One Dose, One Time Early Stage Breast Cancer Treatment Comes to New Zealand




A team of Auckland breast cancer specialists is bringing an innovative one dose, one time treatment for women with certain types of early-stage breast cancer to New Zealand.

Focus Radiotherapy, a New Zealand clinician-owned specialist radiation therapy service is introducing the new treatment option using the Zeiss Intrabeam intraoperative radiotherapy (IORT) system to the Southern Cross Hospital, North Harbour Auckland and intends to make it available to women across the country.

The new treatment means a reduction in radiation treatment time for the patient; minimised exposure to healthy tissue and organs, such as the ribs, lungs, heart and opposite breast; no treatment delay for patients who must also undergo chemotherapy as part of their breast cancer treatment; and same day treatment with no hospitalisation required.



One of the founders of Focus Radiotherapy, Auckland Breast Surgeon Dr Erica Whineray Kelly says: `This may be an excellent therapy option for women having breast-conserving surgery, also known as a lumpectomy. We are the first and only centre in New Zealand offering this revolutionary treatment. The Intrabeam system is used to deliver a prescribed dose of radiation during breast conserving surgery. The goal of this approach is to destroy remaining cancer cells, helping to prevent the possibility of recurrence – and in most cases – eliminating the need for weeks of radiation treatments. Women who have been diagnosed with early-stage breast cancer should talk with their doctor about whether this treatment is right for them.

Chairperson of the Breast Cancer Aotearoa Coalition (BCAC), Libby Burgess, says Intrabeam is a wonderful innovation for women with low-risk early breast cancer: ‘The delivery of surgery and radiotherapy during a single operation will eliminate weeks of daily trips to the clinic, allowing women to avoid ongoing stress and inconvenience and return to their normal lives much faster. 

‘The precise targeting of radiation to the area that the tumour was removed from will avoid unnecessary radiation to healthy tissue.  I’m delighted to see this option being offered to New Zealand women’, Ms Burgess says.

Currently only women who have early-stage breast cancer, have negative lymph nodes and are 50 and older may be candidates for Intrabeam. The clinically documented treatment delivers a single fraction of radiotherapy in 20-30 minutes during the time of lumpectomy. Other forms of radiation therapy can require three to six weeks of treatment.

‘With this new less-invasive treatment, the small spherical tip of a miniaturized radiation device is inserted into lumpectomy incision, Dr Whineray Kelly explains. ‘The therapy is delivered while the patient is still asleep from the lumpectomy. No additional surgery is needed, and both treatment time and radiation exposure are reduced. This can contribute significantly to helping patients get back to their lives more quickly.’

Localizing the radiation inside the breast is effective because this is where cancer is most likely to recur. The international TARGIT research group has been investigating this new method of delivering radiotherapy for breast cancer in which the treatment can be delivered at the time of surgical lumpectomy since 1988. The results of the trial show the overall number of recurrences of the cancer was very low[1].

Dr Whineray Kelly adds: `Radiotherapy delivered at the time of surgery is an exciting advancement. By delivering radiation intraoperatively, primarily the tumor bed is targeted, therefore patients benefit from less ‘scatter radiation’ to the lungs and heart, and fewer cosmetic problems with the breast.’

Intrabeam can also be used for a boost treatment during surgery and to deliver a prescribed dose of radiation therapy in conjunction with whole breast radiation.




How INTRABEAM Works

 Step 1. INTRABEAM IORT is delivered during the lumpectomy procedure, immediately following tumour removal

Step 2. After the surgeon has removed the tumour, the radiation oncologist positions the INTRABEAM applicator in the area of the breast where the tumour was located.

Step 3. Low energy radiation is delivered locally to the targeted tissue in the tumour bed, minimizing healthy tissue exposure to radiation.

Step 4. After 20-30 minutes of radiotherapy, the applicator is removed and the surgeon then closes the incision.

Benefits of INTRABEAM
  • A reduction in radiation treatment time for the patient
  • Minimized exposure to healthy tissue and organs, such as the ribs, lungs, heart and opposite breast
  • No treatment delay for patients who must also undergo chemotherapy as part of their breast cancer treatment
  • Same-day treatment with no hospitalisation required
  • No travel required to a radiotherapy centre for up to six weeks of daily treatment


Further information:

Peter Boyes, BPR: 0275 540 500

Dr Erica Whineray Kelly: 027 453 0020

Focus Radiotherapy PO Box 31-415, Milford, Auckland 0741
| E erica@focusradiotherapy.co.nz | www.focusradiotherapy.co.nz




[1] Vaidya JS, Joseph DJ, Tobias JS, Bulsara M, Wenz F, Saunders C, et al. Targeted intraoperative radiation therapy versus whole breast radiation therapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial. The Lancet 2010; 376: 91 - 102
 Vaidya et al. “Targeted intraoperative radiation therapy for early breast cancer: TARGIT-A trial – updated analysis of local recurrence and first analysis of survival”. San Antonio meeting 2012, S4-2.

Stress on Rural Business Prompts New Initiative From Business Mentors

Business Mentors New Zealand has announced a new initiative to increase business mentoring support to rural businesses throughout New Zealand, which are facing increasing levels of stress worsened by the aftermath of the recent drought, tighter regulations on health and safety, and environmental controls.

The new initiative supported by the Ministry of Business, Innovation and Employment sees the $150 Business Mentors’ registration fee waived for businesses in areas where a medium-scale drought was declared. The country’s 17 Business Mentoring agencies are being encouraged to place greater emphasis on supporting rural enterprises.
Ray Schofield CEO of Business Mentors New Zealand says: `We know that your typical Kiwi guy won’t ask for the help that could help him take his company to the next level.
The purpose of this initiative is to assist rural businesses affected by the drought in those areas where the medium-scale drought has been declared. The funding is specifically to enable free client registrations that normally cost $150. Funding of these registration costs are seen as a means of removing any real or perceived barriers to business owners accessing support from BMNZ.’

