- DIBH radiotherapy is a technique which involves you holding your breath during treatment.
- DIBH technique is used for patients with left sided breast cancer as the heart sits behind the left breast and chest wall. As you breathe in and hold your breath, your lungs inflate and your heart is pushed away from your chest wall and, in turn, from the area being treated.
- DIBH can also be used on areas including the Lung, Pancreas, Liver and Thorax to reduce tumour motion during treatment. This allows for better targeting of the tumour while protecting the normal healthy organs.
As every patient has different internal anatomy, it is not possible to predict if the DIBH technique will be beneficial until the planning CT scan has been completed. For some people, even when breathing normally, their heart and liver will not be in the respective radiation fields and DIBH is therefore of no benefit.
It would be helpful to practice holding your breath for 20 second periods, to get used to the sensation. The radiation therapy team will provide coaching at the time of your CT scan.
The radiation therapy team will provide some coaching and you will be asked to hold your breath 3-4 times for up to 20 seconds at a time. At your planning appointment you will have an initial scan holding your breath. A second CT scan will then be carried out, during which you breathe normally. If you are unable to hold your breath or your chest does not move enough when you hold your breath, then DIBH is not for you and you radiotherapy treatment will be delivered whilst breathing normally.
Every radiotherapy session is the same and your positioning must be identical to that achieved during your planning CT scan. The radiation therapy team will position you and then ask you to hold your breath and release it a number of times until they are happy with your position. The radiation therapy team will leave the room and will communicate with you through an intercom. When they are ready to switch on the radiation, they will ask you to hold your breath. When the radiation beam has been delivered, the team will tell you to release your breath. This will happen several times until the treatment finishes. The number of times you will be required to hold your breath depends on how long you can hold it for. A computer system monitors your breathing and position, so if you release your breath without being advised to, the radiation will switch off. The radiation Therapists are watching you at all times and if, at any point, you are unhappy simply raise your hand.