New technique is sparing women heart damage associated with radiation treatment for breast cancer
The University of Virginia Health System is empowering women with an easy and painless way to spare the heart damage associated with radiation for breast cancer. The technique, known as voluntary deep inspiratory breath hold (DIBH), requires that patients take and hold a deep breath for up to 20 seconds, allowing their care providers to target radiation to exactly where it is needed while avoiding cardiac tissue.
“With this technique, we have a more effective and lower cost way to spare the heart, and we get two things. We get separation of the heart from the chest wall and we also get immobility, which we love in radiation. We don’t want people moving. So it keeps our target still in a patient-friendly way and it also moves the heart out of the way,” said UVA radiation oncologist Monica Morris, MD.
UVA’s technique has been demonstrated, in papers published in peer-reviewed journals, to reduce the radiation exposure to the heart significantly, even beyond the use of more expensive approaches, while still producing outcomes as successful as the traditional treatment approach. Other attempts at using breathing regulation to spare the heart, such as active breathing control (ABC), require a mouthpiece that forcibly controls breathing; with UVA’s technique, the patient is in control.
“Patients really love it because they’re participating in their treatment and care,” Morris said.
Patients are given electronic goggles that show them a virtual gauge tracking their breath holding. By watching the visual feedback, patients can ensure they’re holding their breath appropriately. If the patient moves out of position, the radiation beam automatically turns off.
“The patient’s care team, meanwhile, uses advanced imaging to view inside the body on not just one but two planes, creating a three-dimensional depiction. This allows for an extremely precise approach to administering the radiation, allowing the team to avoid having the radiation beam pass through the heart.” said UVA medical physicist Krishni Wijesooriya, PhD.
“The imaging for positional accuracy, the procedure of voluntary deep inspiratory breath hold and patient cooperation via visual bio feedback – having them play a role – those three components together are what make our program successful,” Wijesooriya said.