Radiation is an integral part of cancer treatment, but people fear radiation therapy due to the damage it might do to adjoining organs. Radiation can sometimes be harmful to some organs where exposure to the radiation beam is unnecessary, and respiratory gating has proven to be lifesaving in various cases.
An example of such a case is a 58-year-old female with breast cancer (a locally advanced, left-sided breast carcinoma). Her medical records confirmed a heart disease (coronary artery disease), and she was treated with heart stenting six months back. The previous medical condition turned out to be a complication of traditional cancer treatment, but through the DIBH technique, we were able to save her heart and coronary arteries. She tolerated the treatment well and had no cardiac compromise post the treatment. Her routine Echo report was up to the mark, and she survived cancer with cardiac disease.
What is DIBH treatment?
Deep Inspiration Breath Hold (DIBH) is a technique used when breast cancer patients receive radiation treatment. It is a radiation therapy technique where patients take a deep breath during treatment and hold this breath while the radiation is delivered. Holding a deep breath while receiving radiation therapy is one of many techniques used to help physicians reduce the amount of radiation that reaches the heart. When we inhale our lungs fill with air, and the heart moves away from the chest.
The DIBH technique delivers the radiation only at the targeted points when the patient inhales. The patient takes a deep breath in and holds their breath for about 20 seconds limiting the exposure of the heart and lung to the radiation.
What is the advantage of DIBH?
1 GY (1 unit of radiation) increase in the dose to the heart, increases the risk of heart disease by 7%. When the person holds the breath during DIBH, the lungs expand, and so the heart is further from the treatment beam. This reduces the risk of the radiation damaging your heart. At Nh, we have treated over 15 patients using DIBH techniques with excellent results.