Radiation.
虽然它肯定不会在肠道化疗包相同的情感踢,辐射让人想起了烧伤皮肤,疲劳的愿景,以及对未知的恐惧:是那些高剂量的X射线,一天周后给予日,做我多好啊长期的危害?
Thankfully, traditional radiation therapy for breast cancer has improved greatly over the past 20 years. More targeted than ever, the chance that radiation will result in serious long-term issues - e.g., a secondary cancer - is pretty much a non-issue these days.
Still, the treatment can take up to 6 weeks: 5 days a week, Monday through Friday. That can stretch to 7 weeks if you're getting "the boost:" an additional course of focused radiation delivered directly to the site of the tumor.
While the actual radiation takes just 10 to 15 minutes, driving to the hospital, waiting, and driving home takes a chunk of your day: especially if you live a long way from the hospital. Thus for many women, the biggest challenge of radiation is the schedule, rather than the treatment itself.
Luckily, there are a number of new therapies that are radically altering the manner in which radiation is delivered. Many are still in the trial stage, and generally unavailable to the public. But a few are gradually making their way into the mainstream - and if you've learned your treatment plan includes radiation, they're worth checking out.
加速整个乳房放射疗法(AWBRT),a.k.a. hypofractionated radiation therapy
AWBRT uses slightly elevated doses of radiation to shorten the course of treatment to 3 to 4 weeks. Yes, it still involves weeks vs. days (or even hours) of treatment; but it's a start.
这种治疗方法是在测试的最后阶段,病人的准则 - 妇女最可能受益,并在什么确切的时间表 - 来确定。散乱设施提供治疗,为数据收集继续;问你的肿瘤医生,如果您的医院是其中之一,如果它可能适合你。
全乳与局部乳房放射
Breast cancer treatment is becoming more and more targeted, and radiation is no exception. Some newer forms of radiation treat just the area where the tumor was removed (partial-breast radiation), vs. the entire breast (whole-breast radiation).
迄今为止的研究表明,没有区别in survival rate between these two types of treatment, though there are more local recurrences (return of cancer to the same breast) with partial-breast radiation.
The two treatments described below involve partial-breast radiation. As such, only certain women are good candidates for them; before you research their availability, find out if you qualify. And this could be confusing, as the two main advisory bodies for radiation protocols disagree on the standards.
The American Society for Radiation Oncology advises partial-breast radiation might be a choice for women over the age of 60 who are ER/PR-positive; with no lymph node involvement; and whose tumors are under 2cm. They advise women with DCIS or other non-invasive cancers, and women with multiple tumors, NOT to use partial-breast radiation.
乳腺外科标准的美国社会是广泛的,包括女性45岁以上,有两种侵入性或原位(DCIS)的癌症;其肿瘤3厘米或更小,手术后切缘阴性;且无淋巴结受累。
下面的两个治疗被分类为局部乳房放射。
“近距离放射治疗”¨
近距离放射治疗带来直接辐射到肿瘤位点,使用小的放射性种子。这些种子可以通过导管被递送;或者,在MammoSite®的情况下,通过插入到其中,除去你的肿瘤的空间中的小气球。辐射是那么内部输送的(而不是通过外部梁)为短短的5天,一天两次。
将种子在每次治疗之后去除,而气球或导管留在原地。由于治疗每天两次交付,大多数女性发现这是有道理留在治疗的医院。
Sound interesting? ReadDani's story,a survivor's first-hand account of MammoSite treatment.
If you decide brachytherapy is for you, you may have to travel to find a facility that offers it. Note that brachytherapy is delivered within days of surgery; so if you've already had surgery, you're probably not eligible. If you're a candidate, but your hospital doesn't offer it, check this link to find facilities that offerMammoSite.
Targeted intraoperative radiation therapy (TARGIT)
This intriguing protocol bypasses the entire radiation schedule, delivering treatment concurrent with surgery. In other words, you wake up from your lumpectomy having already had your radiation.
TARGIT is being offered in scattered locations, but it's not as widely available as brachytherapy. Why not? First, it requires specialized mobile equipment that can be brought right into the operating room. Hospitals will need to purchase the equipment, something most are loath to do in this era of uncertainty around health care and who pays for it.
In addition, the radiation received, though very focused, isn't as intense. And since TARGIT is still so new, there's not enough long-term information to assess how well it'll work compared to traditional radiation.
Still, if the traditional 6-week radiation schedule is going to pose a huge hardship for you - as well it might, given jobs, child care, and gas prices - it's well worth finding out if either TARGIT or brachytherapy is an option.