A new breast cancer treatment option, to be discussed at a major medical conference in Vancouver next week, has had a significant breakthrough thanks to the successful treatment of a Gibsons woman.
In May, Pat Mostovich, a 62-year-old, retired primary/special education teacher from Gibsons, found out that cancer suspected on a mammogram had been confirmed with a biopsy.
Last month, she travelled to the BC Cancer Agency's Vancouver Island Centre in Victoria to receive one week of high dose breast brachytherapy - a potential new option in breast cancer treatment currently under investigation. Her treatment was planned and delivered by a team led by Dr. Hosam Kader, radiation oncologist. This followed a lumpectomy performed by Dr. Urve Kuusk of St. Joseph's Hospital in Vancouver, and a series of consultations with BC Cancer Agency medical oncologist Dr. Karen Gelmon and radiation oncologist Dr. Scott Tyldesley.
Looking at Mostovich, a mother of two and grandmother, you would never know she's been dealing with breast cancer. She is relaxed and optimistic that the treatment she received will help give her a life free from the disease.
"I was originally considered for chemotherapy," she said. "However, further tests of my particular tumour indicated a low risk of recurrence. After reviewing the results, Dr. Gelmon ruled out chemotherapy and referred me to Dr. Tyldesley to discuss the benefits of whole breast radiation therapy to reduce the possibility of recurrence around the tumour site."
She said she wanted to have the minimal radiation treatment necessary to do the job, so was referred to Kader and considered for partial breast radiation via brachytherapy.
This procedure involves placing plastic catheters into or close to the tumour bed region. A tiny radioactive source is then used to deliver radiation treatment through these catheters from within the breast. Other forms of brachytherapy are commonly used in treating prostate and some gynecological cancers; however, it is not currently the standard treatment option for breast cancer.
Brachytherapy is on the agenda at the annual scientific meeting of the Canadian Association of Radiation Oncology taking place in Vancouver Sept. 22 to 25.
"During the last decade, a number of cancer centres in North America and Europe have conducted initial small trials for the treatment of early breast cancer with a four to five day short course of brachytherapy, limited only to the tumour bed region, and without any external beam treatment to the rest of the breast," said Kader. "New facilities and equipment in the BC Cancer Agency allowed us to do a similar study to look at safety, patient tolerance and satisfaction as well as cosmetic results."
He said whole breast external radiation therapy, following surgical removal of the breast tumour (lumpectomy or partial mastectomy), remains the standard recommended treatment until results from large randomized trials show whether partial breast irradiation is as effective.
He said at this time there are no trials of breast brachytherapy underway in B.C., but there is, however, a national Canadian study of partial breast irradiation (the RAPID study) using external radiation therapy. This study is open for patients with early breast cancer who fulfill certain criteria. Under exceptional circumstances, if external radiation is not feasible for technical or medical reasons, brachytherapy may be discussed.
"At the first appointment after reviewing the procedure in depth and at length, Dr. Kader and his team created my unique treatment plan," Mostovich said. "The procedure was done under conscious sedation, so I was unable to recall feeling any pain. Fine plastic tubes were placed through the area of my breast that surrounds the tumour bed. There were no stitches required. After that I had a CT scan to make sure the plastic tubes were in the right places and to complete the treatment planning. I then went home and rested until my first radiation treatment that afternoon."
She is raving about her care, especially its brevity.
"I had nine treatments, Monday through Friday, twice a day, for 10 to 15 minutes each. And that's it. They removed the tubes before I left the clinic on Friday," she said.
