Focus on Urban Health - Keck School of Medicine of USC ...

F E AT U R E•Faster Treatmentand Recoveryfor CancerIntraoperative radiotherapy following breast lumpectomyspeeds recovery, reduces cost By Mary Ellen ZenkaIntraoperative radiotherapy allowed CathyFriedman to keep running.Dennis R. Holmes, M.D.,with the Intra Beamdevice, which can delivera targeted dose ofradiation during surgery.22KECK MEDICINE | Winter 2011 IssueHelping people face personal difficulties is the goal ofthe trauma and crisis intervention organization whereCathy Friedman is associate director. Last January,Friedman faced her own crisis – she was diagnosedwith breast cancer.“It came as a total surprise,” says Friedman. “I hadabsolutely no risk factors. No one in my family everhad breast cancer. I am a vegetarian who exercisesregularly, and I breast-fed my children.”She knew she needed surgery and was informedabout the standard six weeks of post-surgical radiation,but she did not want to endure the long treatmentand recovery process, and miss running in the LosAngeles Marathon. A runner for 30 years, she hasraced in the marathon for the past five years.Friedman was referred to Dennis R. Holmes,M.D., director of intraoperative radiotherapy andbreast surgeon at USC Norris Comprehensive CancerCenter and Hospital. Holmes explained to Friedmanthat because her type of cancer allowed for breastconservation, she would have the option of enteringthe TARGIT Trial – an international clinical trial ofintraoperative radiotherapy.“Rather than the typical multi-week course of radiation,the cancer site receives radiotherapy immediatelyafter tumor removal using a device called theIntra Beam, manufactured by Carl Zeiss Meditec,”explains Holmes, who is assistant professor of clinicalsurgery at the Keck School of Medicine of USC.“The Intra Beam is directed into the breast and canprecisely dispense radiation to the targeted area. Theprocedure takes as little as 17 minutes as compared tothe usual 30-35 days over six weeks.”Standard radiation covers the full breast and cancause injury to surrounding organs and the skin of thebreast. The advantage of intraoperative radiation isthat a lower dose can be used because the radiationis administered to the interior of the breast and doesnot pass through the skin. Intraoperative radiationalso permits the temporary insertion of internal radiationbarriers to protect the underlying heart and lungfrom the effects of radiation.An added benefit is the reduced cost of treatment –one-third to one-half the cost of standard radiotherapy.“More than 2,200 patients around the world havereceived this new form of radiotherapy with excellentresults. Cancer recurrence rates using intraoperativeradiotherapy are statistically equivalent to standard radiationtechniques,” Holmes says. He is upbeat aboutwhat this means for improving treatment for women.“USC Norris is now a leading institution, and theonly one in Southern California, for both defining thefuture of this technology and expanding the trial forpatients who might not have qualified for the TAR-GIT trial,” Holmes says.For Friedman, the choice was simple. The intraoperativetherapy option was quick with none of the sideeffects commonly experienced with standard radiation.“I took one week off to recover from my procedure,and I returned to my marathon training activitiesthe next week. I am so pleased to have found Dr.Holmes,” Friedman says. “His caring demeanor andrecommendation for my inclusion in the TARGITTrial calmed my breast cancer crisis – something Itruly value.” •For further information or an appointment, contactHolmes’ referral coordinator at 323-865-3628.Photo by Philip Channing (left); Photo by Greg Mancuso (top)