25 July 2014

CANCER - Half-hour breast cancer treatment can replace weeks of radiotherapy: Thousands of women could benefit from treatment given during surgery






Half-hour breast cancer treatment can replace weeks of radiotherapy: Thousands of women could benefit from treatment given during surgery 


  • Intrabeam radiotherapy will be given to breast cancer patients in surgery
  • Treatment has been given provisional go-ahead for use on NHS by NICE
  • Up to 36,000 women with early breast cancer could benefit from technique 

By JENNY HOPE
The new treatment, which is called intrabeam radiotherapy, will be given to breast cancer patients under anaesthetic during surgery (file picture)
The new treatment, which is called intrabeam radiotherapy, will be given to breast cancer patients under anaesthetic during surgery (file picture)
Tens of thousands of women with breast cancer could soon be offered a single 30-minute shot of radiotherapy, sparing them weeks of exhausting treatment.

The new treatment called intrabeam radiotherapy is delivered during surgery, while the patient is still under anaesthetic.

It has been given the provisional go-ahead for use on the NHS by the ‘rationing’ watchdog NICE because it is more convenient and improves quality of life.

NICE estimates up to 36,000 women with early breast cancer could benefit, with the technique being offered as early as next year.

International trial results show that it is at least as good as standard radiotherapy, and widespread use might save the NHS £15million a year.

Although the machines are around £435,000 each, running costs are lower than standard radiotherapy, freeing up staff and equipment in hard-pressed departments.

At present, conventional radiotherapy is offered to all women who have breast-conserving surgery, where only the lump is removed rather than the whole breast.

Conventional external beam radiotherapy, which irradiates the whole breast, involves many hospital visits for patients, often spread over several weeks to reduce side effects such as tissue shrinkage.

Professor Carole Longson, of NICE, said the new treatment has the potential to be much more efficient. ‘With the Intrabeam Radiotherapy System only one dose is required,’ she said.

‘This single dose is given at the same time as surgery, eliminating the need for numerous hospital visits.

‘Regular radiotherapy typically requires numerous doses over a three-week period – although some people may receive it for longer – and is performed weeks or months after surgery or chemotherapy.’

She said NICE’s appraisal committee concluded that ‘while current evidence was not extensive, this type of radiotherapy was more convenient for patients and can improve a person’s quality of life’.

Further consultation on draft guidance will culminate in a final decision in November and if approval is confirmed the NHS will be obliged to offer the service three months later.

    NICE draft guidance suggests around 6,000 women a year might opt for treatment out of 36,000 eligible patients.
    It has imposed conditions, saying the NHS must explain the pros and cons to women and men offered treatment, and include their details on a national register. Doctors must also commit to collecting data.

    Professor Longson added: ‘So far, only six centres in the UK have used the Intrabeam Radiotherapy System to treat early breast cancer. Because it is still relatively new it is only right to recommend its use in a carefully controlled way.’ 

    Professor Michael Baum, professor emeritus of surgery at University College London, is one of the trial leaders who carried out the first procedure using intraoperative radiotherapy in 1998.


    INTRABEAM RADIOTHERAPY: 'IT WAS A GODSEND... I HAD NO SIDE EFFECTS'

    Thankful: Marcelle Bernstein with her husband Eric
    Thankful: Marcelle Bernstein with her husband Eric
    Marcelle Bernstein had intrabeam radiotherapy after screening picked up a rare type of invasive breast cancer in 2012 at a very early stage.
    The writer and teacher, 71, who lives in London with husband Eric, 76, was treated at a private hospital that was pioneering the therapy.
    She said: ‘It was a godsend. It meant I could avoid the trauma and exhaustion of travelling to hospital daily for weeks of radiotherapy.
    'I suffered none of the side effects of standard radiotherapy, such as local tenderness, swelling, reduced range of movement or change in breast appearance. I spent one night in hospital and then I walked away, all treatment completed. I was back at work within weeks.’
    She takes a drug to prevent recurrence and is thankful that ‘for me, I effectively felt I had breast cancer for only two months’.

    He said: ‘It’s wonderful news for breast cancer patients but it’s been a long time coming. This innovation was pioneered in Britain but we’re lagging behind and almost the last to take it up. It’s already offered in 200 countries.’

    Spokesmen for Breakthrough Breast Cancer and Breast Cancer Campaign welcomed the move but said women should be made fully aware of the pros and cons of the treatment. Jackie Harris, clinical nurse specialist at Breast Cancer Care, called it an exciting development but added: ‘There is not yet evidence of its long-term benefits.

    ‘It’s also worth remembering that single dose intrabeam radiotherapy will only be suitable for a small number of women having breast-conserving surgery.’

    Source: http://www.dailymail.co.uk


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