What if we had the power to limit radiation only to the area of a cancerous tumor in the breast, sparing the surrounding healthy tissues?
Some cancer treatments can injure other areas of the body while fighting malignant cells. Advancements in treatment technologies have helped target therapies like radiation more accurately. One of the newest tools in CentraState’s toolkit is a type of respiratory gating called deep inspiration breath hold (DIBH).
The goal of DIBH for breast cancer treatment is to decrease the dose of radiation to the heart by moving the heart away from the breast and out of the radiation field.
In the past, when women received radiation to treat cancer in the left breast, incidental radiation to the heart, and particularly the left anterior descending artery, could increase her risk of developing cardiac issues in the future, such as cardiovascular disease or heart attack. Even small doses of radiation can affect the heart, so sparing heart tissue as much as possible is important.
With this technique, radiation is delivered when the patient’s lungs are expanded, creating a larger space between the chest wall and heart. This allows us to significantly decrease the amount of radiation that the heart—and in some cases the lungs—receives.
Learning a New Way to Breathe
Before treatment, a CT scan is performed and if the patient’s heart is close to her breast, her physician may consider DIBH. If appropriate, patients are then coached on breathing by specially trained radiation therapists, with the aid of specialized video goggles that allow patients to track their breathing. They are able to see when they have taken a deep breath sufficient to reach the target level. The delivery of radiation is planned based on the patient’s anatomy during this deep breath.
During treatment, the patient wears the goggles to track her breathing. She is asked to hold her breath at the threshold level for 20 to 30 seconds at a time. The radiation beam is only turned on when the breath is held at the pre-specified level. The patient controls the treatment; if she needs to exhale, the beam is turned off. The technique is meant to be as comfortable as possible for the patient. Studies show that DIBH can decrease radiation exposure to cardiac tissue by up to 70 percent.
Are You a Candidate for DIBH?
While CentraState’s objective is to decrease incidental radiation to the heart, the technique may not be ideal for every patient. In each case, we’ll assess patients to tailor the safest and most effective course of treatment.
The ideal candidate:
- Has left-sided breast cancer where the heart is close to the chest wall
- Should be able to hold her breath for 20 to 30 seconds
If this technique isn’t right for you, CentraState has other ways of minimizing the amount of radiation to the heart, such as delivering treatment in the prone position (while lying on your stomach) or using techniques that shield the heart from the radiation beam.
We tailor our methods to each patient’s particular circumstances and anatomy, ensuring each person gets the best individualized treatment. CentraState’s focus is not only on curing a patient’s cancer, but also on sparing normal tissues to the greatest extent possible to ensure the best long-term quality of life for our patients.
Dr. Neesha Rodrigues is a board-certified radiation oncologist on staff at CentraState Medical Center. She can be reached by calling 866-CENTRA7.
