The BC Cancer Agency's Vancouver Island Centre is the first cancer treatment centre in Western Canada to study a more localized form of radiation therapy for early breast cancer – a technique that can reduce treatment time and improve quality of life for patients.

The technique, called "breast brachytherapy," is being tested in a clinical trial led by Dr. Sam Kader. Brachytherapy delivers radiation therapy by placing the radiation source into the body area requiring treatment. Breast brachytherapy is not a new technique, explains Dr. Kader, but the way it is being used for breast cancer treatment in this study is a first in Western Canada.

Conventionally, after surgical excision of a breast tumour (partial mastectomy), external beam radiation is used to eliminate remaining tumour cells in the breast. Existing radiation therapy regimes use x-ray machines to give external treatment to the entire breast, over three to six weeks. In brachytherapy, treatment is directed only to the part of the breast with a significant risk of recurrence, and is given during a five-day period.

Breast brachytherapy involves placing several catheters in the patient's breast on the morning of the first day of treatment. The catheters stay in place over the five-day course of treatment and are removed after the entire course is completed. The treatment consists of two short outpatient sessions each day. During each session, the catheters are connected to a special radiation machine, which sends a minute radiation source into each catheter in sequence. Actual treatment time for each session is only a few minutes and is completely painless.

Melynda Okulitch, a Saltspring Island resident, was the first patient to participate in the trial. Fully expecting to undergo several weeks of external beam radiation, she was pleased to know that she qualified for the clinical trial.

"I was concerned about the effects of external beam radiation on my body," she says. "Because my tumour was deep, it would have affected the tissues of my heart and lungs. This seemed to be the least invasive procedure. And cosmetically, I just have a few small dots that are fading. No burning, no pain, and no sloughing of the skin."

One of the benefits of this technique is the short treatment course: only five days. For patients traveling long distances for treatment, or for those with active professional or social schedules, this technique could help them return to their routines much more quickly. Another possible benefit is the localized nature of the treatment, potentially reducing side-effects while still effectively reducing recurrence.

It was an advantage for Ms. Okulitch, who would have had a long journey to and from her Island home each day for several weeks. Instead, she was able to arrange a short stay with friends in Victoria, and complete her treatment within a week.

"I was thrilled to be involved in this study and have this treatment available to me," she says. "It is horrible to have cancer, but it's wonderful to have this study. I would hope that it would become a standard of care for those women with the right criteria."

An important goal of this study is to develop a set of guidelines and standards for this technique in order that patients in cancer treatment centres across the country will be able to benefit. "It's a relatively new concept to give a patient's entire adjuvant (preventative) treatment with brachytherapy only," says Dr. Kader. "We hope to launch a nation-wide study of this technique."

To date, five patients have been treated, and have tolerated the therapy well. The BC Cancer Agency aims to recruit 22 patients for this study. If, as expected, the study shows that this treatment is safe and well tolerated by patients, a short course of post-operative brachytherapy could become a new and standard option for women with early breast cancer.

The Canadian Breast Cancer Foundation has provided funding for this clinical trial.

The BC Cancer Agency, a part of the Provincial Health Services Authority, is committed to reducing the incidence of cancer, reducing the mortality from cancer, and improving the quality of life of those living with cancer. It provides a comprehensive cancer control program for the people of British Columbia by working with community partners to deliver a range of oncology services, including prevention, early detection, diagnosis and treatment, research, education, supportive care, rehabilitation and palliative care. The BC Cancer Research Centre conducts research into the causes and cures for cancer.

Nicole Adams
Public Relations Officer
BC Cancer Agency
(604) 877-6272