TACOMA, WA – Tacoma/Valley Radiation Oncology Centers has been designated a Center of Excellence in accelerated partial breast irradiation (APBI) for offering therapy with SAVITM breast brachytherapy. SAVI is a new kind of radiation therapy which allows more women with early stage breast cancer to choose a faster course of radiation following lumpectomy surgery. Tacoma/Valley Radiation Oncology Centers was the first SAVI provider in the Pacific Northwest, is the most experienced, and offers next-day consults.

“Women receive a simple, five-day course of radiation, rather than the traditional six to seven weeks of daily radiation therapy,” explained Ann Pittier, M.D., radiation oncologist at Tacoma/Valley Radiation Oncology Centers. “Patients can receive radiation treatment without giving up their active lives, and SAVI has few side effects.”

The unique design of the SAVI device delivers highly targeted radiation from within the breast through several separate, precisely placed catheters. The new device minimizes potential radiation to healthy structures such as the skin, heart and lungs. SAVI makes it possible to contour radiation based on a patient’s individual anatomy, so that many more women are now eligible to choose APBI – even women with tumors close the skin surface or chest wall, or those with small or irregularly shaped lumpectomy cavities.

Alice Sampson of Olympia was diagnosed with early stage breast cancer. After her surgery, she chose SAVI. “My husband and our grown son were set to climb Mt. Kilimanjaro,” Sampson said. “They were going to have to cancel their trip. SAVI meant I would be finished in just two weeks. I didn’t want them to miss their climb together. I also appreciated that SAVI irradiates the most at-risk tissue, not the entire breast. And I was so pleased with the warmth and care I received from Dr. Pittier and her team at Tacoma/Valley Radiation Oncology Centers. The whole treatment experience was better than I had hoped for.”

Designation as a Center of Excellence recognizes Tacoma/Valley Radiation Oncology Centers’ dedication to education, training and experience in APBI. To qualify, the physicians, medical physicists and clinical staff were required to complete a comprehensive training and education program to demonstrate proficiency in delivering radiation therapy with SAVI. Center of Excellence designation is a tribute to Tacoma/Valley Radiation Oncology Centers’ deep and ongoing commitment to patient education, advocacy and leading-edge treatment for women with breast cancer.

Breast Conservation Therapy

Breast conservation therapy encompasses lumpectomy (surgery to remove diseased breast tissue) and follow-up radiation. This choice is available to some women with early stage breast cancer, based on evaluation and determination of risk by the patient’s doctors, and the patient’s preference for this type of treatment. Until recently, the standard of care for breast conservation therapy included irradiating the entire breast with an external beam. Whole breast irradiation (WBI) involves a lengthy treatment course — once a day, Monday through Friday, for six to seven weeks.

While WBI is effective, the significant time and cost required to complete such an extended therapy often prove too difficult for many women. In fact, this burden is cited as one of the reasons that as many as 30 percent of women do not undergo the required radiation following lumpectomy surgery. Unfortunately, eliminating the radiation portion of treatment can significantly increase the risk that breast cancer will recur.

Accelerated partial breast irradiation (APBI) was developed as an alternative to whole breast irradiation. APBI delivers a more targeted form of radiation to the lumpectomy tumor bed, or cavity, and to the immediately surrounding tissue. This approach safely reduces the length of treatment from six weeks to just five days. This shorter timeframe is significantly more convenient than traditional whole breast irradiation, making it easier for women to choose breast conservation therapy.

The SAVI Procedure

Radiation therapy with SAVI consists of two treatments per day for just five days. SAVI is inserted into the lumpectomy cavity through a small incision in the breast. The ends of the catheters remain accessible during treatment. Once the applicator is inserted, the physician expands the multiple catheters to conform to the cavity.
A tiny radioactive seed is placed inside each catheter by a computer-controlled machine. This delivers the radiation to areas where cancer is most likely to recur, while avoiding areas of healthy tissue. The radiation source is completely removed after each treatment.

After the five-day course of radiation, the physician closes the catheters and removes the SAVI applicator. Most patients are able to return immediately to their normal activities after completing therapy with SAVI.

To learn more about this exciting new treatment call 253.627.6172, email sbissonnette@tacomaradiation.com, or visit www.tacomaradiation.com.

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Spanish Version:

Hyperthermia therapy is a treatment used in battling cancer by heating tumors.  The heating temperature is about as warm as a hot tub.  Research has shown that heat can damage or kill cancer cells in some tumors while also making radiation therapy more effective in treating some tumors that are recurrent or progressive despite conventional therapy. 

