When Betty Malowney was diagnosed with breast cancer eight years ago, she underwent a modified radical mastectomy that required six weeks of recovery from surgery. Last year, a new cancer appeared in her other breast. But this time, says Betty, the difference in her treatment was like “night and day.”

Betty had a far less invasive treatment at Overlake Hospital in Bellevue, Washington, that involved a lumpectomy and five days of outpatient radiation therapy with high-dose-rate (HDR) brachytherapy. The treatment was made possible by a GammaMed® afterloader from Varian Medical Systems and a MammoSite™ device from Proxima Therapeutics. Just one week after treatment, the 57-year-old high school teacher was swimming and boating with friends.

“The ability for people to go on with their lives in a matter of days has been transforming,” says James Pelton, MD, medical director at Overlake Radiation Oncology.

BRINGING THE TREATMENT CLOSER TO THE TUMOR
HDR brachytherapy is a form of radiation therapy that is growing in use around the world, primarily for treating breast, prostate, and gynecological cancers. For many cancers, brachytherapy is a viable alternative to surgery, often with fewer side effects and faster recovery times. In addition, clinicians have found that new, more precise targeting methods enable them to use brachytherapy to treat areas that would have been considered too risky a few years ago, such as within the lung or the head and neck.

The process consists of inserting a radioactive source mounted on the end of a wire into the tumor through a catheter, using a computer-driven device called an “afterloader.” Placement is guided with the help of X-ray images and treatment planning software. The radioactive source is generally left in place for several minutes and then removed.

“HDR brachytherapy systems use very small catheters, meaning they can be placed virtually anywhere in the body,” says Peter Hoskin, MD, consultant clinical oncologist and professor, Mount Vernon Hospital in Northwood, England. “It allows us to give a very high dose of radiation to the target, while the surrounding area receives a very low dose.”

“We have a fully integrated suite of brachytherapy products in one treatment room,” says Rose Guerrero, oncology service line director at Overlake Hospital. Clinicians use Varian’s Acuity™ imaging system to see the patient’s anatomy and guide the placement of catheters and radiation sources.

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