La radioterapia es una alternativa en el tratamiento de cáncer de mama por varias razones:
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Es una alternativa al tratamiento de mastectomía con alto control local y excelente cosmesis
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Conveniente y no requiere anestesia
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La radiación es guiada por imágenes y no afecta los tejidos normales (corazón – pulmón)
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Los resultados cosméticos son excelentes
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Cuando se detecta temprano tiene una tasa de éxito del 95%
ABIERTOS durante Covid 19 para tratarlo
Innovative Cancer Institute will remain open and provide uninterrupted Breast Cancer Radiation Therapy Treatment to patients not displaying COVID-19 symptoms.
Our team will be available 24 hours a day, 7 days a week for the oncologic related questions through Telemedicine.
En el Innovative Cancer Institute no existe un enfoque de "tratamiento único para todos" en la atención al paciente, especialmente cuando se trata del cáncer de mama, el cáncer más común diagnosticado en los EE. UU.
La Dra. Beatriz Amendola y su equipo, le acompañaran durante su tratamiento. ICI utiliza las últimas técnicas de tratamientos modernas y trabajamos directamente con sus médicos.
Opciones de tratamiento del cáncer de mama
Breast cancer is the most diagnosed cancer among women in the US, second only to skin cancer. Statistics show that 1 out of 8 women will be diagnosed with breast cancer in their lifetime.The cure rate for breast cancer is exceptionally high, especially when detected early, reaching up to 95% success rate; however, it remains the second leading cause of cancer death among women.
Why is this the case in today’s advanced technological world? Breast cancer is actually a complicated type of cancer - no two patients are the same, so every woman needs to be evaluated and treated individually. Several types of breast cancer can behave aggressively– spreading quickly to lymph nodes and from there throughout the body. Because of this there is a high recurrence rate, even if the entire breast is removed.
Facts About Breast Cancer
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1 in 8 U.S. women (about 12%) will develop invasive breast cancer over the course of her lifetime
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30% of all newly diagnosed cancers in women, will be breast cancers.
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Good news is that Breast Cancer Is VERY CURABLE
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And the decades-long DROP in breast cancer death rate continues.
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In the most recent 5-year period (2013-2017), the breast cancer death rate declined by 2.1% per year in Hispanics/Latinas, 1.5% per year in blacks, 1.0% per year in whites, and 0.8% per year in Asians/Pacific Islanders, and was stable in American Indians/Alaska Natives.
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Black women are still more likely to die from the condition than white women — the survival rate for Black women is about 10% less than it is for white women.
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Lung cancer is the most fatal cancer for women in the U.S. overall, but it's the leading cause of cancer death for Hispanic women, even though they are diagnosed with breast cancer at lower rates.
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Men can get Breast Cancer Too, but it is NOT common: Less than 1% of all breast cancers and less than 1% of all carcinomas in men are Breast Cancer.
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85% of breast cancers occur in women who have NO family history of breast cancer. However, a woman’s risk of breast cancer nearly doubles if she has a 1st-degree relative who has been diagnosed with breast cancer.
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Most women who get Breast Cancer Do Not have BRCA1 or BRCA2, it’s very rare.
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Types of Breast Cancer
- Although most consider breast cancer as one disease, there are many different types of breast cancer. The all start in the breast cancers but differ in other ways. They can be non-invasive or invasive. Tumor cells can vary in location and how they look under a microscope. And Tumor characteristics can vary as well
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Non-invasive breast cancer - Ductal carcinoma in situ :
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In situ means "in place." In this case the abnormal cells are contained in the milk ducts of the breast and have not yet spread to nearby tissues.
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Without treatment, the abnormal cells could spread and become invasive breast cancer. Some call this type of cancer “pre-invasive” or “pre-cancerous”
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Invasive Breast Cancer
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Cancer cells that spread from inside the milk ducts or lobules into surrounding tissue is invasive breast cancer. There are many types of invasive breast cancer.
