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Alternative Breast Cancer Treatment Serves Kentucky Patients

Weekly radiation treatment for breast cancer has proven to be just as effective as traditional, more frequent treatment, according to a clinical trial by the James Graham Brown Cancer Center.Dr. Anthony Dragun, vice chair and associate professor of radiation oncology at the University of Louisville, is the principal investigator of the study. Traditionally, radiation has required a daily treatment Monday through Friday for six weeks. And while insurance companies will pay for cancer treatment, they don't pay for transportation costs or time lost on the job during treatment. This was a problem Dragun knew had to be fixed to ensure that patients in Kentucky received the best treatment.Nearly 150 women have been treated under the trial since it began in 2010. Thirty percent of patients are African-American women who live in Louisville and rely on public transportation to get to the center, 1/3 of patients live in rural counties and travel an average of 60 miles each way for treatment, and the remainder are professionals or stay-at-home moms who opted for shorter treatment because of the convenience.Jeffersonville resident Phyllis, who asked that her last name be withheld for privacy,  was diagnosed with breast cancer last November. She works four 1o-hour days, cares for her grandchildren and travels on the weekends with her husband.When asked if she thought she would have maintained her schedule with traditional radiation therapy, she said: "No way!"After having a partial mastectomy, she decided to enroll in the clinical trial in April. "You come here once a week and you still keep your routine. You can still work and you're not getting sick or worn out and tired where you can't function and keep up with your normal every day activities," Phyllis said.

Clara Head,62, of Louisville, had surgery three weeks ago. She enrolled in the clinical trial Friday morning."I think it will be better for me and more convenient. This is my first treatment, so it's all new to me," Head said.  Although Europe and the United Kingdom have experimented with once-weekly treatments for the last 20 years, the James Brown Graham Cancer Center is the only institution in the U.S. that offers the treatment. Dragun said with the issues related to healthcare costs, out-of-pocket expenses for patients and access to care, it only made sense to offer the treatment."It's not a standard way to treat in the United States," Dragun said. "There are a lot of disincentives  to treating that way in the United States due to the way the fee for service  is set up in the United States."Despite the fact that radiation technology has improved by leaps and bounds over the last 20 years, there's been a reluctance to change how breast radiation is delivered." On average, once-weekly treatment costs insurance companies 25 to 30 percent less than the cost of traditional treatments, Dragun said.   Dragun said a lack of access to mammography, early detection and access to treatment are the biggest hindrances in the diagnoses and treatment of breast cancer in Kentucky. He said the state's rural communities and those who rely on public transportation suffer the most."The women who are most likely to not have access to radiation are either elderly, underserved minorities, or reside in a rural or Appalachian county," Dragun said.

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