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Texas Center for Proton Therapy
A study published in the Journal of Clinical Oncology reports that incidences of cardiac dysfunction amongst breast cancer survivors increased eightfold within the span of 13 years. The study involved patients who had completed cardiotoxic chemotherapy and underwent echocardiographic screening every two years. In the study, cardiac dysfunction is classified as left ventricular ejection fraction (LVEF) that decreases by 50% after heart-damaging chemotherapy regimens. The cumulative incidence of cardiac dysfunction increased from 1.8% at two years to 15.3% at 15 years from the start of cardiotoxic chemotherapy. Late-onset cardiac dysfunction was most common among patients exposed to traditional radiation therapy, with the median follow-up being 8.6 years and ranging from 1.8–39.8 years. Long-term analysis among all patients showed an annual decline of 0.29% in LVEF (P = .009) over 20 years from breast cancer diagnosis. These findings provide evidence for surveillance post treatment for several years after cardiotoxic chemotherapy, as well as the need to examine and reevaluate the efficacy of radiation treatment options offered to breast cancer patients, bearing long-term health outcomes in mind.
“The breast sits right in front of the heart and is always at risk with radiation. Proton therapy for breast cancer involves targeted proton beams that deliver high doses of radiation to destroy cancerous cells – while minimizing exposure to the heart, lungs, and healthy tissue near the breast,” explains Jared Sturgeon, M.D., Ph.D. of Texas Center for Proton Therapy “Proton therapy reduces the radiation dose to the heart and may reduce the risk of radiation-associated heart disease for many breast cancer cases.”
With breast cancer cases on the rise, it’s important for patients to know their options and consider treatment that offers fewer side effects and spares vital organs, while allowing them to maintain their quality of life. Proton therapy has been shown to reduce secondary malignancies caused by radiation exposure. Radiation therapy often plays an important role in the multimodality management of breast cancer and sparing vital organs is of particular importance in patients with existing risk factors, especially if the patient has been treated for cancer previously.
“For breast cancer patients, especially those with left-sided breast cancer, proton therapy significantly reduces radiation exposure to the heart and lungs. This is crucial in lowering the risk of long-term cardiovascular complications and pulmonary issues,” says Jared Sturgeon, M.D., Ph.D. “Our goal is to effectively treat the cancer while sparing nearby organs, and of course, keeping the patient as comfortable as possible throughout the process. We want to ensure that patients can return to a life that is as normal as possible, with the fewest side effects after treatment.”
Proton therapy’s greatest advantage is that it offers sub-millimeter precision that delivers high-energy proton beams directly to tumors with minimal exit dose, minimizing damage to surrounding healthy tissue, and thereby reducing recurrence rates for many cancer cases. Proton therapy is non-invasive and may reduce side effects and can be used to treat areas that have already been treated with radiation. This allows for appropriate doses of radiation to be delivered to the at-risk tissue, and for radiation treatment plans to be tailored to the precise shape and size of the target. It’s a delicate balance when devising a treatment plan for each breast cancer patient. Conventional X-rays pass through the body and deliver radiation to both the target and to the surrounding healthy tissues, which may cause more side effects and secondary malignancies. Due to its precision, proton therapy patients may experience fewer long-term side effects compared to conventional radiation therapy – making it a promising option for many breast cancer patients, particularly those with left-sided breast cancer at higher risk of recurrence.
Texas Center for Proton Therapy offers pencil-beam scanning, an advanced form of proton therapy. Pencil-beam scanning is ideal for patients with cancer in sensitive areas, including breast cancer, because it uses sub-millimeter precision that delivers high-energy proton beams directly to the at-risk tissue, delicately applying radiation to the area. Proton therapy is a non-invasive treatment for breast cancer patients, including following lumpectomy or mastectomy.
