Jackie Lipez wasn’t surprised when she was diagnosed with breast cancer in October 2015. But she wasn’t expecting her treatment could be done in a single day.
"I was very excited about that because I didn't want to go through radiation if I didn't have to," Lipez says. Lipez already had a close relationship with Dr. Jennifer Manders, a surgeon at The Christ Hospital Health Network, who had treated both her mother and sister for breast cancer. Manders believed Lipez might be a good candidate for intraoperative radiation therapy (IORT) a new treatment that had only been available in Cincinnati for a few months. "I was one of the first patients to have it done here in town," Lipez says.
"We were watching Jackie closely because of her family history," Dr. Manders says. "We found her cancer pretty early thanks to a high-risk screening." Prior to IORT, most cancers like Lipez's were treated with whole- or partial-breast radiation. This can be inconvenient since patients must sometimes visit the hospital as often as twice a day. With IORT, the tumor is removed and radiation is applied to the cavity in a single procedure.
"The biggest advantage of IORT is that you can do it as a one-time treatment while the patient is asleep going through surgery," says Dr. Robert Summe, an oncologist at The Christ Hospital who performed Lipez's radiation treatment. "Patients wake up and both their surgery and the radiation are done." Early signs suggest IORT may have fewer side effects than other common breast cancer treatments. "The amount of swelling or lymphedema that occurs with external beam radiation therapy is really not significant with IORT patients. They do quite well.
The fatigue associated with whole breast radiation therapy is minimized with IORT as well," Dr. Manders says. Cost savings is another benefit. "Radiation in general is charged based on each dose that's given. So there's a lower overall cost for IORT compared to partial- or whole-breast radiation therapy," Dr. Manders says.
Despite growing interest in IORT, both Dr. Manders and Dr. Summe stress it's not available to everyone. "It's a select group of patients," Dr. Summe says. "They have to be older than 50, the tumor size has to be less than two centimeters, and it has to be an estrogen-receptor-positive breast cancer." That's to ensure we're offering IORT safely," Dr. Manders says.
More women may become eligible to receive IORT in the future if patients continue to do as well as those receiving traditional radiation. In addition, the final decision about whether a patient qualifies for IORT can't be made until surgery to remove the tumor is in progress, because the medical team must confirm that the patient's lymph nodes are cancer free. "The patient doesn't know," Manders says.
Lipez met all the requirements during her surgery on November 19th 2015, and received a single IORT treatment. She's had no recurrence of cancer for nearly two years. "After I had it done I was just so thrilled, and I'm doing great. I would hope that everyone could be a candidate for it, although I realize some are not. It really does save you from all the trips and the fatigue and some of the side effects of radiation," Lipez says.
Learn more about IORT.