Southern California has a powerhouse advocate in the fight against breast cancer. Dr. Dennis R. Holmes, chief breast surgeon and medical director of the Los Angeles Center for Women’s Health, is one of the world’s foremost authorities on breast cancer and breast cancer treatment. Dr. Holmes’ involvement in groundbreaking breast cancer treatment positioned him well to take the leadership helm at the Los Angeles Center for Women’s Health. Prior to his current appointment, Dr. Holmes maintained a private practice at USC’s Norris Cancer Center and served as chief of the Breast Section at Los Angeles County + University of Southern California Medical Center where he supervised the surgical management of all breast cancer patients.
Dr. Holmes took time from his busy schedule and grand opening activities to talk to rolling out about intra-operative radiation therapy and how it has reset the bar in breast cancer therapy.
You’ve stated that you, “have dedicated my practice to reducing the burden and side effects of cancer treatments by developing and expanding access to innovative options.” Tell us more about how intra-operative radiation therapy has helped you do that.
I’m really proud of my work in helping to develop a type of breast cancer radiation called intra-operative radiation therapy. Intra-operative radiation therapy is actually given during surgery. Whenever someone has a lumpectomy [removal of lump only] intra-operative radiation therapy is done while they are still on the table. Usually, patients who agree to radiation therapy must commit to six weeks of treatment, five days a week. That’s a lot of time for busy women. What if she doesn’t live near a radiation center? That’s even more time due to a longer commute. Statistics have shown that if it is not viable for the patient, they are less likely to complete the radiation therapy, which increases the chance of recurrence.
Is the treatment widely used? Can doctors everywhere have access to it? Has it completed all of the FDA trials?
The technique and the type of equipment used in breast cancer intraoperative radiation therapy treatment was actually approved by the FDA in the 1990s. Initially, it was approved for use on different parts of the body, but the application was approved for use for brain cancer. Over a short period of time, better treatments for brain cancer emerged, so this isn’t used for that anymore. It didn’t take long before medical researchers thought this might be good for treating breast cancer. An international trial was conducted with over 2,000 patients and we did a comparison of the one-day treatment and the six-week treatment. Half were given the intra-operative and the other half the six-week treatment. And, we followed their progress for about five years [a total of 10 years]. And, you know what? The success and survival rates were virtually equal. We knew it would change the way women viewed radiation therapy — and it has.
LA Center for Women’s Health is a new comprehensive women’s health center that is opening in downtown Los Angeles. The grand opening is Friday, Jan. 20, 2012. As a breast cancer surgeon, I am chief breast surgeon. In addition to breast care, the center also specializes in OB/GYN.