Rising pressures on farmers and recent statistics that show stress and depression is a real issue in rural communities, which has serious economic consequences. Ministry of Health data shows the suicide rate for those living in rural areas is 16 per 100,000 people, compared to a rate of 11.2 per 100,000 people in urban areas

Lack of support for farmers in particular leads to poorer decision making on farm, affecting animals and the whole farm system.  This often leads to poorer farm productivity and profitability.

Ray Schofield explains: `A business mentor is unique one-to-one, confidential and highly experienced in the trials and tribulations of running a small to medium sized enterprise. One of the big things is the isolation which rural businesses are often faced. A business mentor takes that away and provides a sounding board to take the company to the next level.’

Business Mentors New Zealand is the country’s only national volunteer business mentoring service. The not for profit organisation helps around 250 businesses find a mentor every month and has assisted more than 65,000 small to medium-size enterprise owners in New Zealand in the last 22 years. Business Mentors provides access to over 1,900 volunteer mentors (who give their experience, skill and knowledge free of charge). The $150 registration fee allows mentoring for up to two years.

Rural businesses who wish to apply for a mentor under this new initiative are advised to call 0800 209 209 to see if they meet MBIE criteria for a registration code.
For more information please visit www.businessmentors.org.nz
Peter Boyes, Boyes PR - 0275 540 500 peter@boyespr.co.nz

Ray Schofield, Business Mentors - 027 473 5435

CHIROPRACTORS CALL FOR KIWIS TO STRAIGHTEN UP BEFORE THEY FLY

New Zealanders taking to the air in search of a temporary break in warmer climes are warned to take extra special care by the New Zealand Chiropractors’ Association because of the extra strain on the spine and nervous system caused by the country’s long distance from almost anywhere.
Dr Hayden Thomas, chiropractor and spokesperson for the New Zealand Chiropractors’ Association explains: ‘We do see a spike in people visiting us when they get back from a journey overseas. We are a long way from anywhere so the effects are often more pronounced than for other nations. Long periods sitting in cramped positions on planes and in transit lounges, sleeping in different beds and without familiar supportive pillows, reduced hydration and the stress of travel and time zones on the nervous system can all take their toll.
`Turbulence shock and the vibration we experience sitting on long journeys in planes may also cause a change to the structure of the discs between the spinal bones and lead to stiffness and discomfort with increased likelihood of a disc bulge and nerve compression.  We remind people to stay well hydrated and move around regularly during the journey. At this time of year when people tend to take international journeys to escape the New Zealand winter it’s important to be in great health so one can enjoy their holidays.’
The Straighten Up New Zealand (SUNZ) website www.straightenup.org.nz has a series of simple exercises taking just three minutes to complete, to help improve posture, stabilise core muscle groups, enhance health and prevent spinal disability. 
Dr Thomas adds: `We’re also asking people to think about their spines before they fly by keeping the weight in their suitcase to a minimum. Don't be tempted to over fill your suitcase and choose appropriate luggage with wheels or padded and supportive straps. Try our SUNZ exercises to help alleviate muscle tension and joint stiffness during the flight and take care of your spine when lifting your case from the carousel and also loading it into taxis and cars. Keep your back straight, use your core strength, bend from the knees and be sure to use airport trolleys when available. A quick trip to your chiropractor before you fly to help optimise function and prevent any potential injuries is also a great idea.’
The NZCA advises that stretches may help to ease any muscle tension during and after your journey and elevating your legs so that your feet are higher than your knees and regular movement en route should help reduce swelling and incidence of deep vein thrombosis (blood clots).
Healthy food choices, minimal alcohol consumption and adequate sleep while on holiday also help to keep you feeling and functioning at your optimum.
In flight exercises may also include:
SEAT STRETCHES
Sit upright with your shoulders relaxed. Tilt your head forwards until your chin rests close to your chest. Take a big breath in hold for the count of 5 then breathe out and relax. Repeat holding head to either side.
CHIN TUCKS
Sit upright and gently tuck your chin backwards like you are trying to make a double chin. Hold for 5 five seconds, relax and repeat 3 times.
SEAT SHRUGS
Sit up straight, relax and keep your head still. Place your hands on the armrests and hunch both shoulders upwards. Hold for 5 seconds, repeat three times.
ARM & HAND STRETCHES
Sit slightly forwards. Raise your arms up straight and interlock your fingers, palms facing downwards. With your fingers interlocked, turn your palms upwards. Try and keep your elbows straight and fell a slight stretch in both arms. Hold the stretch for five to ten seconds and repeat.
TOE & HEEL TAPS
Sit with your back straight with both feet flat on the floor slightly apart. Lift the toes of both feet up as high as you can. Both feet flat on the floor again. Lift heels up high, keeping the balls of your feet on the floor. Repeat ten times.
KNEE LIFTS
Sit up straight forearms and elbows flat on the arm rests. Lift your right leg up with your knee bent, and then lower it. Repeat this action with your left leg. Alternate legs repeat 20 times.

For further information on the New Zealand Chiropractors’ Association visit
www.chiropractic.org.nz. 
-Ends-

Further Information:

Dr Hayden Thomas, Chiropractor 027 299 9939 or hayden@chiropractic.org.nz


Peter Boyes 027 554 0500 or peter@boyespr.co.nz