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MarneeSpiererMD
(Physician
- Oncology - Radiation
(Verified)
)
| Communities: Breast Cancer | Thank You's: 5 |
| Member Since: Jul. 2011 | Questions: 0 |
| Answers: 21 |
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Professional Statement
No matter what kind of treatment a cancer patient receives, the fight against cancer is more than a physical challenge. It impacts everything from emotional well-being to financial stability. We at The Farber Center believe that caring for a patient is caring for a person. We realize that people exist within a matrix of family, friends, jobs, homes, neighborhoods, geographical areas, and psychological and cultural environments, all of which can influence health and disease. Our mission is to develop a treatment plan that is right for our patient and their loved ones in an environment that supports and nurtures them.
Professional Info
Credential:
MD
Primary specialty:
Oncology - Radiation
State Licenses:
NY
Gender: Female
Age: 44
Board certifications:
American Board of Radiology
Professional memberships:
Breast Cancer, Partial Breast Irradiation (APBI), Non- invasive APBI
Hospital affiliation:
New York Downtown Hospital
Practice name:
The Farber Center for Radiation Oncology
Practice address:
21 West Broadway
New York, NY
10007
Practice phone number:
212-300-0663
Webpage:
www.thefarbercenter.com
Vitals.com page
http://www.vitals.com/doctors/Dr_Marnee_Spierer.html
Personal Bio (My story)
Dr. Marnee Spierer (Radiation Oncologist): A Board Certified physician in Radiation Oncology and partner at The Farber Center for Radiation Oncology in New York, NY. Dr. Spierer recently served as Assistant Professor of Radiation Oncology at Montefiore Medical Center/Albert Einstein College of Medicine, where she served as residency program director and was instrumental in the education of residents and medical students. Dr. Spierer also played an integral part of the multidisciplinary sarcoma, pediatric and breast tumor boards. She specializes in adult radiation oncology, with particular focus on breast cancer, sarcoma, and stereotactic body and CNS radio surgery.
After receiving her B.A. at the University of Michigan, Dr. Spierer pursued her MA at the Teachers College at Columbia University. Dr. Spierer then went on to pursue her M.D. at Columbia University College of Physicians and Surgeons in New York. Following an internship at Saint Barnabas Medical Center in New Jersey, she did her residency in Radiation Oncology at the Memorial Sloan Kettering Cancer Center. Dr. Spierer is a member of the American Society for Therapeutic Radiology and Oncology, the American Board of Radiology, American Association for Woman in Radiology, American Society of Breast Diseases, New York Metropolitan Breast Cancer Group.
Dr. Spierer has been an invited lecturer on several topics including women's oncology and breast cancer. Her published writings have focused on breast cancer, sarcoma, lymphoma, and pediatric malignancies. She has served as principal investigator on several clinical trials and has been actively involved in many clinical research studies.
After receiving her B.A. at the University of Michigan, Dr. Spierer pursued her MA at the Teachers College at Columbia University. Dr. Spierer then went on to pursue her M.D. at Columbia University College of Physicians and Surgeons in New York. Following an internship at Saint Barnabas Medical Center in New Jersey, she did her residency in Radiation Oncology at the Memorial Sloan Kettering Cancer Center. Dr. Spierer is a member of the American Society for Therapeutic Radiology and Oncology, the American Board of Radiology, American Association for Woman in Radiology, American Society of Breast Diseases, New York Metropolitan Breast Cancer Group.
Dr. Spierer has been an invited lecturer on several topics including women's oncology and breast cancer. Her published writings have focused on breast cancer, sarcoma, lymphoma, and pediatric malignancies. She has served as principal investigator on several clinical trials and has been actively involved in many clinical research studies.
MarneeSpiererMD Activities
Doctors should know about ALL possible side effects that patients are experiencing during treatment. Most are easily treatable (skin changes being the most common) which is why it is important that your doctor see you throughout your course of treatment. Other side effects from radiation treatment could potentially happen weeks, to months, to years after completing therapy. So it is essential to have good long-term follow-up with your doctor and tell him/her anything you are experiencing.
