Brachytherapy – A Promising Treatment for Breast Cancer

Dr. Manish Chandra

Cancer.

The mere mention of this word instills instant fear.

But getting afraid is not going to help. Being informed, will.

Recently I got an opportunity to interact with renowned Mumbai-based Radiation Oncologist, Dr. Manish Chandra.

Here are some nuggets of information he shared on Brachytherapy.


 

Question:Talking of numbers, what are the current stats for cancer in India?

Dr. Manish Chandra, Radiation Oncologist, Jupiter HospitalCancer cases are on constant rise in 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 in the next two years.

Thus, by 2020 the country will have 2.5 million people living with cancer!

Cancer-related mortality (deaths) could touch an astounding 8.8 lakh per year.

Cancers detected per day –2000 per day.

New breast cancer cases – 1.5 lakh per year.

And breast cancer is the most common cancer among all detections. This particularly worries the medical experts and healthcare providers in the country.

Globally, 1 in 28 women in their early 30s are affected by breast cancer.

In Indian, 1 in 22 women develop breast cancer and of the two diagnosed, one dies, because of disease.

 

Q: Is there a difference in incidence of breast cancer in Indian and Western women?

Dr.Manish Chandra: Yes, in India, breast cancer occurrence is different as compared to the West. Here it affects more of younger women and cancer remains undetected for a long time.

 

Q:What is the basic line of treatment for breast cancer?

Dr. Manish Chandra: As for the 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.

 

Q: Brachytherapy as a new treatment modality in cancer treatment is a huge topic of discussion in the medical fraternity these days. Tell us something about it.

Dr. Manish Chandra: It’s not a new treatment. Brachytherapy is being done for many years, but most people associate brachytherapy with cervix. Brachytherapy is a procedure that involves placing tiny radioactive material inside the implanted tiny plastic tubes in patient’s body. These plastic tubes are then removed after completion of treatment.  It is basically a type of radiation therapy that’s used to treat cancer.

Brachytherapy allows doctors to deliver higher doses of radiation to more-specific areas of the body, compared with the conventional form of radiation therapy (external beam radiation) that projects radiation from a machine outside of your body.

During cancer treatment, external radiation therapy lasts for 4-6 weeks and involves 21 to 31 sittings. But, with the use of brachytherapy techniques we can reduce treatment time to just one week. Accelerated Partial Breast Irradiation (APBI) and HDR Brachytherapy are the techniques used in breast cancer patients.

 

Q: Can this technique be used in all breast cancer patients or there are any limitations to it?

Dr. Manish Chandra: Brachytherapy comes with a strict selection criterion. It is prescribed for women around 50 years or above, when the tumour size is less than 3 cm provided there is a noinvolvement of axillary nodes.

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.

We are having long term survivors in early breast cancer patients. This technique reduces dose to Heart and lungs to bare minimum (Practically negligible) thus avoiding late cardiac toxicity.

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.

 

Q: What is the future of brachytherapy in cancer treatment?

Dr. Manish Chandra: I find it very encouraging in breast conserving surgery.  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 counselling. 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. I think in years to come we can offer this treatment to younger patients also. We have to design a controlled and well planned study to work on this.

 

Q: What’s your message to our readers about cancer?

Dr. Manish Chandra: I would strongly advice and emphasis enough that greater awareness, early detection and timely medical intervention continue to be the key in the fight against cancers, particularly in breast cancer.

 

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