Radiotherapy for breast cancer: Sergey Golub at the International Conference

Sergey Golub, head of the radiotherapy service at the "Erebuni" Radiotherapy Center, participated in the annual international oncology conference organized by the "Erebuni" Medical Center in collaboration with the Ministry of Health of the Republic of Armenia, Davidiants Laboratory, and the "Friends' House" organization. The conference focused on the diagnosis and treatment of breast cancer.

Golub presented the Center's capabilities, the equipment and special means of breast radiation, which are used in the center. In his report, he explained how and when radiotherapy is applied for this condition and emphasized the importance of conducting radiotherapy while holding one’s breath.

According to him, for most breast cancer patients, radiotherapy is a treatment phase that cannot be skipped under any circumstances. There is only a small group of patients, about 20% of all cases, for whom it would be relatively safe to forego radiation therapy.

Why is radiotherapy so important?

Radiotherapy is primarily aimed at preventing cancer recurrence after surgery.

"The main goal of radiotherapy is to prevent recurrences so that nothing 'grows' at the site of the surgery," explained the specialist.

Radiotherapy is especially indicated for younger patients, as their disease often develops more aggressively than in older patients. Therefore, it is crucial for young patients to utilize the full range of available treatment methods: surgery, medication, and radiotherapy.

How long does radiation therapy last today?

Radiotherapy is not a one-time procedure; it often involves several sessions. However, in recent years, the number of sessions has significantly decreased. Previously, patients needed about 30 sessions, attending daily for more than six weeks, akin to going to work. Today, many patients find that 16-20 sessions are sufficient, and in some cases, the number can be reduced to as few as 5.

According to the doctor, reducing the duration of treatment courses positively impacts patients’ mental states and morale, as the need to visit the treatment center daily for several weeks can be exhausting. At the same time, if approached correctly, reducing the duration of the course does not adversely affect the treatment’s effectiveness and outcomes.

Regarding each session's duration, it typically lasts about 15-20 minutes, including all necessary preparations for the procedure.

Breath-holding technique in radiotherapy

Today, when treating breast cancer, particularly when the left breast is affected, radiotherapy is conducted using a breath-holding technique. This approach has several significant advantages:

• It reduces the dose of radiation to the heart.
• Since the rib-cage wall does not move while holding the breath, there is no need to account for the depth of inhalation and exhalation, allowing for a reduction in the volume of radiation.
• When a person takes a deep breath, the lungs expand, which not only better protects the heart but also decreases the proportion of lung tissue exposed to ionizing radiation. This all reduces treatment toxicity.

"For these reasons, we actively utilize breath-holding during treatment in our clinical practice, including for right breast cancer treatment," noted Dr. Golub.

Radiotherapy after mastectomy

Many patients who receive breast implants after mastectomy wonder how radiotherapy will affect these implants and whether issues might arise. As the specialist explained, the doses of ionizing radiation used in breast cancer treatment do not affect the integrity or structure of the silicone implants themselves.

However, there is a risk of a fibrous capsule forming around the implant, which can compress it and distort the breast. It is important to note that the formation of a fibrous capsule is a common issue that can occur even after aesthetic breast surgery unrelated to cancer treatment.

"There is a risk of fibrous capsule formation both after radiotherapy and without it. In the past, 15-20 years ago, this risk was significantly higher after radiotherapy due to much more limited options regarding dose and technique. However, today’s modern systems ensure a more uniform distribution of the radiation dose, significantly reducing the frequency of fibrosis and other complications. While our priority is preserving life, we also strive to achieve the best cosmetic results," said the specialist.

Radiotherapy for pain syndrome treatment

Pain syndrome is a common issue faced by cancer patients, typically caused by tumors spreading into the bones.

Radiotherapy can be an effective means of combating such pain, although the results may not be immediate but rather take some time to manifest.

"Many patients report that their pain decreases during treatment or immediately afterward, and it becomes easier to manage with fewer painkillers. Overall, their well-being and quality of life improve," noted the doctor.

Radiotherapy affects pain in several ways:

• By reducing the size of the tumor and preventing its spread.
• By decreasing sensitivity in the affected area’s nerve endings.
• By reducing pressure within the bones.

These factors, as Sergey Golub pointed out, can significantly alleviate pain, even if they do not eliminate it entirely.

Prominent specialists from various countries, including oncologists, chemotherapists, surgeons, and radiotherapists from Russia, Iran, Georgia, Spain, and the USA, arrived in Yerevan to participate in the Armenian conference on breast cancer. They discussed issues related to the diagnosis and treatment of breast cancer with their Armenian colleagues.

During the conference, several Armenian and foreign doctors, including Sergey Golub, received awards from the Ministry of Health for their contributions to the treatment of breast cancer in Armenia and around the world.