New treatment for cancer

TomoTherapy, a new way to treat cancer, has given a ray of hope to patients, reports Vishnupriya Sengupta.


A cancer patient undergoes TomoTherapy at a hospital.
Imagine a cancer patient walking into a hospital on a Monday afternoon, undergoing a 30-minute operation, walking out on Friday with minimum side effects and rejoining office the following Monday. This isn’t quite a dream. It is actually possible, courtesy TomoTherapy, and not very far from home — at Gleneagles Hospital in Singapore.

Imagine a terminally ill cancer patient who doesn’t lose the ability to walk even though the cancer may have spread to the bone, specifically the hip joint of the pelvis. Far from spending the remainder of his life in bed or being bound to a wheel chair, he gets a chance to walk again, without feeling an iota of pain. It’s possible at the National University Hospital in Singapore.

Imagine a young woman in her 30s who goes in for a routine check-up for cervical cancer. But instead of undergoing colposcopy, where her cervix is examined with a special binocular microscope, she is subjected to a visual inspection called MediScan which involves a computerised digital data and image archival system, more effective in tracking changes in cervical lesions. This is a technique used at the KK Women’s and Children Hospital in Singapore.

Singapore, touted as a medical tourism hub, is now fast emerging as a one-stop specialist centre. It houses a large pool of oncologists who use state-of-the-art equipment and targeted therapies which maximise outcomes and minimise undesirable side effects. This has resulted in a rapid influx of patients from Bangladesh, Malaysia, Indonesia, Vietnam, the Philippines and the Middle East. In the next five years, the number is set to reach one million.

Some cancers are curable not just in India but also in state-of-the-art hospitals elsewhere. But TomoTherapy, the new revolutionary way to treat the illness, has given a new ray of hope to all cancer patients because it is the most advanced form of image-guided intensity modulated radiation therapy with several advantages.

A year ago, on March 1, 2006, Mount Elizabeth Oncology Centre became the first centre in South East Asia to offer Tomotherapy and treat its first patient with this state-of-the-art machine. While the machine costs well over US $6 million, the good news is that the cost of the treatment in Singapore is less than half the cost of treatment in the US, as it varies between Singapore $20,000 and $ 4,000.

“Tomotherapy combines precise 3-D imaging from computerised tomography (CT scanning) with highly targeted precise radiation beams, says Dr Khoo Kei Siong, deputy medical director, Parkway Cancer Centre, Gleneagles Hospital. With this machine, radiation oncologists can check the location of the patient’s tumour before each treatment. They can then deliver painless and precise radiation therapy based on a carefully customised plan.

Elaborating on the advantages, Dr Khoo Kei Siong says, “As compared to traditional radiation therapy that can only accommodate a few angles, many different angles of entry for radiation beams can be obtained by the use of this machine. More importantly, there is accurate control of radiation delivery to precise areas and at the precise intensity, which minimises side effects because of targeted radiation and precise image guided positioning. Also, there is a lower radiation exposure to the healthy tissues surrounding the tumour.”

Until recently, cancer could only be diagnosed with the help of CT scans and MRIs. But Singapore, in particular the Parkway Group Healthcare, has acquired a super efficient imaging device that helps in the early detection of cancer. The device shows the chemical functioning of organs and tissues and allows a detailed measurement of distinct areas of the human brain while the patient is comfortable, conscious and alert. This imaging technique called Positron Emission Tomography (PET) diagnoses cancers otherwise difficult or impossible to detect.

At times, even when cancer is detected, the patient may be reluctant to undergo surgery. Chang Kat Tat, 59, is a case in point. He has cancer in the rectum and prostate and it has spread throughout the bones in his body. When he was offered surgery for his rectal cancer, he refused. But when he was offered surgery to help him walk again, he agreed.

Assistant Professor Suresh Nathan, an orthopaedic oncologist at the National University Hospital, applied the Harrington Procedure, a palliative surgery — which involves reconstructing the hip and then carrying out a hip replacement, which relieves all pain from standing or walking — on him. Dr Nathan learnt the procedure — which takes three to four hours to complete and costs around Singapore $ 20,000 — at the Memorial Sloan-Kettering Cancer Center in New York. Ever since his return from the US in 2005, he has performed such operations on both adults and children.

Today Chang does not know how long he will live but he is mobile enough to continue his work as a spectacle lens fitter and ride his bike. Says Dr Nathan, “The initial outlay for something like this may be expensive but the alternative is being bed-bound, inviting the cancer to run amok, developing bed sores and dying from the associated blood infection. Also, you save on home and hospice care.”

Singapore has also made significant strides in the early detection of cervical cancer, the second most common cancer worldwide. While there is already a vaccine available which is effective in providing protection against the human papilloma virus which causes cervical cancer, the KKH Hospital in Singapore has also acquired a digital colposcopy network that helps in the diagnoses of cervical pre-cancer.

“While colposcopy is an important step in screening for cervical cancer, it’s effectiveness depends largely on the expertise of the doctor performing the procedure,” says Dr Quek Swee Chong, consultant, Gynaecologic Oncology Unit, KK Women’s and Children Hospital, Singapore. “But now with the help of this new networked system called MediScan, doctors can instantly retrieve digital images captured at various stages and track changes in cervical lesions more closely and accurately,” explains Dr Chong, who was part of the developmental team.

As to stem cell research — one area in which India is also doing its bit for advancement with LifeCell, the Chennai-based stem cell banking and research centre, setting up India’s first stem cell transplant centre in the country last year — Singapore is by no means lagging behind.

Take the case of Oh Tze Sun. When he was nine months old, he was diagnosed with Beta Thalassaemia Major. He had to bear the torment of daily injections and blood transfusion every three weeks. But six years later, Dr Patrick Tan, medical director, Haematology and Stem Cell Transplant Centre at Mount Elizabeth Hospital, Singapore, performed a landmark transplant on him with cord blood from an unrelated donor. With the success of the transplant, Tze Sun was given a clean chit. He no longer needs blood transfusion or injections and can finally lead a normal life.

With such major advancements in the field of oncology, cancer patients can now look forward to starting life afresh.

Source:The Telegraph (Kolkata,India)

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