Some statistics you never forget. In my mind, I am cured of cancer. The tumor’s been removed. I’ve had chemotherapy. Yet, according to oncologists, there is a twenty to forty percent chance that cancer can return to the same area without radiation treatment. It’s too bad because I’m close to feeling “normal” again and would just as soon skip this next phase.

But twenty to forty percent is a large number. And so I start radiation treatment Monday. With trepidation at all the things that can go wrong. With fears of long-term after effects and immediate side effects. Lying under the gigantic linear accelerator where I had my “dry run” last week.

The chief radiation oncologist at my HMO told me that doctors have tried to cherry pick cases, those with good prognosis, to see whether they could get away with doing no radiation. No one’s been successful at that, apparently.

Radiation shrinks the odds of local recurrence (in the same area) to five percent, the oncologist told me. Put another way, the chance of preserving the breast with radiation is close to ninety-five percent. “In terms of cosmetic outcome,” he said, “it’s hard to beat keeping what you have. Put that together with our ability to cure you to be the same, breast conservation is a very good choice. That’s the reason for doing the radiation.”

I asked why the whole breast has to be zapped. Why not just beam the area where the tumor was removed? It seems there has been some research in that department. According to my oncologist, the option is interesting but likely will not become standard because the cosmetic outcome isn’t as good. There is more fibrosis and a denseness of the area that is treated.

We discussed other forms of treatment. Radiation can be delivered from inside the breast through an array of needles. Evidently, women haven’t been clamoring to have this procedure because it is more invasive. However, there are studies that show it is effective. And the array of catheters in the breast is only there over a three-day period.

Another form of radiation therapy is delivered at the time of surgery. A balloon, through which radiation is delivered, is sewn into the lumpectomy cavity of the breast. This is a fairly new procedure, so not enough data is available on its effectiveness. “On top of that,” said the oncologist, “it’s probably only treating about a centimeter of tissue around the cavity.”

A couple of journals, Radiology Today and Medical News Today, have reported on another technique that appears to hold promise. Called intraoperative electron radiation therapy (IOERT), it is “the application of electron beam radiation directly to a tumor or tumor bed during surgery,” according to Radiology Today.

Not everyone is a candidate for the IOERT technique. But what a blessing for those who can make use of it. The tumor area is radiated while the wound is open. The surgery to remove the tumor and the radiation treatment are, potentially, done in one day. Any microscopic cancer cells near the area of the tumor can be hit while they are most vulnerable. Healthy skin that might be radiated with conventional external-beam radiation can be spared.

Of course there are obstacles. Most operating rooms are not equipped with mobile electron linear accelerators. And transporting a patient in the midst of an operation to a shielded area where there is a conventional linear accelerator presents risks and challenges. Then there is the high cost, which helps explain why few hospitals are equipped to administer IOERT therapy.

Still, some of these new techniques show a lot of promise. I can only hope that, one day, the notion of going to a cancer radiation center every day for four to ten weeks will seem arcane. And wouldn’t that be a blessing?