The department of Radiation Oncology at MGIMS is one of the four institutes in Maharashtra to offer Master Degree (MD) in Radiation Oncology.
The department treats cancer by delivering precise and targeted radiation to the tumor. Radiation at MGIMS is delivered as a curative treatment –to cure tumor (e.g. radiation alone in early stage cancer of vocal cord and cervix), concurrently with chemotherapy (e.g. locally advanced cancer of cervix, head and neck), adjuvant treatment – after chemotherapy or surgery to consolidate the tumor further or to get away with residual microscopic disease (e.g. in head neck cancer after chemotherapy, breast cancer after surgery), prophylactic radiation – to sterilize the sanctuary sites (e.g. brain irradiation in acute lymphatic leukemia and in small cell lung cancer) or palliative treatment- to ameliorate a specific symptoms like pain, bleeding or obstruction.
The department uses two techniques to deliver radiation – teletherapy and brachytherapy.
In teletherapy or external beam radiotherapy, radiation source is placed at some distance or away from the patient. In 1997, MGIMS obtained approval from AERB and commissioned a Telecobalt machine- Phoenix. The second source (60Co) was replaced in 2010. The department has a distinction of acquiring India’s first indigenous Linear accelerator (LA) Siddharth-I in 2006.
To compete with the recent advances in radiotherapy like 3D Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy and to achieve higher cure rates with good quality of life, Clinac-ix (dual energy linear accelerator with 6 and 15 MV photons and multiple energy electrons – 6 to 18 MeV) was installed in January 2015 and will be commissioned shortly. The machine is also equipped with the dedicated treatment verification unit. This new linear accelerator will help us deliver high radiation to the tumours with minimal dose to normal tissues. The machine will soon be upgraded to Intensity Guided Radiotherapy (IGRT), Stereotactic Radiation Therapy (SRT) and Stereotactic Surgery (SRS).
In brachytherapy, a sealed radioactive source is placed into or immediately adjacent to the target or areas at risk once the tumor is removed after surgery. The treatment can be delivered using surface mould (for skin cancer), plaque therapy (eye cancer), interstitial therapy (for soft tissue tumor, breast cancer, ano-genital cancers), intracavitary therapy (in cancer cervix and endometrium), intraluminal therapy (cancer oesophagus, bronchus, endobiliary radiation therapy) and intravascular therapy (internal mammary irradiation). The Microselectron HDR unit was commissioned in 2008. The radiation is delivered with the high dose rate using 192Iridium radioactive source.
The appropriate radiation treatment delivery needs accurate and sophisticated planning of the target. This is achieved with the simulator – Simulix which started functioning since 2010. It helps in accurate localization of the target or tumor. The department has two treatment planning systems -Eclipse version 13 treatment planning system for brachytherapy and Oncentra planning system for the newly installed Clinac –ix.We receive and treat all types of solid malignancies and few hematological tumors. Of the 1143 incident cases we treated in the department in 2014, head and neck cancer topped the list (31%), followed by breast cancer (20%) and cancer of the cervix (17%).
Radiation therapy is one of the most expensive cancer treatment modality. MGIMS offers radiation therapy at a price a common man can afford. A six-week course of radiation therapy to a woman with breast cancer costs just Rs 10,000 at MGIMS- a quarter of price charged by private hospitals. Almost half the patient receiving radiotherapy at MGIMS are treated free - thanks to the benefits offered by Rajiv Gandhi Jeevandayee Yojana, a cashless scheme offered by Maharashtra Government.
A 30-bed oncology ward is managed by faculty, residents and nurses who are fully trained in handling commonly used radiation and chemotherapy procedures. The department is actively involved in cancer detection programs, counseling and education of high risk population, and preventive oncology programs.
When choosing treatments for a patient, doctors consider the financial strains they may cause alongside the benefits they might deliver. This is particularly the case with cancer, where the cost of drugs, and of care overall, has risen precipitously. The burden of this cost is borne, increasingly, by patients themselves — and the effects can be devastating. Cancer patients are often driven into bankruptcy by their illness and its treatment. A social worker in the department counsels patients, guides them about the financial benefit packages offered by the government and the hospital, discusses the pluses and minuses and helps them in coping with often unvoiced concerns about cancer and its outcome.
Outstation patients seeking prolonged radiation treatment often need to stay close to the hospital. An Atithi Gruh, that provides residential accommodation to close to 100 people, is an affordable and quality home for cancer patients and their relatives.