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The Breast Cancer Society of Canada

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Protecting the heart during breast cancer radiation treatment

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Omar El-Sherif, TBCRU Trainee

My name is Omar El-Sherif and I am a PhD candidate at the Schulich School of Medicine & Dentistry at Western University, and a trainee in the Translational Breast Cancer Research Unit (TBCRU) at the London Regional Cancer Program. Prior to becoming a trainee I was involved in the development of a tool to help assess heart health using magnetic resonance imaging (MRI). After completing that project, I was recruited by Dr. Stewart Gaede, an Assistant Professor in Medical Biophysics at Schulich Medicine & Dentistry, and a Medical Physicist at the London Regional Cancer Program to pursue a PhD under his supervision. Dr. Gaede is a world expert in radiation treatment of tumours that move around due to normal breathing, such as lung tumours. Targeting “moving lung tumours” requires advanced imaging to accurately capture the motion to ensure that the tumour is effectively treated with radiation while leaving the surrounding healthy organs in a patient’s body relatively unharmed. One of these advanced imaging techniques is referred to as “4D-CT”.

Dr. Gaede and I are currently translating both of our expertise toward the development of new radiation treatment techniques for breast cancer. One common side-effect of left-sided breast radiation treatment is heart disease. This occurs in some breast cancer patients whose hearts are situated near the cancer site to be treated by radiation. The heart is another organ that moves significantly during a patient’s normal breathing. Using more advanced imaging than is typically used for breast cancer patients, we can design treatment plans that only expose the cancer site to radiation when the heart is furthest from the treatment site. To help you visualize this, click on the video link below. If you look closely you’ll see that as the patient inhales the heart moves away from the treatment site and as the patient exhales the heart moves closer towards the treatment site (the treatment site and heart are coloured in RED and purple respectively).

My background in cardiac MRI allows me to identify which portions of the heart are likely most sensitive to radiation so that in the future we have a better idea of which cardiac structures are most important to avoid during breast cancer radiotherapy.

Both my supervisor and I are really passionate about this project and through our hard work we were able to translate our research work into the clinic. Currently, all left-sided breast cancer patients at the London Regional Cancer Program receive the more advanced 4D-CT rather than the standard CT prior to radiation treatment. We are confident that with the extra information from the 4D-CT we will be able to reduce the risk of cardiovascular disease in breast cancer patients and thus improve their overall quality of life after cancer treatment. For me, this is a wonderful project with immediate applicability to patients and I get to do it with a very talented and highly supportive research team. On behalf of our team we’re truly grateful for the funding and support from the Breast Cancer Society of Canada and the Translational Breast Cancer Research Unit. Without their help this work would not be possible.

Currently, I’m preparing an abstract for the Canadian Organization of Medical Physicist’s 2014 Annual Meeting in Banff, Alberta. We plan to showcase our work and to report to other Canadian Cancer Centres the details of our first clinical experience using 4D-CT for breast cancer patients.

Link to CTV News London Video: Heart protection for breast cancer patients

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