Proton Treatment Study Reveals Excellent Breast Cancer Survival Rates and Cosmetic Outcomes

Posted by on Friday, October 31st, 2014

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The latest data from a clinical trial at Loma Linda University’s Proton Treatment and Research Center reveals excellent survival rates and cosmetic outcomes when proton therapy is used on patients with early stage invasive (non lobular) breast cancer. The study, “Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes,” represents the largest and most mature data available anywhere on this topic.

The phase-two clinical trial followed 100 patients who received proton therapy and were monitored for an average of five years following treatment. Results show that the in-breast recurrence-free survival rate was 97 percent with minimal side effects to the breast, lungs and heart. The cosmetic results as assessed by patients and physicians were good to excellent in 90 percent of cases, which was maintained throughout the five years of follow-up. Other published series using photon radiation treatment has shown that good cosmetic results diminish over time, likely due to increased scaring of the breast that occurs due to the increased exposure of normal breast tissues when photon radiation is used. In addition to being less toxic to the patient, the breast cancer treatment also reduced the duration of radiation treatment time from seven to two weeks.

The current standard of treatment for most women diagnosed early with breast cancer includes surgery to remove the tumor followed by photon radiation treatment performed over the entire breast. The Loma Linda University Medical Center study looked at treatment results by using highly targeted proton beam radiation to just the area where the tumor was located instead of the whole breast. With proton therapy the size of the radiation area is reduced significantly, lessening radiation exposure to the heart, lungs and other parts of the body.

The study began in 2004 with initial results presented at the American Society for Radiation Oncology meeting in 2010. These results were published in the peer-reviewed scientific journal Clinical Breast Cancer in August 2011.

The breast cancer clinical trial investigated the safety and efficacy of utilizing proton beam radiotherapy to deliver partial breast radiotherapy following lumpectomy for early stage breast cancer.

Initially, 50 patients who had invasive carcinoma and had undergone a lumpectomy were enrolled in the clinical trial, with 50 more being treated after initial analysis who showed excellent results. The patients had invasive breast cancer with primary tumors that were three centimeters or less and the cancer had not metastasized. During treatment the patients were placed in a prone position in a patented, customized foam mold to improve the precision of the treatment. Proton treatment was given in 10 sessions over a two-week course.

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Lymphedema Therapy is Available at Provision

Posted by on Thursday, October 30th, 2014

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Kathy Kearse, PT, CLT-LANA, of Provision Physical Therapy, performs lymphedema therapy on breast cancer patients.  These patients are benefitting from the nurturing and therapeutic treatments offered by Kearse.  As part of the comprehensive services offered at the Provision campus at Dowell Springs, this beneficial therapy for cancer patients is available right here in Knoxville at Provision Physical Therapy.  The article below appeared in the Shopper News.

Sometimes, the effects of breast cancer don’t end with surgery, radiation or chemotherapy. The cancer itself, and the treatments used to fight it, can leave women with other health concerns.

That’s where Kathy Kearse of Provision Physical Therapy comes in. Kearse is a licensed physical therapist with a specialty certification in the treatment of lymphedema, a condition that can arise when lymph nodes are damaged or removed to treat breast cancer.

“Kathy Kearse was one of the first people to bring this method of treatment to town,” said Dr. George Webber, surgeon with Knoxville Comprehensive Breast Center. “It is a huge step forward in how we treat lymphedema.”

The lymph system takes fluids and waste products away from the body’s cells, pumping them to locations where they can be eliminated from the system. When the system isn’t functioning properly, the patient can experience a buildup of fluids, ranging from mild swelling and heaviness to full-fledged fibrosis, in which the build-up is thick like putty.

Kearse is careful to keep treatment for lymphedema gentle, private and personal, empowering women by teaching them exercises and self-care regimens to keep lymphedema at bay.

“These women have already gone through a lot. Their bodies have gone through a lot,” said Kearse. “I try to treat them in a nurturing, caring way.”

