Breast cancer prognosis brighter than ever - The Jewish Chronicle

Breast cancer is the most common cancer in women. According to Cancer Research UK, one in eight will be diagnosed with it at some point in their lifetime, although it is more likely to affect women beyond age 50. However, today more than ever, there is reason for optimism, as more women are surviving the disease with nearly four out of five living beyond ten years after diagnosis.

As with all cancers, the key to a successful outcome is early diagnosis followed by timely and effective treatment before the cancer has spread to other areas of the body.

After early detection and diagnosis, the main approaches to cancer care are surgery to remove tumours, radiotherapy to target and destroy cancer cells and difficult-to-reach tumours, and chemotherapy — a wide range of drug therapies that destroy specific cancer cells. Of these, radiotherapy is in fact one of the most rapidly advancing ways to treat cancer.

GenesisCare runs specialist cancer treatment centres and one-stop breast clinics throughout the UK and offers many of the latest evidence-based treatments that have been shown to improve outcomes in breast cancer. Here, Dr Eliot Sims, consultant clinical oncologist at GenesisCare, tells us about the important role of radiotherapy and some of the innovations that are changing the way breast cancer is treated.

RADIOTHERAPY IN 2020

Radiotherapy uses controlled beams of radiation energy to destroy cancer cells and is a very effective cancer treatment due to its ability to fatally damage the DNA in cancer cells, resulting in their permanent destruction. In breast cancer, radiotherapy is mostly used after surgery, making the cancer less likely to return, as numerous studies show. New, advanced radiotherapy techniques can achieve this result with shorter treatment times, fewer side effects and better cosmetic outcomes than conventional treatments.

VMAT AND SGRT

Volumetric modulated arc therapy (VMAT) passes a beam of radiation in an arc across the tumour site, carefully changing radiation intensity and beam shape as it moves to avoid healthy tissue and deliver a maximal dose to the cancer cells.

It is used alongside another technology called surface-guided radiotherapy (SGRT) which uses sophisticated body-tracking technology to position patients on the treatment bed. If the patient moves, the radiation beam stops, so it stays on target, avoiding the need for tattoos.

Another innovation, deep inspiration breath hold, is used to protect the heart — and also lungs — during treatment, particularly for cancers that are close to delicate heart muscle. Equipment monitors a patient’s breathing, so the radiation beam activates only when the breath is being held — at which point the expanded lungs push the heart deeper into the chest cavity and away from the treatment site. GenesisCare is now offering this to all patients who receive radiotherapy to their left breast. It is also sometimes used for treatments to the right breast, to enable a higher dose — or boost — of radiation to be given safely.

SABR

Stereotactic ablative radiotherapy (SABR) is sometimes called non-invasive surgery because of its ability to achieve the same effect as surgery. It is a type of radiotherapy that uses very fine, high-dose beams directly at tumours, destroying them in a single treatment or just a few short, powerful treatments. In breast cancer, it can be used to treat small-volume tumours if they have returned — in this case, treatment can be completed in as little as five to eight working days.

The next-generation SABR is delivered using a system called MRIdian which uses an MR scanner to create live images of the tumour while it is being treated.

GenesisCare has already installed the first system in the UK at Oxford and is planning to bring another to their new centre for radiotherapy at Cromwell Hospital in London soon.

The benefits of these techniques are:

Tumour control

More accurate targeting and avoidance of healthy tissue makes it possible to deliver a higher dose of radiation than with conventional radiotherapy. Each cancer responds differently to radiation and clinicians can plan the optimum dose and frequency to exploit the cancer’s weaknesses.

Use with other treatments

Newer radiotherapy treatments can be less demanding on the individual, so it is possible to have other treatments at the same time.

GenesisCare offers these advanced techniques as standard within a personalised care plan that includes life-changing therapies such as exercise medicine and wellbeing.

Evidence shows that you have to treat the whole patient to get the best outcome.

For example, patients are offered an exercise medicine programme which is proven to reduce many of the symptoms and side effects of cancer and treatments such as fatigue, as well as building up physical resilience strength.

Patients also have access to a unique programme of wellbeing and relaxation, in partnership with the charity Penny Brohn UK, to help build their mental resilience to come through the challenges of cancer with a positive outlook.

BE BREAST AWARE

If you are concerned about breast cancer, the best advice is to stay positive and take your breast health into your own hands — literally. Be breast aware and, if you spot anything at all suspicious, book an appointment with your GP or at a one-stop breast clinic, where you can get an assessment with an expert breast consultant, a mammogram and a result on the same day.

Women with Ashkenazi Jewish ancestry also carry a slightly increased risk of inheriting genetic faults, such as the BRCA1 and BRCA2 genes, known to increase incidence of breast cancer in some families. There are now genetic screening tests for these and other cancer genes. These are offered, together with expert counselling and advice, at a simple clinic appointment.

GenesisCare has one-stop breast clinics at Milton Keynes, Maidstone and Cambridge and will soon open in Windsor and Portsmouth. If you do need a biopsy or further investigation, it has the latest diagnostics including digital mammography and MRI scans, so you can have a diagnosis and, if necessary, start treatment within days. Thankfully, nine out ten women who visit a clinic leave with a negative result — but it is worth it for the peace of mind.

cancerresearchuk.org/about-cancer/breast-cancer/survival

If you are concerned about symptoms, talk to your doctor without delay. GenesisCare can be contacted on 020 8108 9675, GenesisCare.com