In clinical trials, data has shown that combining hyperthermia and radiation improves response rates for prostate, cervical, head and neck cancers, melanomas and soft tissue sarcomas.  Most marked improvement has been seen in recurrent chest wall cancer-with complete response rate improvement of more than 40 percent.

We are proud to be the only practice in the Pacific NW (including Washington, Idaho, Oregon and Montana) to offer this advaned treatment modality.   For more information, contact our doctors at Tacoma/Valley Radiation Oncology Centers or visit www.bsdmedical.com/patients.php.

– Hitting the Bull’s Eye

The AccuBoost procedure is an image-guided radiation therapy (IGRT) technique which scientifically targets the radiation dose to the intended site. The real-time image guided procedure uses radiographic (mammographic) equipment to image and pinpoint the tissue that needs to be irradiated. Based on real-time images obtained, the AccuBoost system is able to position the applicator that delivers the therapeutic dose, accurately and reliably to irradiate the part of the breast that has been designated to receive the additional dose. The AccuBoost design gives the radiation oncologist the needed confidence that “you see what you treat and you treat what you see.” Furthermore, the AccuBoost system is capable of recording the therapeutic dose. This feature can be used to adjust and fine tune the radiation field throughout the procedure and archive the information for future reference. This feature of the AccuBoost system gives the radiation oncologist the comfort and piece of mind to know “not only you treat what you see, but also you keep a record what was treated.”

Women with early stage breast cancer can make the decisions to preserve their breasts through an option called breast conservation therapy, which begins with a lumpectomy. Once the surgical procedure is completed, generally seven weeks of external beam radiation therapy follows. Many women will also require chemotherapy and hormonal management. The combination of surgery, chemotherapy and radiation are the time-proven methods, working to fight breast cancer.

A new strategy in breast conservation therapy is partial breast radiation. Tacoma/Valley Radiation Oncology, your most experienced partial breast radiation team, has expanded the treatment options for women with early stage breast cancer by adding the SAVI treatment device to their list of options.

SAVI and MammoSite are forms of partial breast irradiation included in the breast conservation therapy, which target the affected tissue rather than the entire breast AND takes only five days rather than the traditional seven weeks.

Both options are offered in the South Sound area by THE industry front-runners, Tacoma/Valley Radiation Oncology Center. In our Centers, we have rendered over 1200 treatments to women who have welcomed this time-saving option.

• The SAVI and MammoSite device is surgically placed in the cavity by your surgeon at the time of the lumpectomy.
• Radiation is delivered to the lumpectomy site via a tiny radioactive source – called a “seed” – and placed inside the device by a computer-controlled robot.
• Both are removed immediately upon completion of treatment.
• When appropriate, the SAVI or MammoSite is used in conjunction with external beam to the whole breast to shorten the overall treatment time.

These exciting treatments are an option for select patients with early stage breast cancer. If you are interested in SAVI or MammoSite and other options for breast cancer, please contact Tacoma/Valley Radiation Oncology Center at 253.627.6172.

One challenge with conventional radiation treatment options has been to give a high enough dose of radiation to the tumor to be effective, while trying to protect as much of the surrounding healthy tissue as possible. Another challenge has been to accurately target the tumor. Patients and their organs move, and that means the tumor moves. The current method of locating a tumor uses CT scans before treatment. But because that location may move during the weeks of treatment, more of the surrounding healthy tissue is at risk and subject to radiation. IGRT takes into account variations in body and internal organ movement before and during treatment, helping doctors precisely locate tumors. The benefits of IGRT include:

• Safely delivering higher, more effective doses of radiation
• Offering new hope to patients with what were considered “untreatable” tumors
• Helping to protect surrounding tissue
• Shortening the overall treatment period
• Reducing side effects and improving the patient’s quality of life

The Gamma Knife, which focuses 201 tiny beams of radiation on one focal point within the brain, is considered the “gold standard of care” for non-invasive treatment of many types of brain tumors (even some that were considered inoperable), vascular malformations, and neurological disorders. The typical treatment consists of a single four-hour session. Patients do not lose their hair, there is almost no pain or side effects, and most patients return to normal activity within 48 hours.

South Sound Gamma Knife, led by Dr. Michael McDonough, is the only Gamma Knife treatment facility between Seattle and Portland. To learn more about this technology and the Gamma Team, visit the South Sound Gamma Knife Web site.