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Metastatic breast cancer
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Invasive breast cancer that spreads to other parts of the body, such as the liver, lungs, bones and brain is metastatic breast cancer. It is sometimes called stage IV or advanced breast cancer. Note that metastatic breast cancer is not a type of breast cancer, but a stage of disease.
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Opciones de tratamiento del cáncer de mama
Prone Breast
Radiation Therapy
APBI
Brachytherapy
External Beam Radiation Therapy
Image Guided
Radiation Therapy
Prone Breast Radiation Therapy
La radioterapia de seno prona es un concepto que se ha perfeccionado recientemente para tratar el cáncer de seno. Varios estudios nuevos han demostrado que recibir radiación en el seno mientras está acostado en posición prona o boca abajo tiene muchos beneficios para las mujeres
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Este enfoque, mientras obtiene los mismos resultados de calidad que los tratamientos en la posición supina tradicional, donde las mujeres se recuestan sobre su espalda para el tratamiento de radiación, evita la exposición a los órganos internos como el corazón y los pulmones.
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El corazón es especialmente vulnerable al daño cuando se trata el seno izquierdo debido a la ubicación del corazón en el lado izquierdo del tórax, justo debajo del seno. En consecuencia, la posición de la mama prona se usa con mayor frecuencia cuando se irradia el cáncer de mama izquierdo, aunque se puede usar para el tratamiento en pacientes con cáncer de mama izquierdo y derecho
La radiación mamaria prona se administra mediante una mesa especialmente diseñada para ayudar a las mujeres a estar más cómodamente en la posición prona. El otro seno sano se mantiene cerca del cuerpo aislando el área para el tratamiento
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La radioterapia prona-mamaria es eficaz para administrar una dosis de radiación constante y precisa durante todo el tratamiento. Antes del desarrollo de la técnica de senos propensos, las mujeres con senos más grandes se colocaron sobre sus espaldas en la posición tradicional para recibir radiación. Sin embargo, la gravedad hace que los senos queden cerca del cuerpo, lo que provoca la exposición a los órganos internos y hace que el tratamiento sea menos consistente, ya que los senos más grandes pueden quedar planos de manera diferente con cada sesión de radiación. Cuando se utiliza la posición prona, podemos garantizar que la radiación se distribuya de manera uniforme, constante y precisa durante cada tratamiento.
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En ICI estamos encantados de poder ofrecer esta técnica avanzada a nuestros pacientes con cáncer de mama.
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Ventajas de la terapia de radiación de mama propensa:
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La dosis de radiación se distribuye uniformemente en el seno.
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Proteger el corazón y los pulmones de la radiación no deseada.
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Irritación minimizada de la piel.
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Resultados cosméticos óptimos.
¿Debería recibir radioterapia mamaria propensa? En términos generales, cualquier mujer, independientemente de su edad, sin una contraindicación para estar acostada, puede beneficiarse de la radioterapia mamaria propensa. Todos los pacientes están completamente evaluados y cuentan con todas las opciones que les brindan la mejor oportunidad de combatir con éxito su cáncer con los mínimos efectos secundarios. Sin embargo, hay ciertas mujeres que pueden preferir la posición de tratamiento supino convencional.
APBI Brachytherapy
Una alternativa a la irradiación convencional para el cáncer de mama temprano, la Irradiación Parcial Acelerada (APBI, por sus siglas en inglés) significa que solo se trata una parte de la mama y que generalmente se usan ciclos más cortos (de 5 a 7 días) en comparación con el tratamiento de radiación externa convencional que requiere 5 A 6 semanas de tratamientos diarios de radiación. El APBI se administra mediante una variedad de catéteres con balón y / u otros dispositivos para administrar radiación en el área donde más se necesita, con una exposición mínima a los tejidos normales adyacentes, lo que reduce la posibilidad de efectos secundarios.
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La radioterapia también puede administrarse internamente, dentro del seno, con una técnica conocida como braquiterapia, mediante la cual se administra una dosis alta de radiación controlada de forma remota a lo largo de un curso de tratamiento corto de 5 a 7 días en comparación con la radioterapia de haz externo que generalmente se administra durante un período De 5 a 6 semanas.
