[cdn-nucl-l] Met MD in 2000, Breast cancer treatment takes one hour

["Jerry Cuttler" <jerrycuttler@rogers.com>]

They use radioactive palladium seeds.  A similar treatment (brachytherapy)
is commonly used for prostate cancer.

I met Dr. Pignol (from France) at the Toronto Sunnybrook Hospital four years
ago after I gave a lecture there (rounds) to persuade them to try total body
low dose irradiation therapy.  I spoke with Dr. Cyril Danjoux and Dr.
Pignol.  They had articles about TB LDI, and I gave them another 20 articles
(see e-mail message pasted below).  Maybe I planted a seed.

Jerry
---------------------------
----- Original Message ----- 
From: Jerry Cuttler
To: Philippe Duport ; Ted Rockwell ; muckerheide@highway1.com ; Myron
Pollycove
Sent: Thursday, July 27, 2000 10:55 PM
Subject: Good meeting at Toronto-Sunnybrook Regional Cancer Centre

Hello everyone,

I had a very productive meeting this afternoon with Cyril Danjoux, Radiation
Oncologist at the Toronto-Sunnybrook Regional Cancer Centre, following the
presentation I gave there on June 13.  He also introduced me to a young
nuclear physicist from France, who is also an MD (radiation oncologist) -
just joined the TSRCC - and seemed interested in this project.
Cyril is also quite interested in this subject.  He gave me a copy of the
new paper by A. Safwat, and several others as well.  (Cyril has a thick file
of this stuff, including the material I gave him.)
Cyril also suggested a very good approach to make progress through the maze
of radiation oncology in Ontario, and I sense he will help me.  It will be a
fair bit of work to pull it off.
Regards,

Jerry
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http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&c=Article&cid=1094681411926&call_pageid=968332188492&col=968793972154

Toronto Star, Sep. 9, 2004. 06:41 AM

SIMON HAYTER/TORONTO STAR
Karen Todkill was among the first breast-cancer patients to benefit from
radiation therapy pioneered by Dr. Jean-Philippe Pignol.

Breast cancer treatment takes one hour
Cuts side effects, life disruptions

ELAINE CAREY
MEDICAL REPORTER

In a world first, Toronto cancer specialists have developed an innovative
one-hour radiation therapy that could dramatically change the way breast
cancer is treated.

Six women with early-stage breast cancer have been successfully treated as
outpatients at Toronto Sunnybrook Regional Cancer Centre and experienced
none of the usual side-effects of standard radiation treatment that takes up
to seven weeks, Dr. Jean-Phillippe Pignol told a news conference yesterday.
"A breast cancer diagnosis may no longer mean that women have to put their
lives on hold," said Pignol, a radiation oncologist.

"This treatment, if proven equivalent to current standard therapy, may allow
women to remain active, care for their children, go to work, remain in the
community and continue their normal day-to-day activities while receiving
radiation treatment."

Karen Todkill, 51, of Toronto, received the one-day treatment in May, and
"it was an amazing experience," she said. "I felt guilty about feeling so
good.

"I know a number of women who had the traditional treatment and were
emotionally and physically exhausted," she said. "I was back at work the
next day. I just thought: Boy, am I ever glad someone gave me an opportunity
like this."

Standard radiation therapy requires three to seven weeks of daily radiation,
after surgery to remove the tumour, and can cause exhaustion and skin burns.

The women often have to travel long distances to the nearest cancer centre
to get treatment.

With this treatment, small beads of palladium, a radioactive material that
releases very low doses of radiation over the course of two months, are
implanted directly into the centre of the breast.

"This has the ability to capture the world's imagination," said Dr. Carol
Sawka, vice-president of regional cancer services at Sunnybrook and Women's
College Health Sciences Centre. "Imagine what it would be like to treat
women in one day instead of weeks and months."

About one woman in nine will develop breast cancer, and 22,000 new cases are
diagnosed each year in Canada. The new treatment could potentially be made
available to 10 to 20 per cent of them, once it is approved, which could
take up to four years, Pignol said.

`Imagine what it would be like to treat women in one day instead of weeks
and months.'  Dr. Carol Sawka, Sunnybrook and Women's College Health
Sciences Centre

The eligible women are those who have had surgery to remove an early-stage
breast cancer tumour that has not spread to the lymph nodes. The women also
take the drug tamoxifen for five years after treatment.

The six women who have received the new treatment are part of ongoing study
targeting 65 patients.

At that point, it will be evaluated for side effects and, if effective, it
could be expanded to other cancer centres within two or three years, he
said.

"At this point, we have to be very prudent. We don't want to rush and appear
overconfident," he said.

The treatment, called brachytherapy, has been successfully used to treat
prostate cancer for about three years.

But to use it in women, researchers had to develop a device that would allow
them to accurately target the breast tumour scar tissue, where most residual
cancer cells remain.

That device is a small box filled with holes, through which long needles
filled with palladium seeds can be injected into the breast scar.

"I think it's a Canadian world first," Pignol said, "because Canada has a
very long radiation history," which includes developing the first "cobalt
bomb." The University of Toronto's department of radiation is one of the
largest in the world.

A major study last year that showed treating the breast scar tissue with
radiation was as effective as treating the entire breast led scientists at
Sunnybrook to begin thinking of ways to adapt the prostate cancer treatment
for breast cancer, Pignol said.
The treatment takes only one hour, using local freezing, and none of the
women had any skin burning or pain.

The treatment has the potential of being used on other cancers down the
road, he said.

"It's simple, more accurate and less of a burden for patients."
-----------------------------------