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Targeted radiotherapy during surgery cuts breast cancer patients' travel - study

Published 10/05/2016

Under current standard treatment for breast cancer, the cancerous tissue is cut out in a procedure known as a lumpectomy
Under current standard treatment for breast cancer, the cancerous tissue is cut out in a procedure known as a lumpectomy

Giving breast cancer patients a targeted dose of radiotherapy during surgery would save them millions of miles travelling to and from hospital appointments, according to a study.

The procedure, which is widely available in other countries but not on the NHS, would also reduce carbon emissions, the research says.

Under current standard treatment for breast cancer, the cancerous tissue is cut out in a procedure known as a lumpectomy and patients then undergo a course of daily radiotherapy lasting three to six weeks.

But under an alternative form of treatment, patients have a single dose of targeted intraoperative radiotherapy, known as TARGIT, while still in the operating theatre.

This adds around 20 to 40 minutes to the operating time, but in most cases avoids the need for daily hospital visits to complete a standard course of radiotherapy.

The study, published in the BMJ Open journal, says the method saves patients hours in unnecessary trips to the hospital and slashes harmful carbon emissions.

Researchers said TARGIT is as good as standard external beam radiotherapy (EBRT) in suitable patients with an early stage of the disease, and it is routinely offered as a treatment option in many countries, although it is not widely available in the UK.

The report's authors wrote: "The management of breast cancer has changed over the decades. However, the requirement of patients to travel to receive these specialist services is often forgotten by policy-makers."

They added that "introducing TARGIT as an option for appropriate patients in the UK will contribute significantly to saving patients time, cost, fuel and CO2 emissions".

Researchers compared the journey times and environmental impact of the two different types of treatment among 485 patients.

They found that TARGIT patients travelled significantly fewer miles than patients receiving the standard treatment for their treatment, and spent far less time in transit.

When applied to the 50,000 cases of breast cancer diagnosed in the UK every year, researchers calculated that TARGIT could save five million miles in journeys and 170,000 hours of travel time.

It would also slash carbon dioxide emissions by 1,200 tonnes - equivalent to a forest of 100 hectares - every single year, the study found.

Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: "While this study suggests intraoperative radiotherapy could be more cost-effective for patients and the environment, what we really need is greater evidence of its clinical effectiveness.

"If intraoperative radiotherapy was actually proven to work, it could allow some patients to be safely spared multiple cycles of radiotherapy after surgery.

"As such, delivering targeted radiotherapy during surgery - instead of after - could help minimise the impacts of unnecessary travel to and from specialist hospitals for patients."

She said the National Institute for Health and Care Excellence (Nice) is currently assessing the evidence.

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