Treating breast cancer with DIBH
Debbie Callow, from Birmingham, was the first patient to use a revolutionary deep inspiration breath-hold (DIBH) device at a GenesisCare centre. The device reduces the dose to surrounding healthy tissue and organs at risk and is unique in that it allows radiotherapy patients to actively participate in their treatment.
Debbie’s left-sided breast cancer was within 0.1mm of her breast bone and within close proximity of her heart. She knew this meant there was a small risk of long-term heart damage as a result of radiotherapy treatment, so was interested to hear about the DIBH device which uses a spirometer-based design to enable the patient to control their breathing during their radiotherapy treatment, demobilising the tumour and ensuring it can be targeted as accurately as possible.
"As an occupational health nurse I'm always telling people to go straight to their GP with any health concerns, yet I didn’t practice what I preach and just kept putting the lump to the back of my mind.
It was my fiancé, Patrick, and friends at work who nagged me to go to see my GP. I was sent for a biopsy, mammogram, and ultrasound tests and found out I had a grade 3 tumour in my left breast.
It was a complete shock, as I have no family history of breast cancer or anything like that. I was told it was a particularly aggressive cancer and if I’d left it for even three or four months before seeing my GP it would have been a very different story.
I was treated for skin cancer ten years ago, and my initial concern was that the breast cancer was secondary cancer which I know would have been a lot more complicated to treat. The good news – if you can call it that – was that it was primary cancer.
However, the tumour was so close to my breast bone, which did concern me and spoke to my consultant about this. I chose to be treated at Genesis Care's centre in Little Aston as it routinely delivers advanced image guided radiotherapy which targets the tumour more precisely and so reduces the risk to healthy tissue and organs close to cancer.
I found out that they were just about to start using this new breath-hold treatment; the timing was perfect for me. I visited the centre several times to go through and understand what was going to happen, as well as use and become familiar with the breathing device. I’m quite lucky because it was just like the lung function tests that I demo for my job so I took to it quite easily, although everyone was happy for me to practise as much as I liked until I was completely comfortable with it before my radiotherapy treatment actually began.
I didn’t have any concerns about being the first patient to use it. I wanted to do anything that reduced the risk of possible damage to my heart – however small that risk was, and the team at GenesisCare were fantastic.
First, I was asked to inflate my lungs for around 20 seconds so my natural breathing and lung capacity could be measured. My breathing pattern was taken and displayed this onto video goggles for me to use during the actual treatments.
The radiotherapy treatments weren’t very long. During them, I just had to follow the breathing pattern on the video goggles and hold my breath.
I’ve been scuba diving before, and the mouth-piece and goggles were a bit like wearing scuba diving breathing equipment. It felt strange and I needed to concentrate on my breathing, to begin with, but then it became second nature. I have to hold my breath for anything up to twenty-five seconds, so I’m not gasping for breath or anything. And the radiotherapists are talking with me via the intercom system all the time which is very reassuring.
The great thing is I was in control if I needed to suddenly take a breath or have a cough or something the radiotherapy machine would stop, and the team would begin treatment again once I was ready. This didn’t happen very often, but it was very reassuring to know it wouldn’t be a problem.
I had to take time off when I had my chemotherapy as I felt very sick and tired, and it gets you down. However, I worked all through my radiotherapy treatment which really helped me emotionally. I thought I’d be more tired with the radiotherapy, but I have been fine which is great. I got into the routine of having my treatment in the morning on my way to work, which was great. I could just carry on as normal, and have had amazing support from all my colleagues.
I still have to have follow-up appointments and more tests, but I already feel I’m well on my way to recovery. I feel really positive for the future. I’m getting married in a couple of months and am really focused on that, and looking forward to it more than ever."