Transcript Radiation Therapy and Ultrasound Management of Breast Cancer

Case Study:
Radiation Therapy and
Ultrasound Management
of Breast Cancer
hhholdorf

Radiation Therapy (also known as radiotherapy and
radiation oncology) began shortly after the discovery
of X-rays in 1895 by Wilhelm Rontgen.

In 1896, Antoine-Henri Becquerel discovered that
certain elements spontaneously emitted rays or
subatomic particles from matter, a property which
came to be known as radioactivity.

Building on the work of Becquerel, Pierre and Marie
Curie discovered the radioactive elements polonium
and radium. While experimenting, they noticed that
radium killed diseased cells -- the first indication that
radiation could aid not just in the diagnosis of
disease, but also in treatment.
Background and History

Due to the groundbreaking work of Nobel Prizewinning scientists Antoine-Henri Becquerel, Marie
Curie and Pierre Curie, the field of radiation
therapy grew quickly in the early 1900s. A new
era in medical treatment and research began.
Background and History
Background and History
What is radiation therapy?

Radiation therapy is a form of cancer treatment
that uses radiation (strong beams of energy) to
kill cancer cells or keep them from growing and
dividing.
Background and History
How does radiation therapy kill cancer cells?

Radiation therapy kills cancer cells by damaging their DNA
(the molecules inside cells that carry genetic information
and pass it from one generation to the next). Radiation
therapy can either damage DNA directly or create charged
particles (free radicals) within the cells that can in turn
damage the DNA.

Cancer cells whose DNA is damaged beyond repair stop
dividing or die. When the damaged cells die, they are
broken down and eliminated by the body’s natural
processes.
Background and History
Does radiation therapy kill only cancer cells?

No, radiation therapy can also damage normal cells,
leading to side effects. Doctors take potential damage to
normal cells into account when planning a course of
radiation therapy. The amount of radiation that normal
tissue can safely receive is known for all parts of the body.
Doctors use this information to help them decide where to
aim radiation during treatment.
Background and History
Why do patients receive radiation therapy?

Radiation therapy is sometimes given with curative intent
(that is, with the hope that the treatment will cure a
cancer, either by eliminating a tumor, preventing cancer
recurrence, or both). In such cases, radiation therapy may
be used alone or in combination with surgery,
chemotherapy, or both.

Radiation therapy may also be given with palliative intent.
Palliative treatments are not intended to cure. Instead,
they relieve symptoms and reduce the suffering caused by
cancer.
Background and History
What are the potential side effects of
radiation therapy?

Radiation therapy can cause both early (acute) and late (chronic)
side effects. Acute side effects occur during treatment, and
chronic side effects occur months or even years after treatment
ends. The side effects that develop depend on the area of the
body being treated, the dose given per day, the total dose given,
the patient’s general medical condition, and other treatments
given at the same time.
Fatigue is a common side effect of radiation therapy regardless of
which part of the body is treated. Nausea with or without vomiting
is common when the abdomen is treated and occurs sometimes
when the brain is treated. Medications are available to help prevent
or treat nausea and vomiting during treatment.
Background and History
What are the potential side effects of
radiation therapy?
Acute Side Effects

Skin irritation, or damage at regions exposed to the radiation beams.
Acute radiation side effects are caused by damage to rapidly
dividing normal cells in the area being treated. Most acute effects disappear after
treatment ends, though some can be permanent.
Late Side Effects
Fibrosis (the replacement of normal tissue with scar tissue, leading to
restricted movement of the affected area).
 Damage to the bowels, causing diarrhea and bleeding.
 Memory loss.
 Infertility (inability to have a child).
 Rarely, a second cancer caused by radiation exposure.

Late side effects of radiation therapy may or may not occur. Depends on the area
of the body treated
Background and History
Radiation therapy of the breast
Background and History
Radiation therapy of the pelvis. Lasers and a mold
under the legs are used to determine exact position
Background and History
Purpose

The processes was to create an individualized
exercise program, and monitor training of a
breast cancer survivor who was participating
in a fitness plan during and after surgery,
chemotherapy

Radiation treatments were examined over a
391-day period
Case Study:
Exercise capacity of a
breast cancer survivor
Case Study

A 57-yr-old female was diagnosed with stage I breast
cancer (approximately 1.2 cm diameter) with no
lymph node involvement. After lumpectomy and
axillary node dissection, the client completed
chemotherapy treatment followed by 33 bouts of
radiation therapy

Assessment included body composition, lactate
threshold, VO2 max, pulmonary function testing
which was measured 4 days post-diagnosis and 2
months after treatments had ended. The client kept a
daily log of exercise, average heart rate, and rating of
perceived exertion in each exercise session
Case Study
Definitions

Lumpectomy- surgery in which only the tumor
and some surrounding tissue is removed

Axillary node dissection- removal of nodes in
levels depending on the case

VO2 Max- maximum capacity of an individuals
body to transport and use oxygen during
incremental exercise
Case Study
Results

Over 391 calendar days, the client exercised 343
days and completed 424 exercise sessions. The
client's body composition and body weight
remained stable for the entire period. There was
a significant decrease in VO2max before and
after treatment. During the treatment phase, the
client averaged 1.19 exercise sessions per day,
with an average duration of 48 min at
approximately 57% of VO2max. Post-treatment,
the client averaged 1.32 exercise sessions per
day, with an average duration of 69 min at
approximately 59.6% VO2max. Pre- and posttreatment exercise durations were significantly
different.
Case Study
Conclusion

A cancer survivor who engages in a
medically supervised and proactive fitness
plan starting from the day of diagnosis,
maintained a realistic level of physiologic
function during and after cancer
treatment
Case Study
Normal breast
Abnormal: breast cancer
Ultrasound of Breasts
Stages of Breast Cancer

Radiation therapy and regular exercise work
hand in hand, like many diagnostic tests we
have seen, to maximize the benefits of
treatment.

Ultrasound can be used in conjunction with
many other diagnostic tests to maximize the
efficacy and efficiency of diagnoses and
treatments
Conclusions

For example, the patient seen in the case
study would and could have benefited from
an ultrasound follow-up due to the extremely
safe nature of sonograms

Ultrasound allows images to be formed
without the use of x-rays, instead, it uses
sound waves to produce an image
Conclusions

Follow-up after any radiation therapy with
ultrasound is a harmless and useful course of
action since doctors can get the images and
information they need safely, without doing
further harm to their patients

Like ultrasound, exercise proves to be an
important adjunct to radiation therapy, along
with many other therapies, for prolonged and
sustained health of the patient
Conclusions