Doctors should know about ALL possible side effects that patients are experiencing during treatment. Most are easily treatable (skin changes being the most common) which is why it is important that your doctor see you throughout your course of treatment. Other side effects from radiation treatment could potentially happen weeks, to months, to years after completing therapy. So it is essential to have good long-term follow-up with your doctor and tell him/her anything you are experiencing.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified))
1
Answer |
1 month ago
Radiation injury to the heart is most often seen in the pericardium and less so in the myocardium – the anterior wall of the left ventricle more commonly than the wall of the right ventricle. Atrial fibrillation(A-fib) happens when the sinus node that sits in the right atria doesn’t function properly. There are many causes of A-fib that are likely more common than a history of radiation. Make sure to discuss with your doctor!
Radiation injury to the heart is most often seen in the pericardium and less so in the myocardium – the anterior wall of the left ventricle more commonly than the wall of the right ventricle. Atrial fibrillation(A-fib) happens when the sinus node that sits in the right atria doesn’t function properly. There are many causes of A-fib that are likely more common than a history of radiation. Make sure to discuss with your doctor!
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified))
1
Answer |
1 month ago
Patients who need radiation after reconstruction are at a risk of complications with regard to their reconstruction. A woman may have her reconstruction done at the time of surgery (immediate reconstruction) or at some point in the future (delayed reconstruction). Each carries with it different possible complications. Patients need to discuss all options with their surgeons – patient’s cancer and their anatomy play an important role in the determination of which type of reconstruction is appropriate. Regardless, it is essential that proper radiation planning take place and good dialogue between the treating radiation oncologist and the plastic surgeon.
Patients who need radiation after reconstruction are at a risk of complications with regard to their reconstruction. A woman may have her reconstruction done at the time of surgery (immediate reconstruction) or at some point in the future (delayed reconstruction). Each carries with it different possible complications. Patients need to discuss all options with their surgeons – patient’s cancer and their anatomy play an important role in the determination of which type of reconstruction is appropriate. Regardless, it is essential that proper radiation planning take place and good dialogue between the treating radiation oncologist and the plastic surgeon.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Radiation Therapy, Radiation Therapy Options, Radiation Risks, Breast Cancer, Radiation, Breast Cancer Radiation Therapy, Breast Surgery Decisions, Breast Surgery, Radiation Treatment, Breast Cancer Treatment, Breast Reconstruction
2
Answers |
1 month ago
I have not seen any cases of delayed breast cellulitis (DBC). (And this does not mean they don’t exist in my patients – just that I have not seen them.) DBC when it happens occurs several months after treatment and is likely caused as a result of the disruption of lymphatic channels after surgery coupled with tissue damage from radiation therapy. DBC can resolve on its own or it can persist for months. Clinicians need to ensure that it does not represent recurrent disease.
With regard to lymphedema – it is hard to determine the exact cause – most patients being irradiated had some form of surgical procedure to their lymph nodes (axillary dissection or sentinel lymph node biopsy, the former carrying a greater risk). In terms of the actual radiation causing the lymphedema, some studies of nodal irradiation show an increase risk as compared to breast-only irradiation, but the numbers include quite a range. (Typically quoted ranges are 5-50%.) I have not seen any cases of delayed breast cellulitis (DBC). (And this does not mean they don’t exist in my patients – just that I have not seen them.) DBC when it happens occurs several months after treatment and is likely caused as a result of the disruption of lymphatic channels after surgery coupled with tissue damage from radiation therapy. DBC can resolve on its own or it can persist for months. Clinicians need to ensure that it does not represent recurrent disease.
With regard to lymphedema – it is hard to determine the exact cause – most patients being irradiated had some form of surgical procedure to their lymph nodes (axillary dissection or sentinel lymph node biopsy, the former carrying a greater risk). In terms of the actual radiation causing the lymphedema, some studies of nodal irradiation show an increase risk as compared to breast-only irradiation, but the numbers include quite a range. (Typically quoted ranges are 5-50%.)
With regard to lymphedema – it is hard to determine the exact cause – most patients being irradiated had some form of surgical procedure to their lymph nodes (axillary dissection or sentinel lymph node biopsy, the former carrying a greater risk). In terms of the actual radiation causing the lymphedema, some studies of nodal irradiation show an increase risk as compared to breast-only irradiation, but the numbers include quite a range. (Typically quoted ranges are 5-50%.) I have not seen any cases of delayed breast cellulitis (DBC). (And this does not mean they don’t exist in my patients – just that I have not seen them.) DBC when it happens occurs several months after treatment and is likely caused as a result of the disruption of lymphatic channels after surgery coupled with tissue damage from radiation therapy. DBC can resolve on its own or it can persist for months. Clinicians need to ensure that it does not represent recurrent disease.
