Many Breast Cancer Patients Get Too Much Radiation Therapy
A data analysis of millions of women found that two-thirds of the women who got lumpectomy (breast conserving surgery) done underwent a radiation therapy lasting six to seven weeks. However, multiple studies have shown that an alternative course of three weeks of a higher dose radiation called hypofractionated whole breast radiation would be just as effective, convenient and cheaper than this longer, conventional radiation therapy.
The above mentioned study is further corroborated by the guidelines prescribed by the American Society for Radiation Oncology and four other separate studies. Dr. Stephanie Bernik, Chief of Surgical Oncology at Lenox Hill Hospital in New York City cautions women to raise this question of the three-week radiation therapy with their respective radiation oncologists and if they qualify for the therapy. While about 8% younger women received the advanced hypofractionated radiation therapy in 2008, the number improved to 21% in 2013. The numbers in Canada tell a different story. This advanced hypofractionated radiation therapy has been given to 70% of the early stage breast cancer patients since 2008.
Even though the use of hypofractionated radiation therapy reduced the cost for the insurer in the first year after breast cancer diagnosisby 10%, the shorter course had little effect on the patient’s final cost incurred. It did however reduce the amount of time spent in the hospital which meant it reduced the time patients needed to be away from their jobs. On an overall perspective therefore, it was economic and improved the quality of life.
Even though clinically the longer term radiation therapy is equivalent to the hypofractionated radiation therapy, has the same side effects, is more convenient, patient centric and lowers cost of cancer care, it is still infrequently used for women with early stage breast cancer. More information is needed however before it can be determined conclusively the reasons behind the slow transition to this newer radiation therapy.
Although the benefits of hypofractionated radiation therapy are undoubted, research still needs to be done to fully evaluate the effectiveness of this treatment and who can benefit from this treatment. Also, the safety of this procedure on subgroups like very young women, women with large breasts, women with more advanced stages of cancer, etc. still needs to be evaluated.
Given all the grey area surrounding this advanced hypofractionated radiation therapy, researchers still advise patients to discuss their options with their radiation oncologist so that they can get the most effective treatment for their condition.