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Breast-cancer specialists are sharply divided over a new radiation technique that costs less and is more convenient than conventional therapy. The technique, known as intraoperative radiation therapy, or IORT, involves administering a single dose of radiation at the same time a patient is having lumpectomy surgery to remove a tumor. A large, randomized controlled trial concluded that IORT has fewer side effects and appears to prevent the return of cancer nearly as well as traditional treatment, in which patients undergo radiation sessions five days a week for up to seven weeks. (Beck, 8/24)

Second cancers are on the rise. Nearly 1 in 5 new cases in the U.S. now involves someone who has had the disease before. When doctors talk about second cancers, they mean a different tissue type or a different site, not a recurrence or spread of the original tumor. Judith Bernstein of suburban Philadelphia is an extreme example. She has had eight types over the last two decades, all treated successfully. (Marchione, 8/24)

Some of the services are sponsored by established medical centers, including Massachusetts General Hospital and Cleveland Clinic. Others are independent businesses that work with specialists on a consulting basis. Employers increasingly are contracting with such services, and insurance companies at times require patients to get a second opinion, such as for surgery. (Reddy, 8/24)