WHAT WE DO
Max institute of cancer care (MICC) GI cancer multidisciplinary team includes group of experts in medical oncology, surgical oncology, radiation oncology, gastroenterologists, radiologist, pathologist, molecular oncologist, psychologist and physical therapists. They collaborate and provide the best comprehensive cancer care to all patients. The disease management group discussions and management options are discussed with patients to help them choose the best treatment for them.
The molecular profiling of tumors for targeted therapy and genetic test to assess the risk in family members is an integral part of multidisciplinary treatment plan.
Post operative specialized care in dedicated oncosurgery ICU and wards with help of experts intensivist, nurses and physical therapist helps in faster recovery.
Surgical Oncology unit
The surgical unit of GI and Hepato-pancreato-biliary (HPB) DMG are specialized in all surgeries and minimal invasive procedures required for treatment of GI cancers.
Radiation Oncology Unit
What is Radiation Therapy and what does it do?
Radiation Therapy (RT) is use of high energy Ionization radiation (often X Rays ) to kill a cancer cell by damaging its DNA. Goal of Radiation Therapy (RT) is to use focused beams of radiation to kill cancer cell with as little risk as possible to normal cells. Radiation treatment, like surgery, is a local treatment. It affects the cancer cells only in a specific area of the body.
Timing of RT-
RT can be used before surgery to shrink a tumor, called as neoadjuvant/pre operative RT (Pre op RT). It may be used after surgery to stop growth of cancer cells that may remain called as adjuvant RT (Post op RT). At times radiation is used alone with curative intent which is called as Radical RT. It can also be used at the time of surgery known as Intra-operative Radiation (IORT).
Medical Oncology Unit
What is Medical oncology and what does it do?
Medicines form an important part of the cancer treatment. These can be in the form of chemotherapy, hormone therapy, targeted therapy, biological therapy or immunotherapy. It's used primarily in the following scenarios
1) Concurrent partner to radiotherapy to increase the efficacy
2) Neoadjuvant chemotherapy – given before definitive therapy which could be chemoradiotherapy or surgery. This is also given to make inoperable tumours operable by reducing the size in some patients.
3) Adjuvant chemotherapy: this is given post surgery usually to decrease the risk of recurrence.
4) Palliative chemotherapy : to control advanced cancers ( cancer which has spread beyond the site of origin) or locally advanced tumour not amenable to surgery or radiotherapy.
Types of RT
When the source of radiation is from a machine outside the body, it’s called as External Beam Radiation therapy (EBRT). When radioactive material is placed close to tumour or area harbouring cancer cells it’s called as Brach therapy.
What is EBRT?
EBRT is usually given during outpatient visits (OPD Treatment) to a hospital. In this, a machine (also called as Linear Accelerator/LA) directs the high energy rays at the tumor bearing area within body. The type of machine used for radiation therapy is called as a Linear Accelerator and at Max Hospital it has several models like True Beam STx, Novalis or Clinax. Linear Accelerators have the capability of delivering RT by various techniques like IMRT (Intensity Modulated Radiation Therapy), IGRT (Image Guided Radiation Therapy), SRS (Stereotactic Radiation Therapy) and SBRT (Stereotactic Body Radiation Therapy).
What is IMRT?
Intensity-modulated radiation therapy (IMRT) refers to a technique of focusing radiation therapy at cancer bearing area using computer based optimization process to carefully create a gradient or a dose fall-off between the cancer/target tissues and the surrounding normal tissues. This fall of dose saves the surrounding normal organs effectively. Therefore, these techniques offer the prospect of increasing the cancer control probability while decreasing the side effects.
What is IGRT?
Image guided radiation therapy (IGRT) is classically defined as radiation therapy that is delivered only after verification of position of structures of interest by performing either an X-Ray or CT based image. The same are done by an imaging system mounted on the linear accelerator itself. IGRT technically includes IMRT and hence also called as IM- IGRT (Intensity-modulated Image guided radiation therapy)
What is SBRT?
Stereotactic body radiation therapy (SBRT) refers to use of principles of stereotaxy to identify and pin pointedly deliver precisely deliver intense doses of RT to only to cancer/tumour area. SBRT is essentially similar to Stereotactic Radiosurgery (SRS) brain except that term SBRT used when we are targeting areas outside brain. Since SBRT involves delivery of higher intensity of radiation doses in shorter time, it also known as SABR (Stereotactic Ablative RT). SBRT is generally done by combining IMRT and IGRT together. SBRT generally has fewer sitting /fractions of radiation as compared to conventional IMRT or IGRT.
Your Radiation Oncologist will discuss all these techniques and how they are relevant for your cancer and its treatment.
What is more important for successful radiation therapy- Machine or team behind machine?
Both machines and team behind machines are equally critical in successful delivery of RT. We are fortunate that at MICC, we have this critical combination of the modern state of the art machines and a trained team available across all hubs of Max Hospitals.
True beam STX is an advanced radiotherapy system to deliver more powerful cancer treatments with pinpoint accuracy and precision. It uniquely integrates advanced imaging and motion management technologies within a sophisticated new architecture that makes it possible to deliver treatments more quickly while monitoring and compensating for tumor motion. While the technology always opens the door, it is always the skilful doctors who can get inside it.
- Stoma Care Nurse: stoma is an opening on the front of your abdomen which is made using surgery. It allows faeces or urine to be collected in a pouch (bag) on the outside of your body Sometimes, during surgery, it may be necessary for the surgeon to form an artificial opening on the wall of your abdomen called a 'stoma' to collect waste. The stoma may be temporary (to allow the bowel time to heal) or permanent.
- Dietitics and Nutrition
- Cancer Prevention advise & services
- Cancer Genetics
- Molecular / Precision Oncology
- Tobacco cessation services