Ventajas de la braquiterapia API
El tratamiento de braquiterapia realizado por la Dra. Amendola y su equipo ofrece varias ventajas:
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La radiación solo se dirige al área que rodea el lecho tumoral (después de la extirpación del tumor mediante una tumorectomía quirúrgica) en lugar de a toda la mama.
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La radiación se administra en menos tratamientos en dosis mayores, por lo que el tratamiento generalmente se completa en solo 5-7 días.
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La menor cantidad de días requeridos para el tratamiento es especialmente útil para los pacientes que viven lejos del centro de radiación o que tienen un horario ocupado
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Las mujeres de edad avanzada son excelentes candidatas, porque todos los pacientes son tratados con un ciclo más corto de radiación de forma ambulatoria
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La mayoría de las mujeres sienten poca o ninguna molestia durante el tratamiento.
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Los resultados cosméticos son excelentes.
External-beam radiation therapy
Tratamiento convencional conservador del cáncer de mama: su tumorectomía generalmente se realiza con un acelerador lineal (LINAC). Cuando se usa radioterapia después de una lumpectomía, la radiación generalmente se administra mediante un acelerador lineal (LINAC) en un período de tratamiento de 5 a 6 semanas. Esto se denomina radioterapia de haz externo (EBRT). Con esta técnica, se administra radiación desde el exterior del cuerpo que cubre el seno afectado sin dañar las estructuras normales adyacentes. Estos tratamientos convencionales se administran de lunes a viernes durante 5 a 6 semanas y cada sesión de tratamiento dura entre 10 y 20 minutos.
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La mayoría de los cánceres de seno se tratan quirúrgicamente, con la extirpación de la totalidad o una parte del seno que contiene la lesión cancerosa. por cáncer de mama en etapa temprana, una lumpectomía seguida de radiación es el estándar actual de tratamiento. Un cirujano remueve en elTumor y una pequeña porción de tejido normal alrededor del cáncer, dejando el resto del seno intacto. Este es un aceptado y una opción de tratamiento local adecuada para pacientes seleccionados con cáncer de mama en etapa temprana en lugar de extirpar toda la mama (mastectomía).
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En el Innovative Cancer Institute, tratamos el cáncer con radiación, pero nunca olvidamos el resto de su cuerpo. En ICI usamos la última versión del Acelerador Lineal más avanzado disponible comercialmente: el Varian EDGE. Somos el único centro en el sur de la Florida que usa el sistema Qfix Prone Breast Access 360, para tratar a pacientes con cáncer de mama en la posición prona. Esto es muy ventajoso para tratar el cáncer de mama, especialmente en el seno izquierdo para proteger el corazón de la radiación innecesaria.
También ofrecemos irradiación parcial acelerada de la mama (APBI como un tratamiento más corto que usa braquiterapia para pacientes seleccionados con cáncer de mama precoz que no desean recibir el tratamiento habitual de 5 a 6 semanas con radiación de haz externo estándar (EBRT).
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IMAGE guided radiation therapy
Radioterapia guiada por imagen (IGRT) IGRT es un sistema que utiliza imágenes frecuentes del área que se está irradiando para asegurarse de que la radiación se está dirigiendo con precisión al área de tratamiento. Esto es importante porque minimiza el daño a los tejidos sanos.
Si le han diagnosticado cáncer de mama, elegir la opción de tratamiento adecuada para usted puede ser abrumador. Es importante trabajar con su médico para analizar sus opciones de tratamiento, los posibles efectos secundarios y los resultados esperados de su plan de tratamiento.
Are there any radiation side effects? ​
La radioterapia al seno / pared torácica puede causar:
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Piel seca Enrojecimiento de la piel, similar a una quemadura solar.
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Inflamación de la piel, sensibilidad y / o calor del tejido mamario.
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Decoloración de la piel después del tratamiento.
