Radiation oncologists are rooting for brachytherapy as an effective method for treating breast cancer. The invasive procedure is said to be less toxic, reduces treatment time and provides better quality of life.
While external radiotherapy involves use of high energy radiation and lasts for four to six weeks, brachytherapy is a week-long procedure that involves transmitting radioactive energy from a tiny source through thin catheters implanted on the tumour site.
The method, which is widely used to treat gynaecological cancers, is underutilised as many doctors are not trained in it. Dr. Manish Chandra, radiation oncologist at Jupiter Hospital in Thane, who has been using the method for the past 20 years to treat cancers, says, “Doctors are often sceptical about the method as it is performed under anaesthesia.”
Dr. Chandra says the method makes a big difference to breast cancer patients under prolonged treatment. He says the dose to the heart and lungs is significantly less and breast architecture remains largely unaffected. Dr. Chandra pointed out that the facilities to carry out the procedure in the country are limited. There are around 350 radiotherapy units with linear accelerators and only 230 facilities offer brachytherapy. He said the number of facilities dropped further after the government raised duty on radioactive sources.
Dr. Chandra said, “Brachytherapy requires a radioactive source and costs 20% more than external radiation as it requires an operation theatre and hospital accommodation for patients in some cases. But it may turn out to be cheaper on taking into account the overall ancillary costs over four to six weeks.”
‘Reduced side effects’
However, doctors prescribe the treatment only for women aged 50 and above with a tumour size less than 3 cm and without involvement of axillary nodes. Infections on the tumour site and fat necrosis may also occur in some patients. “Patient eligibility may be limited, but the results are good in terms of reduced side effects,” says Dr. Tabassum Wadasadawala, radiation oncologist at the Advanced Centre for Treatment, Research and Education in Cancer of Tata Memorial Centre in Kharghar. She says the procedure is labour-intensive and needs team effort.
Dr. Nagraj Huilgol, radiation oncologist at Nanavati Hospital in Vile Parle, says, “There is no doubt that brachytherapy is useful. It is always better to have different modalities of treatment to target the disease. Brachytherapy enthusiasts may feel that this is the future but one cannot deny that external radiation has evolved a lot over the years and can offer similar results.”
