D. Hunter Boggs, M.D.In recent years, the University of Alabama at Birmingham Marnix E. Heersink School of Medicine has seen remarkable progress in making cancer treatment more precise, efficient and patient-centered. One of the most meaningful advances for breast cancer patients is the move toward shorter-course radiation therapy, reducing the number of treatments without compromising outcomes.

“Traditionally, breast cancer was treated over a course of five to six weeks,” said D. Hunter Boggs, M.D., an associate professor in the Department of Radiation Oncology. “Over the past few decades, studies have shown that it is safe to reduce the overall number of treatments by increasing the daily dose. These studies have demonstrated that, for appropriate patients, side effects are similar to more prolonged treatments, and cure rates are identical.”

Advances in technology and treatment planning have made shorter-course radiation a safe, effective and patient-centered option for breast cancer care.

Modern advances 

Clinicians are able to deliver radiation more precisely than ever before with modern treatment tools.

“In the modern era, we are able to use more sophisticated techniques to ensure an even distribution of radiation dose into the areas that need to be treated,” Boggs said. “We have more tools to reduce exposure to critical organs near the radiation field, such as the heart and lungs.”

One example is the Deep Inspiration Breath Hold treatment, a technique that expands the lungs and naturally shifts the heart away from the radiation field. UAB Radiation Oncology uses adaptive therapy for many patients receiving partial breast irradiation. Adaptive therapy is a technology that allows clinicians to image the patient’s anatomy daily and modify the treatment plan if significant changes occur.

More freedom 

Shorter-course radiation offers a meaningful quality-of-life benefit, especially for patients who face travel burdens, caregiving demands or other responsibilities outside of treatment.

“Cancer treatment is disruptive,” Boggs said. “Patients often have to travel long distances to receive care. By shortening treatment, patients are able to spend less time with us and more time where they need to be.”

Many patients are surprised to learn treatment can be completed in just five sessions.

For whole-breast radiation, a course of 15 to 16 treatments has been the standard for years. Recent studies now show that five treatments can be a safe option for many patients. For patients who require treatment to regional lymph nodes for more advanced cancers, research has shown that a 15- to 16-treatment course provides the same outcomes as a longer regimen. New guidelines from the American Society for Radiation Oncology and the Society of Surgical Oncology reaffirm these recommendations.

Shorter courses are particularly beneficial for sick or elderly patients who may struggle with transportation or the physical discomfort of lying on a treatment table. Breast cancer is more common in older adults, making accessibility an important consideration.

Have a conversation 

It is encouraged for patients to have a conversation with their oncology provider if they are recommended a longer, five-and-a-half- to six-week course of radiation.

“There may be a valid reason for a longer course, but it is always worth discussing if a shorter radiation course offers an equally effective option,” Boggs said.

Through ongoing research, innovative technology and a commitment to patient-first care, the UAB Department of Radiation Oncology is helping make breast cancer treatment more efficient, comfortable and effective. By embracing shorter-course radiation and adaptive therapy, they aim to improve outcomes while giving patients more time to focus on what matters most, living.