New breast cancer treatment cuts radiotherapy time

Photo above: Dr Ong with the intra-operative radiotherapy machine that targets the tumour site after the tumour has been excised. The new regime, however, is suitable for only some, not all, early-stage breast cancer patients.

SINGAPORE - Breast cancer patients in the early stages of the disease who opt to keep their breasts may qualify for a new treatment that cuts six weeks of radiotherapy to one single session of up to 40 minutes.

The intra-operative radiotherapy, unlike conventional therapy, does not involve the entire breast, but targets the tumour site after the tumour has been excised.

Doctors at the National Cancer Centre Singapore (NCCS), where the therapy is offered, said this treatment may persuade more patients to choose a lumpectomy - the removal of the tumour - versus a mastectomy, where the entire breast, including the tumour, is removed.

"These women choose a mastectomy because it's simpler and faster," said Dr Wong Fuh Yong, an NCCS consultant in the radiation oncology department.

"Despite an innate sadness over losing their breast, they choose convenience over bodily function. So we hope to make that choice easier," he added.

The new radiotherapy regime, however, is suitable for only some, not all, early-stage breast cancer patients.

First, the tumour size must be smaller than 3cm in diameter, and the cancer should not have spread to the lymph nodes. Patients must also be above 50 years old.

Other factors include how aggressive the tumour is, and the patient's responsiveness to hormone treatment, said surgical oncologist Ong Kong Wee.

Because it is especially effective for women whose cancers are detected early, the treatment "reinforces the need for regular screening... before the cancer gets out of hand", said Dr Ho Gay Hui, an NCCS senior consultant.

Last year, about 150 patients at NCCS underwent lumpectomies. About a third qualified for the new treatment. The 20- to 40-minute radiotherapy is administered immediately after the lumpectomy, also known as breast-conserving surgery.

With conventional radiotherapy treatment, patients have to return to the hospital five days a week for six weeks.

Since June, six patients have received the treatment with minimal side effects, the doctors said. Side effects from conventional radiotherapy include skin dryness, pigmentation problems, and sores.

Clinical trials are under way to offer the new treatment to a larger group of breast cancer patients.

Madam Ng Kah Goe, 65, is one of the six who have received the treatment.

The part-time seamstress said it has saved her the trouble of travelling from her home in Sengkang to the cancer centre in Outram Park for weeks on end.

"I just felt tired for about two weeks after the operation. But there was minimal discomfort and my appetite returned quickly," said Madam Ng, whose operation took place in June.

Breast cancer is the most common cancer that affects women in Singapore.

About 1,500 cases are diagnosed every year, and about 400 people die from it annually.

Women above the age of 40 are encouraged to screen for breast cancer every year, and once every two years for those aged 50 and older.

As part of next month's Breast Cancer Awareness Month activities, the Singapore Cancer Society will offer a $25 mammography screening subsidy until Dec 31.

There will also be a free public forum on breast cancer on Oct 13 at Concorde Hotel.

melpang@sph.com.sg


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