A new form of treatment, Brachytherapy can now reduce treatment time for breast cancers.
The technique involves the insertion of radioactive implants directly into the cancer cell tissue.
As for treatment, breast-conserving surgery followed by radiation therapy and hormonal treatment/chemotherapy depending on the type of cancer is the standard care for newly diagnosed breast cancer in elderly women.
‘External radiation therapy lasting 4-6 weeks involves 21 to 31 sittings. But, with use of brachytherapy techniques, we can reduce treatment time to one week. Accelerated Partial Breast Irradiation (APBI) and HDR Brachytherapy are the techniques used in these women,’ said a doctor, Manish Chandra.
This technique, however, comes with strict selection criteria; it is prescribed for women around 50 years or above when the tumour size is less than 3 cm provided there is a non-involvement of axiliary nodes. If planned properly, it can be done in a cancer-oriented set up during primary surgery or post-surgically.
‘But, it’s advisable to perform it immediately after surgery when the patient is still under anesthesia. The main advantage of this technique is that it helps in the direct visualisation of the tumour bed which in turn helps in the precise placement of brachytherapy catheters,’ added the doctor.
Performing this technique post-surgically demands a sound clinical judgment and should be done under USG guidance. The technique reduces overall treatment period by 3-4 weeks and eliminates lots of stress in elderly women leading to better treatment compliance and good result.
Unfortunately, this modality is underutilized owing to physician preferences as well as due to lack of training. Use of breast brachytherapy is strongly encouraged and trained physicians should offer this as a standard of care.
Meanwhile, Manish Chandra finds the trend in breast-conserving surgery very encouraging. In the olden days, in women over 60 years decision was often taken by male members of the family. But, these days most patients are involved in pre-treatment counseling.
‘Recently, we treated a 77-year-old woman who didn’t want to settle for anything other than this new technique. Luckily, she fulfilled the selection criteria and today she’s leading a happy and healthy life,’ said the oncologist.
For, cancer cases are on the rise across India, particularly, in urban areas. A study by Indian Council of Medical Research (ICMR) predicts India could be hit by 17.3 lakh new cancer cases down next two years.
Thus, by 2020 the country will have 2.5 million people living with cancer while cancer-related mortality could touch an astounding 8.8 lakh. But, what particularly worries the medical experts and healthcare providers in the country is the alarming rise in the number of breast cancer cases.
Studies also reveal breast cancer globally affects around one in 28 women in their early 30s. This, however, peaks in women in the age group of 50 to 64. Latest Indian data show one in 22 women develop breast cancer and of the two diagnosed, one dies.