Clever Title About Radiotherapy Goes Here!

THE SETUP

Cancer. In 2012, it is estimated that nearly 2 million new people will have it, and more than half a million will die from it - about 1500 a day. To put that in perspective (as if such a statistic needed any context), that is more than more than the total enrollment of Rollins School of Public Health (including doctoral students!) dying each day. To say that cancer is a public health issue is an understatement of comedic proportions. Breast cancer, as the primary cause of cancer death among women, is of particular interest.

THE TURN

Gel based bolus versus. . .

 A paper released by the Department of Radiation Oncology (Rad Onc) at UC Davis under the guidance of Dr. Jyoti Mayadev looked at the health effects of using an alternative method of delivering radiation treatments to women who had undergone mastectomies. Traditionally, a type of material called a bolus is used, that mimics skin and tissue which - especially for mastectomy patients - may be missing. This enables oncologists to deliver the right amount of radiation to a patient on a surface with irregular dimensions - the chest of a post-mastectomy patient for example. As radiation treatments are by design meant to destroy tissue, negotiating the seemingly competing goals of getting patients healthier and sparing long term physical harm is crucial. As Dr. Mayadev notes, ""Managing therapy and harm is a constant balancing act in radiation therapy."

. . .brass mesh bolus

 To this end, as an alternative to the usual gel-based material used in a bolus (called "tissue equivalent"), the department treated some 50 post-mastectomy patients with a new bolus made up of brass mesh. The brass mesh has two desirable qualities: it's conformity to body and something called "electron scattering". Because the brass mesh is more malleable it contours better to a patients body shape reducing the complexity involved in radiation treatments. The scientific whozits of electron scattering is beyond the scope of this blog (and this authors brain), however in layman's terms - radiation increases in power the "farther" it travels. Thus by bouncing off the brass material, you increase the power of a radiation dose by simply changing the material used in treatment; or more importantly use less of a dose with a brass mesh bolus and achieve the same results as with a full dose with skin-equivalent bolus.

THE WHYS OF IT ALL

Why is this an important paper? Simple, less radiation means less taxation on the body, means less people lost to follow-up, means greater survival rates for post-op cancer patients. A quick Google of "stopping", "radiation" and "treatments", paints a clear picture of the emotional and physical toll the road to recovery can have on an individual. For women - who have already undergone a radical physical change from their mastectomies - having to endure less physical stress might be a key to a quicker recovery. The literature on the benefits of skin-equivalent bolus use are numerous; this study was the first of its kind in assessing the health risk (measured by skin damage) of using a brash mesh, and further study is planned to address the potential long term benefits of making this switch.

 Mr. S. Anderson is a Biostatistics PhD, a connoisseur of fine boxed wines, has indeed seen the Matrix and has never lost a game of shuffle board (of course he has never actually played shuffle board but why quibble with details). He is also incredibly lazy, as evidenced by his article selection criteria.

REFERENCE: Erin Healy, MA, Shawnee Anderson, BA, Jing Cui, DSc, Laurel Beckett, PhD, Allen M. Chen, MD, Julian Perks, PhD, Robin Stern, PhD, Jyoti Mayadev, MD (2012).  Skin dose effects of postmastectomy chest wall radiation therapy using brass mesh as an alternative to tissue equivalent bolus .  Practical Radiation Oncology., 2012