Oncology

LUNG CANCER SEED TREATMENT

There is new hope for patients diagnosed with lung cancer but with too much lung disease to go through surgery to get their cancer removed. Radioactive seeds deliver concentrated doses of radiation treatment to the specific areas affected by cancer.

Lung cancer is the leading cause of cancer deaths in the United States. It kills more people than colon cancer, prostate cancer, and breast cancer combined. For patients with cancer that could be removed, but who have lung conditions like emphysema that prevents them from going under the knife, this new approach can still save their lives.
“My lung capacity isn’t good in either lung and so doing the full blown surgery would have really affected my breathing.” Dolores Scolere has emphysema after years of smoking. So when she was diagnosed with lung cancer, doctors considered surgery but because of her already-diminished lung function, cutting out any functioning lung would make her overall outlook bleak.
“I probably would have been on oxygen 24 hours a day, which naturally didn’t appeal to me,” says Dolores.
Until now, there haven’t been any good options for these lung cancer patients who could have their tumors completely removed. Currently patients are either given the larger surgery which means they can’t do their usual daily activities afterward, or they are denied the surgery altogether which means the cancer can spread and progress. The other option is to for patients to undergo a smaller operation along with external beam radiation- radiation from the outside. The problem is many patients don’t stick with this lung cancer treatment.
“What you now see is a longer-lasting treatment using radioactive seeds. These radioactive seeds remain radioactive for about 4-6 months,” says Robert Keenan, who led the research done at Allegheny General Hospital in Pittsburgh. He figured out a way to treat patients like Dolores by doing a smaller surgery. A smaller wedge is removed rather than a whole lobe of lung, and radioactive seeds are placed into the chest, a treatment called brachytherapy.
“We are delivering a very high dose of radiation locally. We’ve directed where that radiation is going to be most concentrated, the areas where recurrence are most likely to happen. And yet when you measure the level of radioactivity outside the chest it’s almost immeasurable,” says Dr. Keenan.
Radioactive seeds are commonly used for prostate cancer.
But Dr. Keenan’s research shows the combination smaller surgery and the seeds kill the cancer just as effectively as the larger surgery. “We’ve done the functional equivalent to a lobectomy, which is the standard operation for lung cancer and yet we’ve saved all that excess lung,” says Dr. Keenan.
“Every three months we do CT scans and if everything is fine by July, my anniversary date. I can say goodbye to Dr. Keenan.”
A larger, multi-center national study is being planned this summer to confirm the study’s findings.
Compared to just getting the smaller surgery, adding the radioactive seeds cut the risk of local cancer recurrence from 16% to less than 5%.

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