Teresa Heinz Kerry Battling Breast Cancer

Teresa Heinz Kerry, ketchup heiress and wife of Senator John Kerry, 71, announced that she has been battling breast cancer. The cancer was initially found on a mammogram in September of this year. She underwent bilateral lumpectomies for what was initially thought to be benign tumors. However, later review decided that the tumors were malignant, and she under went a second round of lumpectomies in November. At that time she had titanium clips placed in her breasts to help in targeted radiation therapy next month. This treatment will reportedly improve her chances of survival to 95%.

What is Radiation Therapy?

Radiation therapy (also called radiotherapy, RT ) is a cancer treatment that uses high doses of radiation to kill cancer cells and stop them from spreading. Radiation therapy works because the radiation destroys the cancer cells’ ability to reproduce and the body naturally gets rid of these cells. Radiation therapy can be used as a cancer treatment by itself (such as in prostate or laryngeal cancer) or more commonly as a supplementary (or adjuvant) treatment, along with surgery and/or chemotherapy. RT can be used to shrink a tumor before surgery or used after surgery to kill any remaining microscopic tumor cells.

There are two primary ways to receive radiation therapy: external beam or internal beam radiation therapy. External Beam RT uses an machine outside your body to direct the radiation to the affected area. It is a local treatment in that the radiation is only aimed at a specific part of the body. This treatment is typically given 5 days a week for a few weeks (usually 2-10 weeks). Although a session may last 30-60 minutes, the radiation is only given over a 1-5 minute period. Prior to the first treatment, a patient will meet with a radiation oncologist and radiation therapist, who will take imaging scans and make colored ink marks on the skin to define the area that will get the radiation. This is called the treatment port. Sometimes a body mold is made. This is a plastic or plaster form that helps keep the patient from moving during treatment. It also ensures that they are in the exact same position each time they get the treatment.

Radiation machine

Internal Beam RT is a form of treatment where a source of radiation is put inside the body, sometimes called brachytherapy. In brachytherapy, the radiation source is a solid in the form of seeds, ribbons, or capsules, which are placed in the body in or near the cancer cells. This allows treatment with a high dose of radiation to a smaller part of the body. A liquid form is also available and is used in patients with non-Hodgkins Lymphoma and thyroid cancer. Most brachytherapy is put in place through a catheter, which is a small, stretchy tube. Sometimes, it is put in place through a larger device called an applicator. A doctor will place the catheter or applicator into the part of the body that will be treated while the patient is either under local or possibly general anesthesia. There are 3 forms of brachytherapy:

  • low dose implants- the radiation is left in place for 1-7 days and then removed
  • high dose implants- the radiation is put in place for 10-20 minutes at a time, then removed, and this is repeated a number of times
  • permanent implants- the radiation is left in place, however its radioactivity decreases every day and become negligible over time

With Internal Beam RT, the patient’s body will give off some radiation while the implant is in place, and safety precautions may need to be in place for a short period. Unless a patient receives liquid radiation,  however, body fluids (urine, sweat, and saliva) will not give off radiation. These include being put in a private room, limiting doctor and visitor times, and prohibiting exposure to pregnant women and children under 18 years old.

Titanium clips are tiny metal clips that may be put into a cancer patient’s body at the time of biopsy or during tumor removal surgery. The clips are used to mark the location of suspicious areas or surgical margins so that they can better pinpoint radiation therapy, or locate those areas again in the future. They are especially used hard-to-find places that are “not palpable”, i.e., you can’t locate them by feeling them.  As they are very small, they pose no danger in follow-up MRIs, and do not set off metal detectors at airports.

For more information:

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Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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