KOCHI: Cancer treatment in the city is gaining momentum. With the linear accelerator (Linac) going functional in a couple of months, cancer patients, who are undergoing radiation treatment, can hope for the best. Linac will reduce the duration of the treatment since it is more powerful than the machines like Cobalt which is used now. It delivers high-energy X-rays or electrons right at a tumour and shrinks it.
“More than 70 per cent of cancer patients require radiation therapy. Innovation on this front is very important. When we go for comprehensive cancer care for people, it is important to have the latest technologies in hand,” said K T Thomas Kannampallil, radiation physicist and RSO, General Hospital, Kochi.
The Linac machine, which will be installed in the General Hospital, has provisions that help it to apply radiation according to the size and shape of a tumour. A machine called multileaf collimator (MLC) is used for this purpose.
“After the machine is installed, which will take at least three weeks, we will begin the tests. The machine will be patient-ready after many tests and retests are conducted. These will span over two months. During this period the clinical approval for the treatment process has to be obtained from the Atomic Energy Regulatory Board,” said K T Thomas.A team of radiographers, radiation physicists and radiation oncologists will be operating the Linac.
Patient Benefits
Patients will get minimal exposure to radiation in the areas where they are not afflicted. Almost 70 cancer patients can be treated using the machine every day. The intensity of the radiation is gradually decreased over the period of treatment for the patients. Currently, over 1,300 patients routinely undergo radiation at the General Hospital. Apart from this, the patients looking for pain relief (Palliative) also undergo radiation therapy at the hospital. Once the machine is installed, it will come as a big relief to the patients belonging to the middle and lower middle-class from Central Kerala.
GST Issue
The machine, which is worth Rs 7.4 crore was brought to Kochi a few months back. However, a GST of Rs 1.46 crore was charged and this caused a delay in its installation. The issue has been sorted out with the hospital using its hospital development society’s fund to offload the machine from the Kochi port. The government has promised a reimbursement. The installation process began on Wednesday and all the pending permissions have been acquired. The total expense incurred for the installation of the machine is Rs 16 crore. This includes the cost of the machine, installation, supporting equipment and the building where it is being installed.
Linac lasts longer
The cobalt machine, which is being currently used, is radioactive and degenerates with time. Whereas the Linac machines use X-rays. It emits radiation only when the controller pushes the button. Operated from outside the room, only the patient will be exposed to the X-rays. Cobalt machines were also vulnerable to leakage. Linac doesn’t have those issues. The speed of radiation of the cobalt machine reduces with time.
Peculiarities
“The machine will be placed in a building with walls made of concrete that are 2.4 m in thickness. If not the X-rays can penetrate the walls and reach the exterior of the building,” said Sajeesh, radiation physicist, General Hospital. Actually designed for nuclear tests, Linac is now helping cure cancer all over the world. The building has been built near the old RMO quarters in the vicinity of General hospital.
How does the equipment work?
The linear accelerator uses microwave technology (similar to that used for radar) to accelerate electrons in a part of the accelerator called the “wave guide,” then allows these electrons to collide with a heavy metal target to produce high-energy x-rays. These high energy x-rays are shaped as they exit the machine to conform to the shape of the patient’s tumor and the customized beam is directed to the patient’s tumor. The beam is usually shaped by a multileaf collimator that is incorporated into the head of the machine. The patient lies on a moveable treatment couch and lasers are used to make sure the patient is in the proper position. The treatment couch can move in many directions.