Journey to the Center of Technology

igrt radiotherapy Bangalore

It was the year 1895. A new unknown ray, which showed the bones of the hand of the discoverer's wife, made an unprecedented sensation. This hitherto unknown invisible factor was named X-ray.  Human adventurism made people try this X-ray on all possible things. From acne to eczema were treated with this. Then came the reports of side effects, most horrific was the "skin burn," which was pretty visible. Till 1919, people shunned x-ray usage; however, some continued to use it for the selected situation. This period was considered a dark era of radiotherapy. Meantime, X-ray imaging was born and the ability of this ray to kill cancer cells was observed. Alexander Graham Bell suggested putting the radioactive tubes inside the tumor (later named brachytherapy). In 1919 somebody started using it to treat voice box cancer and in 1922 published the series of patients cured of voice box cancer. In 1932, Graham Bell's "ring" to doctors manifested in the cure of cervical cancer where radiation tubes were introduced to the uterus cavity along with radiation from outside. Radiotherapy became an established specialty following passionate discussion at Curie Center, France, between the surgeons (no radiation specialty at that time). The group conceded that in some stages of cervix cancer radiation gave better results than surgery.

Yet, the types of equipment were primitive at that time, called deep x-ray machines. Skin burn was high; the bone would crumble, intestines would get blocked, distressing bleeding the stool and urine were common. Patients would be cured of cancer but would be unhappy day-to-day. Then by the 1950s, two parallel developments happened. The design of the cobalt equipment considered a super-machine compared to the earlier deep-ray machine had a dramatic effect on the reduction of side effects.  The machine was stable, effective, revolutionary at that time and became the "workhorse" all over the world. The Second World War led to two boons for cancer patients. One was as a spin-off of radar technological revolution, and a machine Linear Accelerator was born. This machine proved better than cobalt over a period and formed the foundation for today's Robotic AI evolution. The second was the use of mustard gas as biological warfare in World War II, which became the frontline therapy in the treatment of leukemia. 

When I finished my MBBS internship in 1977, I did not know of the existence of a specialty of radiation therapy. I became a faculty in the radiology department of Victoria hospital in 1978. One day I happened to look up the building and found the plaque "Cancer Ward." During the time, radiologists were managing the cancer ward, and there was no speciality of medical oncology. Passion work in the cancer field (precipitated by reading a book by Nobel Prize-winning Aleksander Solzhenitsyn’s book "Cancer Ward") took me to the ward and my journey to the "Center of Technology" began. I cannot forget the time when I sat next to a defunct deep x-ray machine and learned about super-voltage machines. Lessons learned during those earlier machines and treating under relatively adverse conditions became a foundation for my knowledge that streamed in later years. Even today, I have fond memories of the cobalt machine and linear accelerator, which were heroes of that time (like yesteryear Bollywood legends). 

After a stint in Victoria and getting the required qualification, I later moved to Kidwai Memorial Institute of Oncology.  Working under Dr. Krishna Bhargava, a doyen of oncology and a person with an obsession to make the latest facility available for the deserving people in Karnataka, was an un-erasable commitment. My best part of life was those 22 years in Kidwai hospital.  Spending a month in Washington University, University of Iowa, in 1998 took me to observe the next revolutionary technology, i.e., Intensity Modulated Radiotherapy (IMRT).

Later came the quest for technological skills, which took me to be in the team in Pune for introducing the first IGRT in India, training in several international centres, back to Bangalore again, and work in CT-On-Rails, Cyberknife, Tomotherapy technologies. Presently at CTI, I have the opportunity to implement extreme precision therapy even in the simple techniques to the most sophisticated radiosurgery

Fig 1: Invention that changed radiotherapy forever: Fine rods (multi-leaf) that could move independently & automatically; giving a myriad of shapes for the beams sent into the body; blocking the normal tissues and focussing on the treatment area. (TrueBeam STx, Aster CMI)

Now the field of radiation therapy is in the middle of further technological developments. Next to Robotic surgery, radiation therapy machines are at the forefront. Most of the treatment is already automated, reducing the errors significantly, giving the least possibility of side effects, section by section being taken over by AI. If there is any problem with the machine or even before the problem develops alert is triggered in America or Germany !!!!. The development of components of the software in India completes the loop. 

Fig 2: Before the first session of treatment checked for accuracy and dose distribution – “A self-evaluation by the machine” for each patient (TrueBeam STx, Aster CMI)

Fig 3: Modern-day console, most of the work is on “autopilot mode” (TrueBeam STx, Aster CMI)

On the horizon, new technology is gathering called FLASH Radiotherapy, which might make radiation as safe as routine air travel. If I give radiation in one location, cancer elsewhere in the body can respond and disappear (Abscopal Effect). Simultaneously, surgeons heading towards scar less minimalistic intervention, medical oncologists are on the way not only killing the cancer cells but also improving the person's immunity (immunotherapy). Most importantly, all these are converging to make cancer like diabetes or hypertension, when not in cure mode.

Cancer Therapy India is the first to launch laser guarded IGRT radiotherapy in Bangalore and has the best radiation oncologist experienced in treating any kind of cancer by using Radiation Therapy for cancer in Bangalore. The Department of Radiation Oncology has a highly qualified and experienced team of Radiation Oncologists, Medical Physicists and Radiation therapy technologists, backed by state-of-the-art equipment capable of delivering a precise dose of radiation accurately to cancer with minimum damage to normal tissues.

Cancer Therapy India offers the best radiation therapy in Bangalore and the best treatment and cares you need.