IORT Offers One-and-Done Treatment for Select Cancer Patients

For decades many cancer patients’ typical treatment involved the trifecta of surgery, radiation and chemotherapy. But cancer care is evolving, and recent innovations are allowing for easier and faster treatment regimens.

A prime example is now available for some breast cancer patients at The University of Kansas Cancer Center who qualify for a “one and done” option that provides all the radiation therapy they need in conjunction with a lumpectomy in a single procedure. For Colleen Markman, 63, of Olathe, Kansas, intraoperative radiation therapy (IORT) made a world of difference.

A firm believer in the value of annual screening mammograms, Colleen had no family history of breast cancer but never failed to be screened using 3D mammography. “I’ve had quite a few friends and co-workers diagnosed with breast cancer, and I knew that those who found it early had an easier time with treatment and recovery,” she says. “But I never really expected to be the person with a diagnosis myself.” 

In November 2020 Colleen’s screening mammogram detected an area needing further evaluation. A follow-up ultrasound led to a biopsy. “I was freaked out,” Colleen admits. Her primary care physician referred her to the cancer center where she had additional tests. “I had a biopsy on December 11 and got the call on December 15 that I had invasive ductal carcinoma,” she recalls. “That afternoon I made my first appointment with Dr. Kilgore.”

Lyndsey Kilgore, MD, a breast surgical oncologist with the cancer center, met with Colleen just before Christmas. Along with a radiation oncologist, Dr. Kilgore determined that Colleen would qualify for intraoperative radiation therapy (IORT), which The University of Kansas Cancer Center began offering in January 2021. IORT is an intensive radiation treatment that's administered during surgery.

IORT is also an option for some patients with prostate and other cancers, Dr. Kilgore explains, noting that it is appropriate for specific tumor types, stages and sizes. Women older than 45 are considered for the treatment if they meet other qualifying parameters. Fortunately, Colleen’s cancer was a small, early-stage tumor, and her cancer-free history, type of cancer and age made her a candidate for IORT.   

IORT adds about 15-to-30 minutes to an outpatient lumpectomy procedure. The surgeon removes the tumor and prepares the resulting cavity to receive a thin probe with a bulb on the end. The surgeon then places the probe into the cavity, and the radiation oncologist delivers radiation directly through the probe to the internal site. The radiation dose and duration vary depending on the patient’s individual needs.

“Once IORT is administered, for 85% to 90% of patients there is no need for follow-up external beam radiation therapy,” Dr. Kilgore says. “This typically saves people 3-to-5 weeks of daily radiation treatments, so it really allows patients to get back to work, and back to life and what they enjoy much faster.”

She adds that the procedure is now considered standard of care for certain cancers. It has fewer side effects than external beam radiation, and patients experience improved cosmetic results. The focused nature of the radiation dose means less healthy tissue is exposed, and the single treatment is typically covered by insurance and is less costly than a full course of external beam radiation. The risk of cancer recurrence is virtually the same for IORT and external beam radiation.

Taken together, the benefits of IORT make it an increasingly popular choice for patients and physicians alike. “Breast cancer treatment is constantly evolving and changing, and we stay up with the best practices in our field,” Dr. Kilgore says. “We know that a cancer diagnosis is stressful and overwhelming, but we’re our patients’ team, and we’re excited to offer the best opportunities for treatment and a return to normal life.”

Colleen was home by 1 p.m. after an early morning lumpectomy and IORT in January 2021. Her follow-up pathology tests indicated no evidence of disease, and Colleen quickly recovered and returned to work as a reading specialist for the Olathe School District.

Because her medical oncologist, Qamar Khan, MD, found that Colleen’s cancer was hormone positive, which means hormones fueled Colleen’s cancer, she now takes medication to suppress her hormones and help prevent recurrence. Colleen sees Dr. Khan regularly to monitor her medication dose and any possible side effects. “Really, though, Dr. Khan has encouraged me to eat well and exercise and just live my best life,” she says.

Colleen is grateful for many things. “I’m blessed that my cancer was found early, I’m cancer-free now, I have supportive family and my team at the cancer center took such good care of me,” she says. “I’m just enjoying life and I feel great.”