I wanted to be in the TARGIT trial. I wanted it a LOT. I had already been treated with lumpectomy
and whole breast radiation for DCIS three years prior. Now, with a small lesion
in my other breast, I knew what lay
ahead. Day in, day out visits to the radiation oncology chamber for invisible
treatment that would torture my skin and leave me exhausted.
The TARGIT trial was testing Intra-operative radiation
treatment (IORT) – a logical development that offered hope for fewer side
effects. Immediately after surgical resection the patient receives a targeted dose
of radiation delivered by an entirely different delivery system. It looks kind
of like a steampunk ice cream cone. Providers use a plastic-draped robot to guide
the bulb into place without themselves getting exposed to radiation.
The trial was due to open for enrollment at my hospital within
days of my treatment decision. “Stick that thing into my tumor bed, please!” I
thought. I wanted badly to avoid a
second experience with external beam radiation.
Don’t try this at
home
Eventually I was granted off-trial access. But I did not get
to skip more than the final three days of the traditional radiation protocol.
My IORT exposure was considered legitimate substitution only for the “boost”
dose, so edema and fatigue plagued me again for a few weeks.
Today I stumbled across a point/counterpoint article
in ASCO Connection. Hurrah! IORT is validated! At least, some physicians
believe it is. In the context of cost/benefit tradeoffs, shared decision making
and real-world numbers, IORT has shown its value. It may be most helpful to women who live in
rural areas and others for whom it’s problematic to travel daily for six weeks
of treatment.
As I read the article I feel a twinge of pride. I was
patient #2! Even though I was not on
the trial, by volunteering I helped my physicians learn to use the IORT sterile
robot safely and accurately. It’s a good feeling.
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