With regard to lymphedema – it is hard to determine the exact cause – most patients being irradiated had some form of surgical procedure to their lymph nodes (axillary dissection or sentinel lymph node biopsy, the former carrying a greater risk). In terms of the actual radiation causing the lymphedema, some studies of nodal irradiation show an increase risk as compared to breast-only irradiation, but the numbers include quite a range. (Typically quoted ranges are 5-50%.)
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified))
1
Answer |
1 month ago
In early stage breast cancer, there is no “test” that makes this determination. There have been several randomized studies comparing surgery alone with surgery plus radiation. To date, all the data suggest a benefit with the addition of radiation therapy to surgery, however the benefit may be small in selected women. And in these women (older, small tumors, node negative), they should hear the data and discuss with their doctors if forgoing radiation is reasonable. There is a new “test” in the DCIS world (ductal carcinoma in situ), and it is called the Oncotype DX. This is a genomic assay that provides an individual prediction of recurrence after lumpectomy without radiation. The test should be used along with the patient’s pathology data and help in the discussion between doctor and patient.
In early stage breast cancer, there is no “test” that makes this determination. There have been several randomized studies comparing surgery alone with surgery plus radiation. To date, all the data suggest a benefit with the addition of radiation therapy to surgery, however the benefit may be small in selected women. And in these women (older, small tumors, node negative), they should hear the data and discuss with their doctors if forgoing radiation is reasonable. There is a new “test” in the DCIS world (ductal carcinoma in situ), and it is called the Oncotype DX. This is a genomic assay that provides an individual prediction of recurrence after lumpectomy without radiation. The test should be used along with the patient’s pathology data and help in the discussion between doctor and patient.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified))
1
Answer |
1 month ago
Most patients don’t really prepare for each radiation treatment. However, there may be a few things you can do to help yourself during treatment. We require our patients to remain still during each treatment – and anything that can help with this is suggested. We have Integrative Therapists at our center who work with our patients to help them feel at ease. For those anxious patients, this is so very helpful. A relaxed patient is a still patient! Also, it is important to keep the area being treated clean and dry at the time of treatment. Creams, as prescribed by your doctor, should be applied after treatment. Know that you will be fatigued (nearly all patients feel tired during radiation therapy) and listen to your body and nap/sleep when you can. Wearing loose-fitting clothes may help if the area of your body being irradiated rubs your clothing.
Most patients don’t really prepare for each radiation treatment. However, there may be a few things you can do to help yourself during treatment. We require our patients to remain still during each treatment – and anything that can help with this is suggested. We have Integrative Therapists at our center who work with our patients to help them feel at ease. For those anxious patients, this is so very helpful. A relaxed patient is a still patient! Also, it is important to keep the area being treated clean and dry at the time of treatment. Creams, as prescribed by your doctor, should be applied after treatment. Know that you will be fatigued (nearly all patients feel tired during radiation therapy) and listen to your body and nap/sleep when you can. Wearing loose-fitting clothes may help if the area of your body being irradiated rubs your clothing.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified))
1
Answer |
1 month ago
Primary treatment is determined by the FIGO (International Federation of Gynecology and Obstetrics) stage. Primary surgical management with hysterectomy is typically indicated in early stage cancers (IA1–IIA), as these cancers are considered resectable. However, primary radiation may also be considered. We have data that show equivalent tumor control and survival between surgery and radiation in early stage disease. For those patients who undergo surgery, some may need post-operative radiation therapy or post-operative concurrent chemotherapy and radiation. We have data that show a decreased rate of local recurrence +/- an improvement in survival with the addition of adjuvant treatment (either radiation alone or radiation + chemotherapy after surgery). The decision to use radiation alone as an adjuvant treatment or radiation with chemotherapy depends on the pathologic findings at the time of surgery. Locally advanced cases (unresectable) - some IB2 and stages IIB-IVA - are treated with a combination of radiation with concurrent chemotherapy. We have data that show superior outcomes with radiation and concurrent chemotherapy versus radiation alone.
