Quarter-million in grants to Christchurch Hospital will bring new treatments and improve patient safety

March 11, 2016

The NZ Breast Cancer Foundation has committed almost a quarter of a million dollars ($243,000) to new projects at Christchurch Hospital, with an emphasis on improving survival, prolonging life for women with advanced disease, and improved patient safety. The investment is on top of the NZBCF’s $500,000 to-date funding of the Christchurch Breast Cancer Register at CDHB.

Improving cardiac safety for breast cancer patients – new treatment launched today

The NZBCF has paid $113,000 for equipment for Deep Inspiration Breath Hold (DIBH) for patients having radiation to the left side of the chest, making Christchurch the first public hospital to offer DIBH technology to its patients.

Around half of breast cancers are left-sided, and many patients receive radiation therapy after surgery to help prevent the cancer coming back. Until now, patients have been asked to hold their breath while the radiation dose is delivered, but inevitably, vital organs like the heart and lung receive some radiation. This can lead to cardiac problems down the track.

Several overseas studies have shown DIBH can reduce average radiation dose to the heart by 50% or more, with a lesser but still significant reduction in radiation to the lung.

“It’s an awful irony that the treatment designed to save women’s lives and prevent recurrence of their breast cancer can cause heart problems for a few patients,” said Evangelia Henderson, chief executive at the NZ Breast Cancer Foundation. “We want patients not just to be cured of their cancer, but to go on to live long and healthy lives. DIBH is offers a real gain in the safety of radiotherapy, and we were excited that Christchurch Hospital was keen to take this progressive approach.”

Christchurch Hospital’s DIBH programme, which uses the Elekta Active Breathing Coordinator, is officially launched today. It’s the first DIBH technology in a public hospital in New Zealand

Stereotactic brain radiotherapy to be available in Christchurch

The NZBCF will contribute $100,000 towards equipment for Christchurch Hospital to introduce stereotactic treatment for breast cancer patients whose cancer has spread to the brain. Conventionally, patients with brain metastases receive radiation to the whole brain, which can cause negative cognitive effects. Stereotactic radiotherapy delivers high dose, highly precise radiation to a very small area. It has better outcomes in controlling the cancer in the brain and in overall survival, and a much better cognitive outcome.

“Internationally, there is a trend towards more assertive management of the spread of cancer, using radiosurgery or traditional surgery. We talked with Christchurch Hospital about the potential to introduce stereotactic radiotherapy, and they were very enthusiastic about the chance to upskill and to expand their offering for advanced cancer patients,” said Evangelia Henderson, chief executive at the NZ Breast Cancer Foundation. “We’re keen for stereotactic treatments, which can slow disease progression, prolong life, and improving quality of life, to be available to all women who need them.”

An estimated 30% of women with advanced breast cancer develop metastases in the brain, many of them likely to be younger women. The incidence of brain metastases is increasing as new drugs allow women to live longer with their advanced breast cancer. “Some women survive a live a long time with brain metastases – we want them to have the best quality of life, and that includes the best possible cognitive function,” said Evangelia Henderson.

Stereotactic treatment can also be used for breast cancers that have spread to lungs, liver and bones. The NZBCF hopes that treatment at Christchurch will be extended to these areas in future.

Rob Hallinan, acting service manager for oncology and palliative care at Christchurch Hospital, expects the new treatment to be introduced in September. He noted that while the radiation oncology initiatives are for the benefit of breast cancer patients, they will benefit patients with a wide range of cancers including, lung, oesophagus, rectum, prostate and melanoma.

Clinical trial seeks to shrink large tumours before surgery

The final NZBCF grant is $30,000 to support patient participation in the ELIMINATE clinical trial at Christchurch Hospital.  This multi-centre trial, coordinated by the Australia New Zealand Breast Cancer Trials Group, will investigate whether some women with large breast tumours will benefit from being given hormone treatment concurrently with chemotherapy, before surgery. If successful, some previously-inoperable tumours may disappear or shrink to a size that makes them operable, or women with operable tumours might be able to have breast conserving surgery (lumpectomy), instead of more aggressive surgery (mastectomy).

“Women with larger tumours tend to have a lower survival rate, so we’re keen to see the results of this trial, which delivers the benefits of hormone treatment earlier and may also reduce the burden of surgery,” said Evangelia Henderson, chief executive at the NZ Breast Cancer Foundation. The NZBCF is also supporting the ELIMINATE trial at Auckland Hospital.

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