Los efectos secundarios del cáncer de mama pueden no ser los mismos para cada persona. Durante el tratamiento, nuestros médicos y el personal de terapia lo controlarán durante el tratamiento. Se recomienda a los pacientes que reciben radiación en la pared del pecho / pecho que evalúen su piel regularmente y limiten la exposición al sol y al cloro, ya que estas cosas pueden crear un efecto de sequía e intensificar la reacción de la piel al tratamiento.
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What is the success rate of radiation therapy for breast cancer?Success rate is as high 97-98 % in early cancer stages for the majority of patients
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Is breast cancer treatment possible without breast removal?Yes and Radiation Therapy is the option that allows for what we call breast conservation, or conservative treatment. If you qualify for the treatment, you can be treated with a lumpectomy, followed by conservative radiation treatment, and you can keep your breast/s. It also is just as successful as a mastectomy, while being far less painful and risky.
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Does radiation on left breast affect the heart?No. As mentioned above, using modern technology we avoid affecting any surrounding organs.
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What should you avoid during radiation?It’s best to avoid skin irritants, use mild soaps and creams that are recommended by the Doctor.
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How long is a radiation treatment for breast cancer?It depends and timing ranges based on a variety of reasons. For the most part cases are short, as brief as 5 days to 2 weeks. However in some special cases where lymph nodes need treatment and/or the tumor is more advanced it can take up to 25-30 days of treatment.
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Does radiation for breast cancer cause heart problems?No. As mentioned above, we leverage various techniques that allow us to completely shield and protect any vital organs.
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What are the side effects of radiation therapy for breast cancer?Radiation effects occur only in the treated area. In early cancer the only effects are minor redness or mild pigmentation on the skin of the treated area. If the tumor is advanced and if the dose of RT to skin needs to be higher than normal there may be a temporary reaction on the skin which is easily treated with topical creams.
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Is radiotherapy painful for breast cancer?Radiation therapy is painless. The only thing close to pain you can expect is some slight discomfort from lying in the required position, but that is very brief.
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Can radiation for breast cancer damage your lungs?No. Using modern technology we avoid damaging any surrounding organs. We have imaging that follows the respiration, and then we employ either controlled breathing techniques or treat patients using prone position in order to protect vital organs.
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What are the long term effects of radiation for breast cancer?For the most part long term effects of radiation are very limited, at most some will get some skin discoloration or light tanning of skin where treatment was. In very limited cases, some patients can develop fibrosis or changes in the skin telangiectasia (blood vessels visible in the skin) or some patients may get lymphedema of the arm, but those are typically in more advanced cases that require higher doses of Radiation Therapy to the axilla.
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Do you lose your hair with radiation therapy for breast cancer?No, you typically lose hair during chemotherapy. You do not lose any hair for Radiation Therapy for Breast Cancer, the worst side effect that you can expect is some mild skin redness.
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What is a PSA?The Prostatic-Specific Antigen or PSA test, measures a substance in the bloodstream which is created only by the prostate gland. Abnormally high PSA levels may signal the presence of cancer. However, PSA levels are also higher in men with large prostate glands from benign prostatic hypertrophy (BPH) a very common benign condition among men older than 50 years of age. In order to differentiate BPH from prostate cancer in patients with elevated blood PSA levels, doctors also use a test called PSA density, which relates PSA level to the size of the gland. A digital rectal exam, in which the doctor inserts a gloved lubricated finger into the rectum, is used to detect unusual bumps or hard areas on the prostate that might be cancer. If these tests raise concern, the next step is a prostate biopsy.
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How curable is prostate cancer?In general, the earlier the cancer is caught, the more likely it is for the patient to be cured. Because approximately 90% of all prostate cancers in the US are detected in the local stages, the cure rate is very high for patients with prostate cancer who are treated appropriately using radiation therapy or surgery.