Primary treatment is determined by the FIGO (International Federation of Gynecology and Obstetrics) stage. Primary surgical management with hysterectomy is typically indicated in early stage cancers (IA1–IIA), as these cancers are considered resectable. However, primary radiation may also be considered. We have data that show equivalent tumor control and survival between surgery and radiation in early stage disease. For those patients who undergo surgery, some may need post-operative radiation therapy or post-operative concurrent chemotherapy and radiation. We have data that show a decreased rate of local recurrence +/- an improvement in survival with the addition of adjuvant treatment (either radiation alone or radiation + chemotherapy after surgery). The decision to use radiation alone as an adjuvant treatment or radiation with chemotherapy depends on the pathologic findings at the time of surgery. Locally advanced cases (unresectable) - some IB2 and stages IIB-IVA - are treated with a combination of radiation with concurrent chemotherapy. We have data that show superior outcomes with radiation and concurrent chemotherapy versus radiation alone.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified))
1
Answer |
1 month ago
Breast cancer patients can report pain in the irradiated breast for years after treatment. Quality of life studies have actually been to assess this issue. In one study, it showed roughly the same percentage of chronic pain (25%) after lumpectomy + RT and after mastectomy without RT. Other prospective trials followed women after lumpectomy WITHOUT radiation and women WITH radiation. One study showed no difference in breast pain between the two groups at 1 year. The other study showed women who received RT to have more pain in the first 2 years but after the 2-year mark, both groups were the same. After lumpectomy, with modern equipment and technology, skin changes referred to as portal hyperpigmentation, should go away within a few weeks of completing therapy. Telengiectasias – or dilations of the skin vasculature — can be a late effect following radiation for breast cancer. This is much more common after mastectomy than it is after lumpectomy. Skin thickening or fibrosis (referred to here as 'scar tissue') can also occur after radiation to the breast. Most of these late toxicities are influenced by total dose and dose per fraction of the radiation when it was given. So that was the LONG answer — the short answer is that side effects from breast cancer treatment are complex. At the very least, they are quite patient-specific and likely reflect a combination of the surgical procedure and the radiation. It is very important to have good follow-up with all of your breast cancer doctors.
Breast cancer patients can report pain in the irradiated breast for years after treatment. Quality of life studies have actually been to assess this issue. In one study, it showed roughly the same percentage of chronic pain (25%) after lumpectomy + RT and after mastectomy without RT. Other prospective trials followed women after lumpectomy WITHOUT radiation and women WITH radiation. One study showed no difference in breast pain between the two groups at 1 year. The other study showed women who received RT to have more pain in the first 2 years but after the 2-year mark, both groups were the same. After lumpectomy, with modern equipment and technology, skin changes referred to as portal hyperpigmentation, should go away within a few weeks of completing therapy. Telengiectasias – or dilations of the skin vasculature — can be a late effect following radiation for breast cancer. This is much more common after mastectomy than it is after lumpectomy. Skin thickening or fibrosis (referred to here as 'scar tissue') can also occur after radiation to the breast. Most of these late toxicities are influenced by total dose and dose per fraction of the radiation when it was given. So that was the LONG answer — the short answer is that side effects from breast cancer treatment are complex. At the very least, they are quite patient-specific and likely reflect a combination of the surgical procedure and the radiation. It is very important to have good follow-up with all of your breast cancer doctors.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Radiation Side Effects, Breast Cancer, Radiation, Scar Tissue Discomfort, Side Effects, Pain, Radiation Oncology, Cancer, Skin Discoloration
1
Answer |
7 months ago
I am not sure I understand this question. I can answer the following: Under what circumstances is radiotherapy considered necessary for women who DON'T undergo breast-conserving lumpectomies, but rather mastectomies? (I apologize if this is not the intended question.) Radiation is considered standard of care after lumpectomies (also called partial mastectomies). Radiation is also advised after mastectomy in certain clinical situations. And this is based on tumor size, extent of resection (ie were there positive margins at the time of mastectomy?), nodal status (and if so, how many nodes were involved?), and other factors associated with the mastectomy specimen that is reported by the pathologist. In general, radiation is suggested if the risk of local recurrence is significant enough to justify the risks.
