Study's data splits docs over one-dose treatment

Risk of recurrence is debated because of less costly radiation therapy that's easier to take

Should a breast cancer patient opt for radiation that costs less and is more convenient when it might double or triple the small risk of recurrence?

That's what's currently being debated in the medical community regarding those in the early stages of the disease.

According to a story last week in the Wall Street Journal by Melinda Beck, a single dose of intra-operative radiation therapy, usually shortened to IORT, normally is given while lumpectomy surgery is happening.

The procedure reportedly has fewer side effects than conventional radiation with treatments that last five days a week for five to seven weeks.

Critics, the story says, claim a study shows the risk of recurrence in women treated with IORT is 3.3% rather than 1.3% over a five-year period.

But critics of the critics say the risk is small and worth it — and some point to a potential conflict of interest because many radiation centers take in huge amounts of revenue through the extended treatments.

Dr, Anthony Zietman

According to the article, Dr. Anthony Zietman, radiation oncologist at Boston's Massachusetts General and a Harvard professor, wrote an editorial in the International Journal of Radiation Oncology this month that said a single treatment, "depending on your perspective…is either a significant threat or a quantum leap forward."

The cancer industry debate has intensified because of the release of data stemming from the Cleveland Clinic study of 1,000 patients who've undergone IORT at 19 U.S. centers. 

Radiation has allowed lumpectomies to surpass mastectomies in popularity, with 60 percent of new patients now choosing the former. But its side effects include fatigue, skin blistering and, although infrequently, damage to hearts, legs and rib cages.

Because elongated radiation "can be disruptive for women who work, care for children or live far from radiation," Beck's article says, "about one-third of women who begin radiation don't finish their prescribed courses, studies show."

IORT started in Europe in the late 1990s but has grown in acceptance, with 260 medical centers worldwide now offering the treatment.

Want to know more about lumpectomy versus mastectomy, or about radiation treatments? Check out "Rollercoaster: How a man can survive his partner's breast cancer," the VitalityPress book I, Woody Weingarten, aimed at husbands, boyfriends, fathers, sons and brothers who are caregivers.