Heart metastases successfully treated

Radiation treatment only takes a few minutes, you don’t feel it, and yet this form of cancer therapy is very effective. “The high-energy X-rays are to us what the scalpel is to surgeons,” says Hans Geinitz, head of radio-oncology at the Barmherzige Schwestern Hospital in Linz. Radiotherapy is also constantly evolving. What was once unthinkable is now common practice: Franz Rechberger (67) was admitted to radio-oncology because of heart metastases and was successfully treated. After ten high-dose radiation treatments and simultaneous immunotherapy, only residual tissue remains, which no longer grows. The patient has regained his quality of life.

Healing is often possible

65,000 radiation treatments are carried out in the radio-oncology department at the Linz Barmherzige Schwestern Hospital every year. It is the largest radiotherapy department in Upper Austria. In addition to surgery and medication, radiation is an essential part of many cancer therapies. The most common areas of application are breast cancer (25 percent of all radiation treatments), prostate cancer (17 percent), bone metastases and lung cancer (8 percent each). “Around two thirds of radiation treatments have a curative intention, which means that the patients are potentially cured. The others are palliative treatments, which aim to alleviate the disease,” explains Geinitz.

Treatment is carried out with high-energy X-rays in order to achieve a good effect even in deep tissue. “This causes DNA damage in the tumor cell, which causes it to die or prevents it from growing further,” explains the radio-oncologist. An individual radiation plan is drawn up on the basis of computer tomography images. During the session itself, it is important to position the patient correctly. The radiation then only takes a few minutes and is painless. “Of course there can be side effects, the head and neck area in particular are very sensitive, but the radiation is usually well tolerated,” says Geinitz. The radiation is often combined with chemotherapy, immune therapy or anti-hormone therapy. It can also be carried out before or after a surgical procedure.

Special challenge

In principle, radiation can be used in all regions of the body. “In the abdominal cavity, however, the intestines are particularly sensitive, some types of cancer do not respond at all, or drug therapies are more effective for so-called liquid tumors such as leukemia and lymphomas,” says the radiation oncologist. Radiation around the heart is a particular challenge.

The situation was very critical for Franz Rechberger (67) from Linz. Shortly after his retirement, he was diagnosed with parotid gland cancer. He underwent multiple operations and radiation therapy. Almost two years later, a heart metastasis was discovered that had also spread to the atria. “The patient already had poor cardiac function and the risk of cardiac arrhythmia was high,” explains radiation oncologist senior physician Lukas Kocik, who treated him. After a detailed consultation, Franz Rechberger decided to undergo radiation therapy.

High-dose radiation

“There was no alternative. I had water in my lungs and couldn’t breathe when I was lying down,” recalls the man from Linz. The heart was irradiated in close cooperation with the cardiology and internal oncology doctors. “The dose was very high in order to be able to control the tumor in the long term. We decided on ten sessions within two weeks, and even during this time there was a significant improvement in the shortness of breath,” says Geinitz. At the same time, the patient received immunotherapy. Franz Rechberger has now stopped immunotherapy for nine months. The CT images only show the residual tissue around the heart, which is not growing.