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What is a Gleason Score ?The Gleason Score is an exam based on the pathologic examination of prostatic tissue obtained either from study of the prostate removed at surgery or more commonly from study of small core of tissue obtained from a needle biopsy of the prostate in patient suspected of having prostate cancer. This biopsy is usually done in patients who have a palpable nodule on rectal exam or a high PSA level. Multiple samples of prostatic tissue are obtained using a core needle biopsy under local anesthesia via a Trans-Rectal approach with Ultrasound (US) guidance (TRUS). Some of the results from this prostate biopsy are usually given in the form of a Gleason score. On the simplest level, this scoring system assigns a number from 2 to 10 to describe how abnormal the cells appear under a microscope. A score of 2 to 5 means the cells still look very much like normal cells and pose little danger of being malignant. A score of 6 is considered low risk prostate cancer, some of these patients may be observed depending on several factors including age, lifestyle and doctor and patients references. A score of 7 indicates intermediate risk prostate cancer and in general indicates need for treatment although the tumor still likely to be confined within the prostate. A score of 8 to 10 indicates that the tumor is very likely to be aggressive and may be already outside of the gland. These patients in general need to start treatment without delay. The Gleason score is one of the best tests available to gauge the severity of the prostate cancer and guide its management however, it is only one piece of information that you and your doctor will use. Biopsy reports also typically include the number of biopsy core samples that contain cancer, the percentage of cancer in each of the cores, and whether the cancer occurs on one side or both sides of the prostate. This information is key to guide treatment.
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If there are no symptoms, how is prostate cancer detected?"Screening for prostate cancer can be performed in a physician's office using two tests: the PSA (prostate-specific antigen) blood test and the digital rectal exam (DRE).
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What is the best treatment for prostate cancer?You and your doctor will decide what is the best option for you. This will be dependent upon many factors including your type of tumor and its stage, your medical condition, and your wish to maintain sexual potency and urinary continence.
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How do you protect yourself from Skin Cancer?The biggest thing you can do is limit your exposure to the sun, but here are some tips that can help: Use sunscreen regularly, and it should be the kind that can protect against UVB light and UVA rays and an SPF (sun protection factor) of 30 Reapply often when outside and especially after swimming or sweating. Wear sunglasses Use SPF lip balm Wear sun-protective clothing Avoid tanning beds as they will increase the risk of skin cancer See your dermatologist every year for a skin exam
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Are there side effects to treating skin cancer with Radiation?Rarely, but some redness or a rash may appear on the skin which usually resolves itself within a week.
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Will my cancer come back? Or will I get more skin cancers?People who have already had one skin cancer have a higher risk of developing additional skin cancers in the future, so anyone who has been diagnosed with one basal cell carcinoma should be especially watchful for signs of recurrence. Most recurrences happen within three to five years of a patient's original diagnosis.
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Can I get skin cancer anywhere on my skin?Most skin cancer happens on skin that is exposed to the sun most often such as your head, neck, chest, and arms. However, it is possible to get skin cancer on parts of your body that rarely or ever see sun such as genitals, but that is much more rare.
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How can I know if I am more likely to get Brain Cancer?In most cases of brain tumors, the cause is not clear. However there are two factors that can increase the risk of cancer, prior exposure to radiation is one, and the other is family history of Brain Tumors.
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What are the Symptoms of Brain Cancer?Signs and symptoms of a brain tumor vary widely and can depend on the tumor's size, locale, and how fast it grows. Some signs or symptoms might include: Onset or new pattern of headaches Headaches that become more frequent and more severe over time Unexplained vomiting or nausea Vision problems Gradual loss of sensation in limbs Difficulty with balance and speech Confusion in everyday matters Personality/behavior changes Seizures, especially in you don’t have a prior history of seizures Problems hearing
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What is difference between benign brain tumors and malignant brain tumors:Benign brain tumors are non-cancerous, but that doesn’t mean they should not be considered for treatment. Malignant tumors are cancerous and typically are more aggressive and spread faster than others and definitely require treatment.
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How is it Diagnosed?Diagnosis starts by taking family history and reviewing symptoms, followed by a physical and neurological exam. The doctor may then recommend a CT scan or MRI, and or an MRA or Angiogram. The doctor may also recommend a biopsy in some cases.