Patients with breast cancer are being coached to hold their breath while doctors deliver radiation treatment, in a technique that may virtually eliminate long-term risks from radiation to the heart.
Epworth Hospital radiation oncologist Andrew See said radiation was an effective treatment for breast cancer but was linked to a small increased risk of cardiac complications including heart attacks in the years to follow.
He said the new technique helped minimise radiation to the heart and lungs by delivering a dose only when patients held their breath, which expanded their chest and pushed it away from their heart.
Dr See said women being treated for left-sided breast cancer at the Epworth hospital were being invited to use the technique, which would soon be part of a clinical trial to run at multiple hospitals around Australia.
‘‘The heart is slightly inclined to the left-hand side so the major chamber and coronary vessels can come close to the radiation field,’’ he said.
‘‘Rates of heart injury were very high in the 1970s and 80s because the treatments were quite crude and beams used to shoot through the entire cardiac silhouette.
‘‘With modern treatments the heart dose is quite low but it’s not zero. With this new technique, we can bridge that gap and reduce the low dose to almost a zero dose.’’
Dr See said the technique had been used successfully overseas but was relatively new to Australia.
Patients using the technique at the Epworth can monitor their breathing using goggles or a television screen and only receive radiation doses while they are holding their breath, usually for 20 to 30 seconds.
Dr See said women undergoing radiation for left-sided breast cancer had a one to two per cent increased risk of cardiac complications within five years but this was higher for some groups, including women with diabetes.
He said a clinical trial would compare cardiac complications in women who used the breathing technique, called ‘‘deep inspiration breath holding’’, with those in who did not use it.
Judith Rothe is one of about 10 patients to try the breathing technique since it was introduced at the Epworth in May. She was diagnosed with breast cancer five years ago and recently found a recurrence of the cancer under her arm, requiring surgery, chemotherapy and radiation treatment.
Mrs Rothe said she was concerned to protect her heart following a heart operation to repair her mitral valve about 10 years ago, and will use the breathing technique while having six weeks of radiation treatment.
‘‘I was a bit concerned, it’s all on the one side – the breast cancer, the recurring lump and the heart. But [Dr See] put me at peace with that and said this new technique will be helpful,’’ she said.
