For some breast cancer patients, treatment at Memorial Hospital will now be a lot easier and more convenient.
Memorial Hospital performed its first intraoperative radiation therapy (IORT) on June 24.
For 79-year-old Emilie Fiedler, the medical center's first IORT patient, the procedure replaced weeks of coming to the hospital every weekday for standard radiation therapy. IORT delivers a concentrated radiation dose in a single treatment.
"I feel good and I'm happy," Fiedler said.
Traditionally, breast cancer patients have a lumpectomy - a surgery to remove the tumor - and then return to the hospital Monday through Friday for three to six weeks for standard radiation treatments.
In Fiedler's case, she was able to have surgery, the IORT treatment and go home the same day.
IORT involved inserting a balloon device to the site where her tumor was removed. Then, while Fiedler was under anesthesia on the operating room table, a machine called the Xoft Electronic Brachytherapy System pumped radiation through the balloon. The balloon was removed, and the surgical incision was closed.
"In Mrs. Fiedler's case, it worked out perfectly," said Dr. Jane Ridings, medical director for Memorial's department of radiation oncology.
Not only did the new treatment save time for Fiedler, it also was less painful and less costly.
Fiedler went through daily radiation therapy for a plasmacytoma, a blood cell tumor, in 2012. Her husband of 61 years said going to and from the hospital every day was disruptive.
"You have to plan your whole life around radiation," George Fiedler said.
Since IORT was all the radiation she needed this time, George Fiedler doesn't have to drive Emilie the 20 minutes from their home to the hospital five days a week.
That convenience makes a big difference for breast cancer patients who can't easily make it to the hospital.
"I've had many patients over the years who have decided to have a mastectomy because they weren't able to commit that time," said Dr. Laura Pomerenke, Fiedler's breast surgeon. "They live out of town, they work or transportation is a problem. And that always made me really sad because that's not a good reason to have your breast cut off."
IORT is cheaper, too, allowing patients to avoid co-pays for daily radiation. Ridings said IORT is one-tenth the cost of standard daily radiation.
Though the 45-minute procedure lengthens the initial surgery, it avoids the cost of running external beam radiation machines five days a week. Because the IORT machine is low-energy, it also doesn't require a room with 6 feet of concrete shielding, which is needed for standard radiation machines.
Additionally, IORT comes without the side effects of daily radiation exposure, like itchy, red skin.
It's thanks to another hospital, Poudre Valley Hospital in Fort Collins, that cutting-edge technology for IORT is possible at Memorial. Poudre Valley has been performing IORT procedures since buying the Xoft Electronic Bryachytherapy System in 2011. Since University of Colorado Health operates both hospitals, the machine can be shared.
However, it's a new treatment, and it isn't for everyone. Ridings said IORT is only viable for certain patients - generally older people with low-risk, early stage breast cancer.
Fiedler fit the criteria.
When a biopsy confirmed a small spot in her right breast was cancerous, Fiedler said she wasn't scared. She had already overcome other health problems like the plasmacytoma and a different, stage 0 cancer in her other breast. She wasn't frightened when she came to the hospital the morning of her lumpectomy and IORT surgery.
"I was looking forward to getting it done - to getting it out of the way," she said.
George Fiedler waited for his wife for about three hours.
"They explained everything so my mind was at ease," he said.
Afterward, Fiedler said there was little pain unless she touched the incision site. She hugged her husband and they went home.
"It was so simple," she said.