Your DIBH questions answered

Patients often have a lot of questions about DIBH treatment, the process and what to expect. Below are a number of the most common questions patients ask, which you may find useful.

If you have other questions then please speak to your doctor, or call one of our centres – we are always happy to help.

What is deep inspiration breath-hold (DIBH)?

Deep inspiration breath-hold (DIBH) is a method of delivering radiotherapy, which limits the amount of radiation exposure – usually to the heart, during left breast cancer treatment.

Very simply, the technique involves a patient holding their breath for around 20 seconds at a time during treatment.

There a two basic methods of performing DIBH, free-breathing breath-hold and spirometry-monitored deep inspiration breath hold

Free-breathing deep inspiration breath-hold (FB)

The free breathing technique involves a patient breathing freely, then taking a deep breath and holding it at a comfortable level for at around 15-20 seconds. This is repeated until the patient is confident that they can replicate this process during treatment.

There are some studies that suggest this is less accurate way of performing DIBH because patients have no way of truly knowing if each breath hold is the same, and patients can slowly exhale breath without realising it.

Spirometry-monitored deep inspiration breath-hold (DIBH)

This is the method used across all GenesisCare centres. Using this technique the patient wears a pair of special goggles which has an easy-to-read visual display inside them. Using a simple traffic light, stop-start system, it displays the patient breath intake, tells them when to hold their breath, monitors the breath to make sure none is released and then tells the patient when to exhale again.

Studies have demonstrated that this method gives the most reliable and accurate deep breathing results.

What are the benefits of using DIBH?

DIBH causes the lungs to expand which moves the breast outwards and pushes the heart inwards, thereby reducing the risk or amount of radiation exposure to the heart.

A recent, peer-reviewed study by GenesisCare found that the risk of serious cardiovascular side effects and death is higher in patients who do not receive DIBH.

Who is offered DIBH?

At GenesisCare, all patients being treated for left-sided breast cancer will be offered and assessed for their eligibility and capability to have DIBH. Since introducing the technique, we have treated 95% of all eligible and capable left-sided breast cancer patients with it.

Because DIBH eliminates movement caused by breathing, it can also be suitable for certain thoracic or abdominal cancers.

Are there any risks associated with DIBH?

There is no evidence of any risk associated with DIBH.

To ensure patients are also appropriately assessed for potential cardiac risk, GenesisCare follows protocols to ensure all patients treated for with DIBH undergo a pre-participation cardiac assessment.

Will I suffer from any side effects?

Patients may experience side-effects associated with radiotherapy. However, DIBH is a technique designed to reduce the potential for heart-related side-effects.

What happens if I’m unable to master the breath-hold technique?

Although most patients find the technique relatively easy, not all patients can master or tolerate it. If this is the case, patients are offered normal free-breathing radiotherapy and every effort is made to shield their heart from the radiation beam as much as possible.

Is DIBH painful or uncomfortable?

No, patients do not feel pain because of this technique and most patients cope with it very well.

How will I know if DIBH is suitable for me?

At GenesisCare, each potential DIBH patient is invited to a training appointment with experienced radiographers to ensure they are comfortable with the equipment and holding their breath for a short period of time. At this appointment the radiographers assess whether DIBH will be beneficial and will organise a CT planning scan.

What happens during radiotherapy treatment with DIBH?

There are various resources about DIBH, including patients own descriptions about having treatment, which you may find useful.

If you have any questions or concerns about deep inspiration breath hold (DIBH) or would like to find out more about other treatments and services offered by GenesisCare then please contact the centre nearest to you.

 

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On 8th January 2016, we changed our name to GenesisCare.