With cancer patients living longer and survival rates increasing, the potential long-term side effects of cancer treatment are becoming more evident. Among these is an increased risk of heart disease in women who underwent radiation therapy for left-sided breast cancer. With older radiation techniques, treating the left breast also tended to expose the heart—which is located on the same side of the chest—to a fair amount of radiation, potentially damaging healthy heart tissue and leaving the patient more vulnerable to a cardiac event down the road.
In an effort to mitigate this risk, cancer centers began administering radiation with these patients in a prone (face down) rather than supine (face up) position, which allows the breast to fall forward, creating a space between the heart and breast. But this technique proved to be effective in protecting the heart for only some patients.
The good news for women in our community is that the Mercy Health – Perrysburg Cancer Center now offers advanced radiation technology that helps position the patient so her heart is more effectively shielded from exposure, thus reducing her risk of long-term cardiac complications.
Eric Kielhorn, MD, a Board Certified Radiation Oncologist with Toledo Radiation Oncology who is the Director of Radiation Oncology at the Mercy Health – Perrysburg Cancer Center, explains that this new technology, AlignRT developed by Vision RT, is used in conjunction with what is called the Deep Inspiration Breath Hold (DIBH) technique. “With this technique, the patient is instructed to take a deep breath and hold it for 15 to 20 seconds, which creates a space between the breast and heart while the radiation is being administered,” he says. “However, ‘a deep breath’ is subjective, so we use AlignRT to determine whether the space is adequate with inhalation and it’s safe to administer the radiation.”
According to Dr. Kielhorn, AlignRT monitors the patient in real time to ensure her body remains in the correct position and there is enough space between her breast and heart, ensuring that the radiation is targeted precisely. If the patient moves out of the desired position—for example by inhaling too much or too little—AlignRT will automatically signal for the treatment delivery system to pause the radiation. Treatment using AlignRT technology is not only highly accurate but also reproducible, which ensures the same degree of accuracy in subsequent treatment sessions. What’s more, it can be adjusted during treatment as needed.
“With DIBH and AlignRT technology, we can reduce radiation exposure to the heart to an extremely low level. Taking the deep breath changes the patient’s anatomy and allows us to block the heart more aggressively without compromising treatment. This is a tremendous benefit because, based on published studies, we know that the higher the level of radiation exposure to the heart, the greater the likelihood of long-term cardiac complications,” Dr. Kielhorn says.
Though the most common use for AlignRT is protecting the heart from radiation exposure during left-breast treatment, this safe, non-invasive technology also has applications in treating other cancers, for example brain, lung, liver, and head and neck cancers. According to Vision RT, this technology is currently available in Ohio only in the Toledo, Columbus, and Cleveland areas.
For more information on this technology or other services at the Mercy Health – Perrysburg Cancer Center, please call 567-368-1500 or visit mercy.com.❦