I am not sure I understand this question. I can answer the following: Under what circumstances is radiotherapy considered necessary for women who DON'T undergo breast-conserving lumpectomies, but rather mastectomies? (I apologize if this is not the intended question.) Radiation is considered standard of care after lumpectomies (also called partial mastectomies). Radiation is also advised after mastectomy in certain clinical situations. And this is based on tumor size, extent of resection (ie were there positive margins at the time of mastectomy?), nodal status (and if so, how many nodes were involved?), and other factors associated with the mastectomy specimen that is reported by the pathologist. In general, radiation is suggested if the risk of local recurrence is significant enough to justify the risks.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Breast Cancer, Radiation, Radiotherapy, Radiation Oncology, Mastectomy, Breasts
1
Answer |
8 months ago
'synchronous' means 'at the same time'. In this context, it would mean getting chemotherapy and radiation at the same time rather than getting it 'sequentially' or one after the other.
'synchronous' means 'at the same time'. In this context, it would mean getting chemotherapy and radiation at the same time rather than getting it 'sequentially' or one after the other.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Breast Cancer, Radiation, Radiation Oncology, Synchronous Chemoradiation, Cancer, Chemotherapy
1
Answer |
8 months ago
Nearly 100%. And the mechanisms of this fatigue are the subject of much research. Different cells in the body's immune system have been implicated. These cells can cause inflammation that leads to fatigue. Other more tangible explanations include pain, difficulty sleeping due to the diagnosis and treatment, history of chemotherapy, etc — both disease and treatment related. It is likely a complex, multifactorial reason.
Nearly 100%. And the mechanisms of this fatigue are the subject of much research. Different cells in the body's immune system have been implicated. These cells can cause inflammation that leads to fatigue. Other more tangible explanations include pain, difficulty sleeping due to the diagnosis and treatment, history of chemotherapy, etc — both disease and treatment related. It is likely a complex, multifactorial reason.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Radiation Side Effects, Breast Cancer, Side Effects, Radiation Oncology, Fatigue, Cancer
1
Answer |
8 months ago
This is a great question. I believe that in addition to standard therapy, patients should absolutely consider integrative modalities to help them with side effects from standard therapy and to help with overall wellness during and after cancer treatment. At our radiation center, we actually have a team of integrative therapists work with our patients before or after their treatment sessions. It helps them lay still on the radiation table and it helps them with a feeling of overall well-being. We run an Optimal Healing Environment lecture series where we discuss with our patients the importance of nutrition, physical activity, and all things mind-body in order that they are empowered to feel well after treatment. I also have the privilege to be associated with an organization (You Can Thrive) that provides breast cancer patients (free of charge) with all of these modalities (accupuncture, foot reflexology, mind-body, yoga, essential oil therapy…) during treatment. So the short answer is — we do it all the time with all our patients. Those who are interested, take advantage and LOVE it.
This is a great question. I believe that in addition to standard therapy, patients should absolutely consider integrative modalities to help them with side effects from standard therapy and to help with overall wellness during and after cancer treatment. At our radiation center, we actually have a team of integrative therapists work with our patients before or after their treatment sessions. It helps them lay still on the radiation table and it helps them with a feeling of overall well-being. We run an Optimal Healing Environment lecture series where we discuss with our patients the importance of nutrition, physical activity, and all things mind-body in order that they are empowered to feel well after treatment. I also have the privilege to be associated with an organization (You Can Thrive) that provides breast cancer patients (free of charge) with all of these modalities (accupuncture, foot reflexology, mind-body, yoga, essential oil therapy…) during treatment. So the short answer is — we do it all the time with all our patients. Those who are interested, take advantage and LOVE it.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Complementary Treatments, Complementary And Alternative Medicine, Complementary Medicine
2
Answers |
8 months ago
There are some preventive skin care regimens however there is a paucity of scientific data to support them.
There are some preventive skin care regimens however there is a paucity of scientific data to support them.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Radiation Therapy, Radiation, Skin, Radiation Burn
1
Answer |
8 months ago
What is the significance of the recent study regarding synchronous chemoradiation for breast cancer?
