Stereotactic radiosurgery could be extended to the body, we could give a higher dose in 3 to 5 sittings which would improve the control rate of the tumour significantly without causing much side effects.

In an interview with ETHealthworld, Dr Kumara Swamy, Consultant Radiation Oncology, HCG, talks about the advancements in radiation oncology that has greatly improved the quality of life and minimised the side effects too. Edited excerpts:

How has quality of life improved in cancer care, over the years?

The problem that we faced earlier was that even if the patient gets cured there used to be long term side effects affecting their quality of life until the patients lived. Things changed in 1990 to 2000 when linear accelerator came into the picture and with that we were able to deliver the dose to the tumour or confirm the shape of the tumour, therefore it was significant improvement over the earlier techniques and we were able to avoid some of the organs.

By 2000 we had a technique called the IMRT ? Intensity-Modulated Radiation Therapy with which we were able to avoid the sensitive structures around the tumours like in head and neck cancers. We can now avoid the parotid glands from receiving the significant dose and there are some international guide lines according to which we should restrict the dose to the parotid. Most of the patients have a good quality of life.

Earlier we were not treating prostate cancer at all until 1990?s, then subsequently after IMRT in 2000-2005, we were able to treat the prostate by avoiding the urinary bladder and the rectum. These two organs are spared with the long term complications of bleeding in the urine or in the stool which has stopped since then. In prostate cancer the quality of life is almost normal and IMRT has become elderly friendly. These changes are happening in such a significant way because of the development of computers and in the imaging field and as we are now able to confine the radiation to the tumour.

The major improvements are interms of the short and long terms side effects. IMRT has led to a next phase of development called stereotactic poly radiotherapy to treat tumours of the brain. It was first used in a short fraction with relatively higher doses which could be tolerated easily and that was named as stereotactic radiosurgery. Stereotactic radiosurgery could be extended to the body, we could give a higher dose in 3 to 5 sittings which would improve the control rate of the tumour significantly without causing much side effects. It is an ideal equipment to target the tumour avoiding the surrounding tissues.

Cancer of the lung is curable if detected early, but in elderly patients they had difficulty in curing them. With the advent of imaging and the computer, the use of cyberknife as a stereotactic radiosurgery has shown significant development.