For patients undergoing breast radiotherapy to treat their cancer, receiving a high-quality standard of care is important – particularly given they receive treatment over several sessions.
However, this consistency can be challenging to maintain as each patient's body is different. Positioning the breast accurately is key to ensuring the radiation targets the right area, yet variations in body shape and size can make this difficult.
“How to best position a breast for treatment has been a universal problem, particularly for some body types which make positioning more challenging," explains Dr. Cheryl Duzenli, principal investigator and former department head, Medical Physics at BC Cancer.
Recognizing these challenges, a multidisciplinary team at BC Cancer – including radiation therapists, radiation oncologists, medical physicists, nurses, engineers and an in-house machine shop that helps to build specialized devices – set out to design a better way.
Together, they addressed three design challenges:
- Finding a shape that could support a range of breast sizes.
- Developing a structure that was light enough to not interfere with radiation.
- Ensuring the device could be repositioned in exactly the same way for patients who come back for multiple treatments.
The solution is CARA – the Carbon-fibre Adjustable Reusable Accessory: a breast support device designed to reduce painful skin reactions and improve precision, comfort and consistency in radiotherapy for patients of all body types.
As CARA evolved, it became a collaboration with the University of British Columbia (UBC) Composites Research Network to refine the design, test materials and prepare the device for use in clinical settings. The partnership combined expertise in cancer care with advanced knowledge of composite materials to build something light and durable.
Through multiple design iterations and input from patients and radiation therapists, CARA became a universal, ergonomic and reusable clinical device. Its reproduceable design ensures that each session is delivered with the same precision, every time, for every patient.
When introduced in clinical studies, it performed well radiologically and received positive feedback from both patients and staff.
“We wanted to know the experience from the patient perspective, and we also wanted to know what the experience was from the therapist," explained Tania Arora, resource radiation therapist, BC Cancer.
“All were positive. If we can reduce painful skin reactions and possibly other treatment side effects, we can give the patient a better quality of life after their treatment is done and provide a better outcome for them. That's what we're here to do – to improve health outcomes and improve lives."
“This is a beautiful example of collaboration, not only within our department which includes multidisciplinary professionals, but also within the entire province of British Columbia," says Dr. Alanah Bergman, senior medical physicist at BC Cancer. “It's not just a device; it's a shared vision to try to improve care for our patients."
This work was made possible with generous funding support from Canadian Cancer Society and the Michael Smith Foundation for Health Research.
Currently patients at BC Cancer's Kelowna, Prince George, Surrey, Victoria and Vancouver centres are being treated with the CARA device, as prescribed by radiation oncologists. Abbotsford centre is equipped with the device and is working towards clinical implementation.
Watch the full story in our video.