A recent study (SECRAB – Sequencing of Chemotherapy and Radiotherapy in Adjuvant Breast Cancer) reported their findings at the European Multidisciplinary Cancer Congress. The study involved over 2000 women treated in 48 centers throughout the UK. Women with early stage breast cancer were randomized to synchronous (between chemotherapy cycles) or sequential (after chemotherapy was complete) radiation therapy. The 5-year local recurrence rates as reported at the conference were 2.8% (synchronous) and 5.1% (sequential). Optimal timing of chemotherapy and radiation has been a hot topic of debate for a long time. These results certainly raise important issues and will no doubt spark lots of discussion. Long-term follow-up will be important – to assess potential late toxicity and the local benefit. Lastly, we look forward to reading the study in its entirety in a peer-reviewed journal.
A recent study (SECRAB – Sequencing of Chemotherapy and Radiotherapy in Adjuvant Breast Cancer) reported their findings at the European Multidisciplinary Cancer Congress. The study involved over 2000 women treated in 48 centers throughout the UK. Women with early stage breast cancer were randomized to synchronous (between chemotherapy cycles) or sequential (after chemotherapy was complete) radiation therapy. The 5-year local recurrence rates as reported at the conference were 2.8% (synchronous) and 5.1% (sequential). Optimal timing of chemotherapy and radiation has been a hot topic of debate for a long time. These results certainly raise important issues and will no doubt spark lots of discussion. Long-term follow-up will be important – to assess potential late toxicity and the local benefit. Lastly, we look forward to reading the study in its entirety in a peer-reviewed journal.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Radiation Therapy, Studies, Breast Cancer, Radiation, Radiation Oncology, Synchronous Chemoradiation, Chemotherapy, Cancer
1
Answer |
8 months ago
Radiation therapy is the use of high energy X-rays to kill cancer cells. It works by destroying or damaging rapidly growing cells, such as cancer cells, that may have been left behind by even the best surgeon. It damages cells only in the area of the body where the radiation is given. Before patients begin receiving radiation therapy, the radiation oncology team will carefully tailor their plan to make sure she receives safe and accurate treatment. Treatment will be carefully planned to target the cancer while avoiding healthy organs in the area - like the heart and lungs. Special computers are also used to monitor and double–check the treatment machines to make sure the proper treatment is given. Radiation beams come out of a machine called a linear accelerator. The beams are aimed at the target (breast, chest wall, +/- lymph node regions). The actual radiation treatments are painless — they take only a few minutes to deliver.
Radiation therapy is the use of high energy X-rays to kill cancer cells. It works by destroying or damaging rapidly growing cells, such as cancer cells, that may have been left behind by even the best surgeon. It damages cells only in the area of the body where the radiation is given. Before patients begin receiving radiation therapy, the radiation oncology team will carefully tailor their plan to make sure she receives safe and accurate treatment. Treatment will be carefully planned to target the cancer while avoiding healthy organs in the area - like the heart and lungs. Special computers are also used to monitor and double–check the treatment machines to make sure the proper treatment is given. Radiation beams come out of a machine called a linear accelerator. The beams are aimed at the target (breast, chest wall, +/- lymph node regions). The actual radiation treatments are painless — they take only a few minutes to deliver.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Radiation, Radiation Oncology, Radiation Treatments, Cancer
1
Answer |
8 months ago
Radiation oncologists, like other cancer doctors, use evidence-based medicine to advise patients on appropriate treatment recommendations. This means we use results of big studies to guide our management recommendations. For example, several big studies compared lumpectomy alone versus lumpectomy plus radiation. The results showed a much higher risk of local recurrence with lumpectomy alone. Therefore, based on these studies, the addition of radiation after lumpectomy is considered standard of care based. Often times, patient's individual circumstances call for a discussion amongst the treating physicians to determine the specifics of a patient's treatment — whether or not we radiate lymph nodes, if a patient can get partial breast irradiation, if a patient needs a 'boost', if a patient is eligible for the "short-course" of radiation, etc. Dialogue between the surgeon, medical oncologist, and radiation oncologist is imperative for these decisions.
