How new techniques and technologies shield this vital organ.

When radiation treatment is needed for cancer of the left breast, the nearby location of the heart means it requires extra protection. Cancer radiation specialists at Saint Barnabas Medical Center (SBMC) employ a variety of techniques, technology and treatment plans to help patients avoid radiation damage to this vital organ.

“Advances in breast cancer mean more people are living longer,” says Alison Grann, MD, chairman of the Department of Radiation Oncology at SBMC. “And people with breast cancer might have greater risk for certain heart diseases later in life. We understand that and have long taken steps to reduce that risk.”


Treatment is customized for each patient, Dr. Grann explains. However, positioning and breath control are key considerations.

“To give the maximum dose of radiation to the area of cancer and avoid exposing the heart and other parts of the body, we sometimes have patients lie on their stomachs in what is called a ‘prone’ position, on a specially designed table,” Dr. Grann says. “We also teach some patients how to hold their breath in a certain way—with what’s called the Deep Inspiration Breath Hold—to shift the heart away from the breast tissue during the short bursts of radiation.

“We have almost two decades of experience using the prone technique, and we were the first in New Jersey to offer it,” Dr. Grann says. “Together with advanced technology tools, these techniques allow us to reach cancer while greatly limiting exposure to other parts of the body.”


Patients at SBMC also have the benefit of a new technology that increases the accuracy of the radiation beam and, therefore, improves protection of the heart. The state-of-the-art Vision AlignRT, used for Surface Guided Radiation Therapy, employs three advanced cameras and computerized software to track the patient’s breathing and other movements during radiation therapy. With AlignRT, physicians can automatically and quickly pause the treatment if a patient moves out of position.

A recent study showed that AlignRT in combination with Deep Inspiration Breath Hold effectively prevented radiation-induced abnormalities in blood flow to the heart.


The SBMC radiation oncology team adopts the latest research findings to benefit patients in other ways.

“In the past, all women who had lumpectomy and chemotherapy needed six weeks of radiation therapy,” Dr. Grann says. “Now lots of studies have shown us that you can deliver radiation in three to four weeks in an equally safe way.” She notes that these findings apply to women who have had lumpectomies, but not those who have had mastectomies—so far. “Studies are ongoing to look at whether or not it’s safe to shorten treatment for that patient population.

“As soon as those studies came out, we began offering shorter terms of radiation as a standard treatment practice for our eligible patients,” Dr. Grann says. “We truly do what’s best for the individual patient.”

That philosophy of individualized treatment holds true for any radiation patient at SBMC. Not everyone with breast cancer should have radiation in the prone position, and in fact not every breast cancer patient even needs radiation.

The best treatment depends on many factors, says Dr. Grann, who has published research papers and lectured on topics related to radiation oncology. Those factors include the patient’s age, the size of the breast cancer, the specific receptors on the breast cancer itself and more.

“Every woman is different, and every cancer is different,” she says. “Using the latest advancements and research, we offer a variety of ways to treat people with breast cancer and avoid as many side effects as possible.”


Protecting the heart in every way possible is important, especially for patients who have other risk factors for heart disease. The American Heart Association journal Circulation recently reported that some breast cancer treatments can weaken the heart muscle or cause changes in the arteries of the heart. While these side effects are not always permanent, avoiding them is a goal during treatment.

Patients can improve their risks for both heart disease and breast cancer because these conditions share some of the same controllable risk factors. Taking steps to adopt a heart-healthy lifestyle is associated with a lower incidence of breast cancer, according to the American Heart Association. The organization recommends that people follow what it calls “Life’s Simple 7”:

• Maintain a healthy body weight.

• Eat a healthy diet.

• Be physically active.

• Avoid tobacco.

• Manage blood pressure.

• Control cholesterol.

• Reduce blood sugar.

Follow your doctor’s recommendation for any treatment.

For more information about Radiation Therapy at Saint Barnabas Medical Center, call 973-322-5630.