Center has provided brachytherapy for more than 40 years, pioneering many of the current techniques. UWCCC radiation oncologists have performed thousands of brachytherapy procedures and have developed tremendous expertise in this specialized form of cancer therapy.