Figure 2: The patient works with his mouth to bite the breathing tube, hook the nasal clip, and wear refracting glasses. (Photo provided by Wang Shenghong)
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Text / Wang Shenghong
Ms. Chen is 32 this year. She was diagnosed with left breast cancer in situ a month and a half ago. After breast preservation surgery, she was transferred to the outpatient oncology radiotherapy department for evaluation of postoperative radiotherapy.
As soon as she entered the clinic, Ms. Chen asked, “Doctor, did a friend of mine tell me that radiation therapy for breast cancer damages the heart?” This is a problem that patients who receive radiation therapy after breast cancer surgery may encounter.
Please read on …
Indeed, some foreign studies have shown that radiation therapy for breast cancer increases the risk of ischemic heart disease and heart failure. past. Especially if special technical assistance is used, the radiation dose and side effects of the heart can be significantly reduced. Among them, Active Breathing Control (ABC) is the most ideal, which can reduce the average radiation dose to the heart by about 50%, reducing risks and side effects.
Reduces the dose of heart radiation
Ms. Chen asked, “How do you get this precision medicine?” In fact, the principle is very simple. When the patient receives the treatment, she must cooperate with the method of holding her breath after taking a deep inhalation (Figure 1). Postoperative radiation therapy for breast cancer, especially for the left breast, because the heart is on the left, the action of deep inhalation and holding the breath can increase the distance between the heart and the breast room, keep the heart away from the breast and reduce the radiation dose to the heart. Increased lung volume during inhalation and breath holding can also reduce the radiation dose to the lungs, so it’s safer!
Figure 1: A Patient Undergoing Radiation Therapy with Active Breath Control Technology The image is a situational photo and the people in the image have nothing to do with this article. (Photo provided by Wang Shenghong)
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During the treatment, the patient must cooperate by wearing different pieces of equipment (Figure 2), bite the mouthpiece, similar to the bite of a diving tube, and put a nasal clip on the nose to remind the patient to breathe through the mouthpiece; then wear a refractor. Glasses, through the refractory glass, you can see your breathing curve on the screen. When each deep inhalation reaches the threshold, the computer will help hold the breath and the patient will perform radiotherapy when the patient cooperates with each breath hold (Figure 3).
Figure 3: When you hold your breath after inhalation, the breathing curve will be a horizontal line in the green area and radiation therapy will be performed at this time. The lower right corner is the countdown to the treatment. (Photo provided by Wang Shenghong)
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It can be seen from the screenshots of the image that when breathing freely, the chest wall of the left breast is only 2.7 cm from the heart; but when holding the breath after a deep inhalation, the position of the chest wall relative to the heart can reach 5.2 cm At this time left breast radiotherapy is performed, in particular it can reduce the risk of cardiac radiation doses. (Figure 4)
Figure 4: Comparison of the distance between the chest wall of the left breast and the heart between deep inspiration and free breathing. (Photo provided by Wang Shenghong)
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“So can I use active breathing control technology?” Miss Chen asked enthusiastically. I replied: “As long as you can hold your breath for at least 20 seconds and can cooperate with the command, the respiratory flow monitoring system will detect your respiratory status, assist you in the process of deep inhalation and hold your breath, reach the volume of ideal lung expansion and successfully complete radiotherapy “.
Miss Chen: “Thanks Dr. Wang for the explanation. It doesn’t seem too difficult to hold your breath for 20 seconds and cooperate with the instructions so I can feel comfortable.”
(The author is the attending physician of the Oncological Radiology Department of Lugang Christian Hospital)
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