Modernisation in radiation treatment has been brought on by Stereotactic body radiation therapy (SBRT), Stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT). Radiation or radiotherapy has played an important role against cancer, no matter what stage. Since the 19th century deep X-ray therapy and after that cobalt-60 machine and now the modern linear accelerator has been used to fight cancer.
The new version of the linear accelerator can provide a previously 30-day treatment in just 5 days. With the linear accelerator's true beam version, a highly advanced four-dimensional CT scanner machine is required. It is used to record the patient's respiration and through the help of the computer, the radiation oncologist and medical physicist team deduce a high-quality treatment plan which gets completed in the treatment planning computer.
Afterwards, that treatment is applied by a radiation technologist. Therefore it can be seen that this treatment is continuing like a chain and there can be no cracks on the way. If there are any lapses it can be harmful to the patient. This ultra-modern treatment started in Bangladesh in 2014.
SBRT mainly used to focus on the lungs and liver but now it can be applied to the prostate as well. But the problem is that this type of treatment is only applicable for the early stages of cancer. For example, treatment is possible if the size of the disease in the lungs is a maximum of 4 cm, better if the tumour is in the periphery of the lungs and it is not possible to treat if it has spread throughout the lungs. In case of the liver, the largest size of the tumour can be realistically 6 cm. In case of patients for whom other treatments like targeted therapy did not work, this SBRT treatment has shown great success in liver cancer.
SRT and SRS have been widely used for brain cancer treatment. The same condition is applicable here as well, the size of the tumour has to be small, and it has to be away from the brain stem which is the main part of the brain.
In SBRT treatment high-energy X-rays from true beam linear accelerator are used which is 5 times stronger than a normal linear accelerator X-ray beam. Through SRS treatment method the whole treatment can be completed in a day. It is extremely important for cancer to be at an early stage but Bangladeshi patients get to apprehend cancer at a later stage.
Also, through the help of four-dimensional CT scanner, breathing can be stopped for 30 seconds to treat cancer on the left side of the breast. Due to the heart being there, in many cases giving radiation in an angular way could be harmful to the heart. This treatment is necessary to reduce the radiation dose in the heart. Because of this treatment, a very low amount of rays reach the heart and hearts of the breast cancer patients stay well.
These advanced treatment methods can massively help Bangladeshi patients. The precision and efficiency of this treatment is very good and also has low risks to other healthy organs.
The writer is a Senior Consultant at the Department of Radiation Oncology, United Hospital Limited, Dhaka.