Cheryl Marback barely had time to digest her diagnosis.
The Woodstock woman was told she had cancer after doctors found a lump in her breast during a routine mammogram last fall.
Then she received better news. Marback, it turned out, was a candidate for intraoperative radiation therapy, a relatively new procedure that allows for a one-time radiation treatment to the cancer site during surgery to remove the tumor.
Without the normal six to eight weeks of post-surgery radiation, doctors said, Marback could be back on her feet and back to her normal life within a couple of weeks. And she was.
“It happened quickly,” Marback said. “I was diagnosed, they scheduled the surgery. ... And 10 days from beginning to end, I was virtually cured.”
Though it isn’t yet widely used across the country, intraoperative radiation therapy is growing in influence as a treatment for breast cancer. Marback received her treatment at Advocate Good Shepherd Hospital, one of the first in the Chicago area to use the technique.
The Barrington hospital adopted the treatment in the spring of 2012.
“It’s so intuitively obvious to patients when you say you’ll wake up and you will be done with operation and radiation,” said Dr. Barry Rosen, a surgeon at Good Shepherd. “It really allows people to move on with their lives a lot faster.”
So far, the hospital is taking a conservative approach toward who receives the treatment.
Older patients who find their tumors early are generally the target group. Specifically, doctors pinpoint those over age 50 with tumors less than 3 centimeters in size, and who don’t have any clinically positive lymph nodes, said Dr. James Ruffer, medical director of radiation oncology at Good Shepherd.
Ruffer estimates that about 20 percent of the breast cancer patients treated at Good Shepherd qualify for and are treated with intraoperative radiation. Some, the hospital notes, end up having to receive post-operation radiation anyway.
But Rosen added that as research continues to show that the treatment is as effective as post-operation radiation, the number of patients receiving intraoperative radiation therapy will likely continue to increase, and not just at Good Shepherd.
“All you have to do is treat one patient to recognize the advantages,” he said.
The treatment isn’t yet an option at the Centegra Sage Cancer Center in McHenry, but Centegra radiation oncologist Dr. Terrence Bugno said it’s on the radar of physicians at the center, who await further data.
“There’s always a new kid on the block,” he said. “One of the intriguing and so far good options seems to be this intraoperative approach.”
Bugno said that, consistent with the direction treatment is going, Centegra has taken other measures to reduce post-operation treatment times by delivering more targeted forms of radiation.
Bugno and Sage physicians use a treatment called “partial breast radiation.” One to three weeks after surgery to remove the tumor, doctors insert an applicator in the cancer site called a strut adjusted volume implant, or SAVI. The patient’s 10 targeted radiation treatments are administered over the next five days.
“As our technology gets better, we are moving in an era where we’re reducing the number of treatments, because we can be much more target specific,” Bugno said.
Technology advancements to offer more targeted radiation treatments – which aren’t contained to breast cancer – offer several positives beyond reducing the time frame, he added. Such treatments ease the cosmetic damage to patients and reduce complications by lessening the damage caused by radiation.
But there’s another more long-term gain: cost. That’s one way that Ruffer and Rosen sold their hospital on the upfront expenses for intraoperative radiation technology. Long-term, the treatment could mean lower hospital bills for cancer patients.
“I think, generally speaking, the argument is the [lower] number of treatments, it becomes more cost-effective,” Bugno said.
In the days after her operation, Marback experienced only minor side effects. She had some tenderness, but that dissipated quickly. And cosmetically, she said, these days, “you could not even tell that I had something done.”
Marback was back at work within a week of the surgery. More than a year later, she’s cancer-free and healthy – although, with the weather turning, she’s been battling something recently.
“I have a cold now,” Marback said. “That’s taken longer to recover from.”