Treatment for lymphedema is four-fold. Gentle massage techniques are used to guide fluid build-up towards functioning lymph nodes in other areas of the body. Exercises use the body’s natural muscle action to pump fluids out of areas affected by lymphedema. Compression uses a firm sleeve or glove to keep fluids from building up. And finally, women are taught skin care and risk reduction practices to help minimize lymphedema.

“I like to say knowledge is power,” said Kearse. “If you know how to take care of yourself, you are empowered to do that.”

Kearse said that modern medical treatments have lessened instances of lymphedema in breast cancer patients. She added that early intervention is crucial to treating the condition.

“The goal of the lymphedema community is to have earlier intervention for women with higher risk,” she said. “I love my job. To have the opportunity to work with these women and see them overcome so many obstacles, it’s just amazing. These women are absolutely beautiful, and I feel honored to work with them.”

For more information or to make an appointment with Kathy Kearse, please call (865) 232-1415 or e-mail info@provisiontherapy.com

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Dr. Meek Discusses Radiation Options for Breast Cancer

Posted by on Wednesday, October 22nd, 2014

Radiotherapy, surgery and chemotherapy are the mainline treatments for patients with breast cancer. As a treatment modality, radiotherapy has many roles to offer these patients.  These include treatment of the breast after a partial mastectomy in order to conserve the breast and treatment of the chest area after a total mastectomy in order to decrease the chance of the cancer recurring in that area.  In both these situations radiation may also be given to the lymph node regions around the breast in order to prevent a relapse in these sites.  Many studies have demonstrated that radiotherapy given in these settings decreases the chance of the cancer recurring and increases the probability of cure for the patient. Another role for radiotherapy is in treating recurrences of breast cancer, either in the chest area or elsewhere in the body known as metastasis.  Radiotherapy is very effective at remitting these secondary lesions and relieving associated symptoms leading to an improved quality of life.

Along with surgery and chemotherapy, radiotherapy is becoming more targeted, providing more punch to the cancer cells and less to the normal cells.  This is partly due to improved diagnostic imaging which provides us better localization of targets for the radiotherapy and partly due to improved technology in radiotherapy which allows us to conform the dose of radiation to these targets more precisely.  The goal in developing a plan of radiotherapy for a patient is to develop the plan with the maximum therapeutic ratio, namely the ratio of the dose to the cancer target to the dose delivered to normal tissues.

Compared to conventional x-ray therapy, proton beam radiotherapy generally provides a greater therapeutic ratio.  This is due to the fact that whereas x-rays will travel the entire thickness of the part of the body they are aimed at, protons will only travel a limited distance in the body depending on their energy.  The energy imparted to a proton and its direction of travel can be very precisely set and thus the range of the proton beam in the body can be carefully limited.  In breast cancer this allows us to thoroughly treat the breast or chest area and the lymph nodes while substantially limiting the dose of radiation to the heart and lung compared to x-ray therapy.  This will lead to decreased heart and lung disease later in the patient’s life.  With more and more patients being cured of their breast cancer, reducing these preventable medical conditions becomes even more important.  As proton beam radiotherapy becomes more generally available, more and more patients will be able to take advantage of this safer treatment option. Proton beam has a more limited role in treating patients with metastatic breast cancer, though frequently is considered when a patient needs retreatment of a previously radiated area.  Because the volume of tissue receiving this second course of radiotherapy can be better limited with proton beam, it can be the less risky treatment option for these patients.

To find out if proton therapy is right for you, contact Provision Center for Proton Therapy at (865) 862-1600 or visit www.ProvisionProton.com

 

Dr. Allen Meek is Medical Director of Provision Medical Group and a board-certified radiation oncologist practicing at Provision Radiation Thearpy and Provision Center for Proton Therapy.  Dr. Meek was recognized as a 2012 U.S. News and World Report “Top Doctor” and one of the Best Doctors in America® for 2014.

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