Breast cancer treatments made easier

New technology at Good Shepherd eliminates many problems

Dr. Barry Rosen. Along with radiation oncologist Dr. James Ruffer, Rosen has been using a new technology to reduce the side effects for many breast cancer patients.
Dr. Barry Rosen. Along with radiation oncologist Dr. James Ruffer, Rosen has been using a new technology to reduce the side effects for many breast cancer patients.

BARRINGTON – Almost exactly one year ago, Advocate Good Shepherd Hospital began using a new technology that is changing the way doctors treat breast cancer.

The process is the INTRABEAM Intraoperative Radiotherapy (IORT), and the way it works is like something you would see in a sci-fi film, as doctors seem to zap the cancer away with what looks in diagrams like a laser beam.

Dr. Barry Rosen, a surgeon at Good Shepherd, and his colleague Dr. James Ruffer, a radiation oncologist, first became interested in IORT in 2010, when they read about a trial of the technology.

Rosen said the technology has been used for at least 10 to 15 years in Europe, but still isn’t widely used in the U.S. because he said American doctors didn’t see it as equivalent to traditional radiation therapy.

Rosen and Ruffer had been using alternative therapies to treat breast cancer patients, but none were ideal. “We had experience doing a brachytherapy,” said Rosen. This involved inserting a catheter into a woman’s breast post-op, and she would receive treatment through that for several days.

“The problem with that technique is it’s kind of messy,” said Rosen. “You have to walk around with a tube sticking out of your breast for a week and a half. It’s more invasive.”

Upon seeing the successes with IORT, the pair saw it as a natural progression in their radiation treatments.

“What could be simpler than just getting all the radiation treatment while you’re under anesthesia? This was of great appeal to us,” Rosen said.

When a medical team decides that a woman should undergo surgery to remove a cancerous tumor from her breast, they now also have the opportunity to administer radiation treatment, right at the source.

During the lumpectomy, the tumor is surgically taken out and the surgeons measure the cavity, to make sure the IORT applicator fits. The radiation oncologist takes the applicator, which is a cone with a ball at the end, and puts it into the area that the tumor just came out of. In a 20- to 30-minute procedure, they send a small beam of radiation right to the source, hitting the area where the cancer was found. The patient’s incision is closed up and the procedure is over.

Barrington’s Good Shepherd Hospital is one of two hospitals in the Chicago area using IORT to treat its cancer patients. While a lot of requirements have to be met to qualify for the treatment, it can eliminate losing hour after hour to repeated radiation treatments.

Normally, the surgery is far from the end of the road. For most women who have a lumpectomy, seven weeks of radiation treatments follow. These aren’t just quick, once-a-week events. It means taking time five days every week to go to the doctor and dealing with the unpleasant side effects as the untargeted radiation hits her entire body.

The National Cancer Institute lists skin irritation and fatigue as some of the common side effects of radiation. Other possibilities include nausea and vomiting, trouble swallowing and diarrhea.

To be eligible for IORT, which eliminates most of those problems, doctors recommend candidates whose cancer was discovered in the early stages and whose tumors are relatively small.

Elizabeth Hart, a Lake Zurich resident, was one such woman whose situation aligned perfectly with the requirements.

Hart had carefully monitored what she calls “suspicious lymph nodes,” meaning she would get regular mammograms. Her family has an aggressive history of breast cancer, but she never expected to get it. That fateful day came a year ago when her doctors found something abnormal. After a biopsy, she was diagnosed with cancer during the first days of May 2012.

“It’s as you would expect. It’s terrifying,” she said. “You never think it would happen to you.”

She met with Dr. Rosen at Good Shepherd, where he recommended her for IORT. Hart’s husband is a cancer survivor, and she did not want to go through what he had dealt with during traditional radiation therapy. She also worried about the amount of time she would have to take off of work.

On May 24, 2004, Hart had the surgery and included IORT in her procedure. Her story is one of success.

“You’ve got some aches and pains, but pains that you’d have with surgery. There was a little skin discoloration. I was literally walking around Lake Zurich the next day and I was back at work in a week.”

Rosen said this is how most of the procedures have gone over the past year. He estimates they have treated about 30 women, or 15 percent of breast cancer patients at Good Shepherd.

All of the feedback he has received from patients has been positive.

While they still aren’t able to treat every breast cancer patient, he says they can work with 25 to 40 percent of them. His hope over the next few years is to extend this reach to all of their patients, and have more hospitals embrace the technology.

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