Naturally, being diagnosed with breast cancer scared Clare Micinski. She expected the treatment for it to be just as frightening.
But Micinski, a registered nurse at Rockford Health Physicians, turned out to be the ideal first candidate for brachytherapy, internal postsurgery radiation, with Rockford Memorial Hospital’s new Axxent Electronic Brachytherapy System. Instead of going five days a week for five to seven weeks of radiation therapy with external beam radiation, Micinski’s radiation treatment was over in five days.
“It was almost too simple,” Micinski said. “I kept thinking that there was something that I was missing here. I don’t know how to explain it except that it was like ‘OK, when is it really going to get bad?’ and it never was.”
Micinski, the first of five patients the hospital has treated with the new machine, underwent a lumpectomy to remove a tumor from her right breast on April 7, and during the operation, a temporary catheter was inserted in the breast to prepare her for possible electronic brachytherapy.
Three days later, after a final pathology report showed the cancer hadn’t spread to surrounding lymph nodes, the temporary catheter was replaced with one that would be used for the treatments. The next Monday through Friday, she received two 7 1/2-minute radiation treatments a day, one before she started work and the other near the end of her shift.
Her total time in treatment was 75 minutes.
Radiation oncologist Dr. Karen Smorowski said the machine delivers radiation to the site of where the cancer was removed with a small x-ray tube directed there by the catheter.
“The catheter is a balloon,” Smorowski said, “and there is a tube in the catheter. Inside it, there are seven dwell spots. Based on a treatment plan that we do, the x-ray tube goes all the way down to the last dwell spot.
“We calculate out how many seconds it has to stay there and then it remotely comes back a little bit and spends so many seconds at the next dwell spot and so on. So we can conform the dose based on the biopsy cavity.”
The result is that the patient can receive a higher dose of radiation in each treatment, 340 centigray compared with 180 to 200 centigray in a standard treatment, without damage to surrounding tissue.
“The vast majority of breast cancers, if they are going to come back, come back in the biopsy cavity which is what we are treating,” Smorowski said, “and because we are treating just the biopsy cavity, we can give more per day more dose per day safely than if we had to treat the whole breast.”
Smorowski said the patient doesn’t experience nausea, vomiting, skin changes or hair loss and the electronic brachytherapy is less stressful to the heart and lungs than partial breast irradiation. “The patient care is so much easier because they don’t have any side effects other than some mild tenderness or discomfort where the catheter is inserted,” she said. “The patients just fly through this.”
After the fifth treatment, the catheter is deflated and removed leaving a small incision site to heal.
Not every breast cancer patient is a candidate for electronic brachytherapy, Smorowski said.
The general qualifications are that the tumors have to be less than three centimeters in size, the patient has to be at least 45 years old, the tumors must have clean margins, and the cancer cannot have transferred to surrounding lymph nodes.
Micinski, like all breast cancer patients, will be monitored for the rest of her life, but said she was happy to have been able to work through the treatments.
“It happened so fast that I think I’m just coming to the realization of how fast it was now,” Micinski said. “By the time I had my surgery and had my treatments, there was no time to digest it.”
The treatment is more expensive than external radiation and Joyce Benson, manager of the hospital’s radiation oncology department, said patients should check with their insurance companies to determine coverage and eligibility for the procedure.
Staff writer Mike DeDoncker can be reached at 815-987-1382 or mdedoncker@rrstar.com.