By Jana Soeldner Danger
Katy Casanova didn’t expect to have to relearn how to breathe after she was diagnosed with breast cancer at age 29.
But to make the most of new technology that allows physicians to track a patient’s respiratory pattern to minimize exposure to radiation, Casanova had to learn to match her breathing to the treatment.
Patients hold their breath so that when radiation is delivered, the tumor doesn’t move with respiration and the target is more precise. It’s used with many kinds of tumors that may move when a patient breathes, including lung and liver cancers, as well as left-sided breast cancers. If a patient inadvertently starts to breathe, the machine automatically senses it and treatment stops instantly.
“Deep inspiration breath hold is a cardiac-sparing technique to treat left-sided breast cancer,” says Dr. Laura Freedman, director of radiation therapy for Sylvester Comprehensive Cancer Center at Deerfield Beach, part of the UHealth-University of Miami Health System. “Prior studies indicate that patients with left-sided breast cancer may be at greater risk for developing heart problems from radiation delivered to the left breast. When the patient takes a deep breath during radiation treatments, the chest wall and breast tissue move away from the heart, reducing the radiation dose to the heart and lung.”
Patients are coached on the technique. “We can set parameters to the patient’s breathing pattern, and if she goes outside the parameters, the machine senses it and cuts off,” Freedman says.
Casanova’s case, however, was a bit different. Her breast cancer was on the right side, but her doctors said she had an usual breathing pattern. “They told me they had never seen anything like it before.”
Once her breathing was in sync with the technology, Casanova’s treatment times were cut in half. A psychologist and former singer, she said the training reminded her of training as a vocalist. “I had to relearn how to control those parts of my body again — how to expand and fill my rib cage with air, and how to relax.”
Casanova wanted to finish her treatments as quickly as possible because her grandmother’s 90th birthday party on a cruise was approaching.
“I got my final treatment on a Friday and went on the cruise on Monday,” she says. “We got back the following Friday and I got married on Saturday. It was a nice way to celebrate being finished with my treatments.”