Radiation oncologists, like other cancer doctors, use evidence-based medicine to advise patients on appropriate treatment recommendations. This means we use results of big studies to guide our management recommendations. For example, several big studies compared lumpectomy alone versus lumpectomy plus radiation. The results showed a much higher risk of local recurrence with lumpectomy alone. Therefore, based on these studies, the addition of radiation after lumpectomy is considered standard of care based. Often times, patient's individual circumstances call for a discussion amongst the treating physicians to determine the specifics of a patient's treatment — whether or not we radiate lymph nodes, if a patient can get partial breast irradiation, if a patient needs a 'boost', if a patient is eligible for the "short-course" of radiation, etc. Dialogue between the surgeon, medical oncologist, and radiation oncologist is imperative for these decisions.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Radiation, Radiation Treatment, Radiation Oncology, Treatment Decisions, Cancer
1
Answer |
8 months ago
Breast cancer treatment has two main components: 1) getting rid of the tumor and 2) keeping the tumor from coming back and/or spreading. A surgeon takes care of the first. A medical oncologist – through chemotherapy and or hormonal therapy — and a radiation oncologist take care of the second. Chemotherapy is a systemic treatment – it keeps the cancer from spreading to distant sites in the body. Radiation is a local treatment — it keeps the cancer from coming back where it started: in the breast and in local lymph node areas.
Breast cancer treatment has two main components: 1) getting rid of the tumor and 2) keeping the tumor from coming back and/or spreading. A surgeon takes care of the first. A medical oncologist – through chemotherapy and or hormonal therapy — and a radiation oncologist take care of the second. Chemotherapy is a systemic treatment – it keeps the cancer from spreading to distant sites in the body. Radiation is a local treatment — it keeps the cancer from coming back where it started: in the breast and in local lymph node areas.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Radiation, Radiation Treatment, Radiation Oncology, Cancer Treatment, Cancer
1
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8 months ago
Breast cancer treatment requires a team of doctors. The treating doctors include a surgeon (a breast cancer surgeon and sometimes a plastic surgeon), a medical oncologist, and a radiation oncologist. Together, we all decide the most appropriate treatment course for our patients. Despite the fact that the radiation oncologist is often the last clinician to see the patient, he or she is often consulted earlier in the treatment course for recommendations regarding the patient's eventual need for radiation therapy.
Breast cancer treatment requires a team of doctors. The treating doctors include a surgeon (a breast cancer surgeon and sometimes a plastic surgeon), a medical oncologist, and a radiation oncologist. Together, we all decide the most appropriate treatment course for our patients. Despite the fact that the radiation oncologist is often the last clinician to see the patient, he or she is often consulted earlier in the treatment course for recommendations regarding the patient's eventual need for radiation therapy.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Support Team, Radication Oncologist, Clinical Team, Radiation Oncology
1
Answer |
8 months ago
Many patients who have breast implants may still be able to undergo breast conservation surgery (lumpectomy or partial mastectomy) followed by radiation therapy. There are many determining factors to this, including, the type of tumor, stage of tumor, and extent of cancer within the breast.
Many patients who have breast implants may still be able to undergo breast conservation surgery (lumpectomy or partial mastectomy) followed by radiation therapy. There are many determining factors to this, including, the type of tumor, stage of tumor, and extent of cancer within the breast.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Breast Conserving Surgery, Breast Cancer, Radiation, Breast Surgery, Radiation Oncology, Implants, Surgery, Radiation Treatments, Cancer
1
Answer |
8 months ago
There are currently two ways to do Accelerated Partial Breast Irradiation: AccuBoost (a precise form of high dose rate (HDR) brachytherapy done as part of a protocol or off-label use. It can be done twice a day for 5 days, or once daily for 10 consecutive days. The other form is done via external beam radiation therapy, typically intensity modulated radiation therapy, or IMRT.
There are currently two ways to do Accelerated Partial Breast Irradiation: AccuBoost (a precise form of high dose rate (HDR) brachytherapy done as part of a protocol or off-label use. It can be done twice a day for 5 days, or once daily for 10 consecutive days. The other form is done via external beam radiation therapy, typically intensity modulated radiation therapy, or IMRT.
New answer by MarneeSpiererMD (Physician - Oncology - Radiation (Verified)) in topic(s) Breast Cancer Treatments, Partial Breast Irradiation, Radiation, Radiation Treatment, Non-invasive Treatments, Radiation Oncology
1
Answer |
8 months ago
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The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
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