New radiation technology at Russell Medical is easier on the heart

As a part of its continuing effort to bring the highest quality radiotherapy to the people of Alexander City, the UAB department of radiation oncology is excited to announce the availability of new respiratory gating technology at the UAB Medicine Russell Medical Cancer Center.

Research conducted during the past decade has shown that patients who receive high radiation doses to the heart during breast cancer treatments have a higher chance of long-term cardiac side effects, such as hardening of the coronary arteries and heart failure. As radiation oncologists, our goal is to develop techniques to decrease the doses of radiation to a patient’s heart while appropriately treating the breast that is at risk for cancer recurrence.

For more than 10 years, UAB has used respiratory gating technology at its main Birmingham campus to successfully decrease radiation exposure to the heart in patients with left-sided breast cancer. When a patient undergoes a scan (or simulation) in preparation for radiation treatment, a monitor is placed on the patient to track his or her breathing motion. We ask the patient to deeply inhale and hold that breath for about 10-15 seconds. We then compare this “breath hold” to a normal (or free-breathing) scan. In most patients, the breath hold scan shows that the heart is farther away from the radiation beams, which results in lower radiation exposure to the heart.

How does taking a deep breath move a heart away from the radiation field? When lungs fill with air, it expands the chest wall out. At the same time, the heart is pulled back and down. As a result, much more of the heart is behind and below the radiation portal than in a normal breathing scan.

We recognize that the depth and length of each breath will differ with each attempt. The purpose of the monitor is to let the radiation therapists know if the breath is adequate and reproducible. This allows them to ensure the radiation target is in the same location every day and that the heart is appropriately out of the way for each treatment.

We began treating patients with respiratory gating technology at Russell Medical in August 2018. Since that time, we have simulated and treated seven patients.

In the past, many patients with left-sided breast cancer were recommended to temporarily relocate to Birmingham to receive radiation treatments with respiratory gating technology. With the availability of respiratory gating in Alexander City, almost all breast cancer patients will be able to stay home for their radiation treatments.

This technology is part of a comprehensive effort by the Cancer Center to bring the highest quality of care to our breast cancer patients. With the arrival of three breast cancer surgeons from UAB (Dr. Helen Krontiras, Dr. Rachael Lancaster and Dr. Catherine Parker), we now hold virtual multidisciplinary clinics with seamless access to Birmingham-based physicians. We are thrilled to be able to provide our patients here in Alexander City the same quality of care as patients who are treated at our main Birmingham campus.

~ Dr. Hunter Boggs is a radiation oncologist at UAB Medicine Russell Medical Cancer Center.