Breast cancer patients now have an experimental option for treatment that lets them get back to a normal lifestyle much sooner after a lumpectomy surgery by reducing the amount of time they spend receiving radiation treatments.

This month, the John Stoddard Cancer Center became the first medical center in Central Iowa to begin signing up patients for a clinical trial using a device called a MammoSite to deliver intense bursts of radiation over a period of five days, versus six weeks with a standard treatment cycle. The clinical trial is designed to evaluate whether partial breast irradiation to the area where cancer is most likely to recur is as effective as whole breast irradiation.

Dr. William McGinnis, a radiation oncologist at Stoddard, feels that many early-stage breast cancer patients could be treated effectively with partial breast irradiation treatments such as those provided by the MammoSite.

“A lot of us, for a long time, have felt that you don’t need to treat the entire breast, especially for a small amount of cancer,” McGinnis said. “The basis for this device (MammoSite) and treatment technique is to try to not treat the whole breast and to minimize the hassle for the patient so that they can do breast-conserving therapy as opposed to taking the breast off.”

According to Dr. William Rhoades, another Stoddard radiation oncologist, when surgeons started doing breast-conservation therapy, or lumpectomies, in the 1980s, they learned that it was necessary to use radiation treatments after surgery to prevent the cells surrounding the cancerous tumor from becoming problematic later on. Many women who could have been candidates for lumpectomies have chosen mastectomies, or full breast removal, because they did not want to return to the hospital for the lengthy irradiation treatment cycle.

“There are still more mastectomies being done than breast preservation, even though many patients are candidates for conservative therapy,” Rhodes said.

Candidates for this clinical trial have early-stage breast cancer (stage I or stage II) and have had a lumpectomy at Stoddard. If it is discovered that the woman’s tumor is too close to the surface of the skin, or if the lumpectomy cavity is not uniform, the cancer center will administer external beam radiation from the high-dose-rate machine. Women from the clinical trial will be tracked to determine whether partial breast irradiation is as effective in treating breast cancer as whole breast irradiation.

After a lumpectomy, the MammoSite, which consists of a small, soft balloon attached to a thin catheter, is implanted inside the woman’s breast in the cavity where the cancerous tumor was removed. When the balloon is in place, a portion of the catheter remains outside the patient’s breast.

During radiation treatments, the catheter on the MammoSite carries water and a small radiation seed to the balloon. Radiation treatments are administered twice a day for 15 minutes using a high-dose-rate machine, each treatment lasting about 15 minutes. Each treatment uses about twice as much radiation as standard treatments. After the five-day treatment cycle is complete, the surgeon removes the device.

“The amount of radiation a patient receives on the HDR machine is biologically equivalent to the total dose a patient receives with standard treatments,” McGinnis said. “The condensed time frame is important, because the quicker you give radiation following surgery, the more effective it is.”

Brian Pence, Stoddard’s manager of radiation oncology, expects the convenience of the MammoSite to appeal to many women. He estimates that about 25 to 30 patients will sign up for the clinical trial through the cancer center over the next 12 months.

“A lot of ladies – from ones living in rural communities to ones working in the local business community – they get a mastectomy instead of a lumpectomy because they don’t want to interrupt their quality of life by driving here for radiation treatments for several weeks,” Pence said. “But with this, after essentially one business week with high-dose irradiation, they are done with their course of therapy and can resume their normal lives.”

Nationwide, MammoSite has been used to treat 12,000 breast cancer patients since the technology was launched about five years ago. The method only recently became available in Iowa, and is now offered at Stoddard, the University of Iowa Hospitals and Clinics in Iowa City and the Genesis Medical Center in the Quad Cities. Although MammoSite is new to Des Moines, Pence said the HDR unit used to administer the irradiation has been used to treat other types of cancers for more than a decade.

“We have extensive experience with using the machine that will be administering this treatment,” he said. “This is just a new site for us to use the HDR port.

So far, no patients who have received the treatment during the past 29 months have had a recurrence of cancer. But McGinnis cautions that it is really too early to tell at this point what the long-term results will be.

“In order to determine effectiveness, you have to have a lot of patients involved over a long period of time,” he said. “Just because something is new and easier doesn’t mean it will be better. But we can’t learn whether this is an appropriate treatment unless we get people into the trial.”