Breast cancer treatment in half the time - Intraoperative Electron Radiation Therapy

IOERT Therapy Intraoperative Electron Radiation Therapy

Betty McBurney had a nagging feeling. Her daughter had received a mailer urging her to get her mammogram. Even though her daughter hadn't lived with her in years the piece of mail remained on her countertop.

"I kept meaning to give it to her," said McBurney. "But there it sat - it was almost like it was whispering to me, 'Get yourself checked, Betty.'" When McBurney had her physical last fall with Richard Hodge, MD, UnityPoint Clinic in Marion, she mentioned she was due for a mammogram.

 "Dr. Hodge told me I could have a walk-in mammogram at the Marion St. Luke's Breast and Bone Health, which was right next door to his office. When he was done with me I walked right in and had a mammogram almost right away. It was pretty slick."

It was during that mammogram doctors found "something." McBurney received a phone call telling her they needed her to come in again and after a biopsy she had a diagnosis: breast cancer. "I was upset but I thought I have to keep a positive attitude because that is what
will get me through this," said McBurney.

"Everyone at St. Luke's was wonderful and really held my hand through everything."
McBurney was connected with Wendy Young, a breast care coordinator at the Helen G. Nassif Community Cancer Center. Once an individual is diagnosed with cancer the care coordinator is available to guide the patient every step of the way.

 "Wendy was really great about explaining the process to me," McBurney said. "She
explained my options. We talked about a mastectomy and lumpectomy. And she also
told me I may be a candidate for a fairly new procedure for early stage breast cancer
patients called Intraoperative Electron Radiation Therapy or IOERT. I was really
interested in it because the recovery time was so much faster and easier."

Intraoperative Electron Radiation Therapy

To learn more about IOERT and her options for breast cancer care McBurney met with Robert Brimmer, MD, FACS, Physicians' Clinic of Iowa cancer surgeon. He is part of a coordinated team of doctors that are part of the Helen G. Nassif Community Cancer Center, which is located in the new Physicians' Clinic of Iowa Medical Pavilion.

"The IOERT unit at St. Luke's is unique because it is a mobile linear accelerator, which produces an electron radiation beam," said Dr. Brimmer. "It creates the same kind of electrons to treat patients as it would at any typical radiation center. Since it is mobile we are able to move it into the operating room and give the identical type of radiation other facilities have been administering for the last 40 years. IOERT's benefit is that a woman receives this  treatment during surgery and we are able to direct the radiation exactly at the spot where the cancer was."

Radiation during surgery

IOERT is offered to early stage breast cancer patients through an international clinical research trial. It is the application of electron radiation directly to the tumor bed immediately
during cancer surgery. This single dose of radiation reduces the need for radiation therapy after surgery - generally cutting post-surgery radiation therapy in half from six to only three weeks.

"Ninety percent of cancer reoccurrences after a lumpectomy come within two centimeters of the cancer tumor location," said Dr. Brimmer. "If we can treat that area with electrons in the operating room we can avoid irradiating the skin, precisely target the tumor location, expect low tumor recurrence rates and simultaneously lower the cost of medical care."

"I hadn't heard about IOERT but after Dr. Brimmer explained it to me it seemed like my best  option for breast cancer treatment," said McBurney. "Removing the tumor and then receiving the radiation treatment right there in the OR where the tumor was - made so much sense. I also liked that my skin wouldn't be exposed directly to the radiation."

McBurney had oncoplastic surgery to repair the lumpectomy defect. Oncoplasty uses plastic surgery techniques for breast cancer patients to minimize breast surgery distortion. When a patient has a lumpectomy it leaves the breast distorted. This surgery sculpts the remaining tissue to restore a natural appearance to the breast shape. The opposing breast may also be modified to create symmetry.

"It was great to have everything done at once," said McBurney. "It saved me a lot of time and headache. When I came out of the operating room everything was done except for only three weeks of radiation therapy. It was such a relief." "It's gratifying to be able to offer these options to patients right here in eastern Iowa," said Dr. Brimmer. "People don't have to travel to achieve advanced cancer care - they can receive it right here in Cedar Rapids and can expect excellent outcomes. It's a great opportunity for our community."

"Everyone I encountered at St. Luke's and the Community Cancer Center treated me like I was their only patient," said McBurney. "I appreciated that so much. I didn't feel like a number, I knew they really cared about me - that meant a lot." Today, McBurney is back to spending time with her family. She especially enjoys attending her grandkids' sporting events. She makes sure to do things today that before her cancer diagnosis she might have put off.

Watch a video and learn more about IOERT.