Image Guided Radiation Therapy (IGRT) Abroad

Image-Guided Radiation Therapy (IGRT) is one of the latest and cutting-edge innovations in radiation therapy and management of cancers. The therapy involves integration of treatment and imaging capabilities into a single machine, which makes it simpler and more effective in the management of cancers and tumors. This technology also increases the accuracy with which the tumor cells can be specifically targets, whilst reducing the damage on the surrounding tissues. India, Jordan, Mexico, South Korea and Turkey are some of the medical care destinations which provide Radiation therapy for management of cancers at competitive costs.

Understanding Image Guided Radiation Therapy:

Image Guided Radiation Therapy is a technique which involves the frequent use of diagnostic imaging to view the location, extent and size of the tumor during the course of the radiation therapy. This not only enhances accuracy and precision of the treatment, but also plays a critical role in the post therapy management of the patient.
In the Image Guided Radiation Therapy, the machine that delivers the radiation dose (i.e. linear accelerator) is linked to any diagnostic imaging equipment like a Computed Tomography (CT scan) Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET scan) or simply an X-ray, via a computer program, which facilitates the physician to view the tumor before, during and after the irradiation. This allows the radiation specialist to make necessary corrections and adjustments during the patient’s exposure to the radiation doses.

Advantages of Image Guided Radiation Therapy over other conventional radiotherapy systems:

• Compared to other systems of radiation therapies , IGRT considerably improves the accuracy of radiation field placement, specific to the tumor.
• The conventional systems require a larger target volume dose, in order to compensate for the errors of localizing the tumor during treatment. This significantly affected healthy tissues, as they received unwanted radiation dose. With increased precision and accuracy, IGRT considerably reduces the damage to the healthy tissue. This in turn increases the intensity and dose of radiation on the tumor.

• Currently used innovation in radiation therapy includes Intensity Modulated Radiation Therapy (IMRT), which molds a three dimensional radiation dose map, specific for the tumor based on its characteristics like size, shape, movement and location. This requires critical data about the tumor which is of utmost importance for planning the target volume margins dose. Image Guided Radiation Therapy allows IMRT to collect critical data which helps it focus on the tumor with the specific dose and intensity.
• Image Guided Radiation Therapy also helps monitor changes that may occur during the treatment procedure (i.e. shrinkage or expansion or change in shape) of tumor. This is of crucial importance for clinical studies and provides better avenues for innovations.

Preparing for Image Guided Radiation Therapy:

• Prior to undergoing irradiation, radio dense markers (which are made up of a material which doesn’t allow the penetration of X ray beams and hence appear as white spots in the image) are inserted into the patients body about a week prior to the procedure.
• The patients skin may also be marked, to assist the radiation therapist to align the equipments accordingly
• The patient is expected not to eat or drink after the midnight of the previous day prior to the procedure.
• The patient is also required to inform the doctor about any medications, which the patient takes as a part of his routine medical care. The patient is also required to share any information about past history of allergic reactions to iodine, shellfish or any other intravenously administered substance

Image Guided Radiation Therapy Procedure:

Image Guided Radiation Therapy is a simple procedure similar to other Radiation therapy procedures. The entire procedure can be classified into three simple steps,

• Stimulation: During this stage the patient is positioned on a CT scan or X ray table and stimulation images are taken. The patient is made to lie in different positions for the oncologist to assess the size, shape and exact location of the tumor. This gives the presiding physician all the requisite information for subsequent planning process.
• Treatment Planning: With the help of a specialized computer system the oncologist would work with the dosimetrist to determine the exact dose to be applied to the tumor while ensuring minimal exposure to the surrounding healthy tissue. Images of the patient in different other positions may be required in this stage. All necessary adjustments are made in the treatment plan and the position of the patient prior to initiating the process of irradiation. (There are two basic strategies of patient position correction that are used. The online strategy involves correcting the patient position and dosage during on going treatment, while the offline strategy involves correcting the patient position and dosage based on the information collected during the stimulation stage and the subsequent planning stage)
• Treatment Delivery: The final step involves the initiation of the radiation therapy treatment as per the plan.

Common side effects of Image Guided Radiation Therapy:

Just like all the radiotherapy treatments, IGRT also is accompanied with the common complications which occur primarily due to exposure to radiation. These include,

• Early Side Effects: These include gastro intestinal disturbances like nausea, vomiting, diarrhea, loss of appetite and weight loss. Hair loss is a fairly common problem attributed to thinning of the hair. Headaches and difficulty in swallowing are also common problems. Occasionally the patient may complain of soreness and swelling in and around the treatment site.
• Late Side Effects: These occur after almost a year of treatment and are often permanent. These include infertility, lymphedema, and changes in the brain, kidney, spinal cord, lungs and colon. There is a rare chance of the patient developing a secondary cancer due to the exposure to radiation dose.

Image Guided Radiation Therapy in India:

India is a rapidly developing country and embraces latest technological advances in the domain of medical science quickly and readily. A team of specialized healthcare professionals and international quality of medical care are the strong aspects of the nation’s booming medical tourism industry.

Image Guided Radiation Therapy in Mexico:

Mexico provides low cost care to U.S. patients in hospitals with international quality standards for medical care. Medical tourists from the United States to Mexico, spend the least time on travel, which allows them to return home early after completing the treatment.

Image Guided Radiation Therapy in Turkey:

After earning a strong reputation in the Middle East for its low cost, and high quality of medical care, Turkey is now focusing on attracting medical tourists from the United States, by providing multiple treatment options at comparable costs. The hospitals and physicians across the country are abreast with the latest technological innovations in the West and provide the same facilities at half the cost.

Image Guided Radiation Therapy in Jordan:

With augmentations in the healthcare infrastructure and stringent government medical quality control procedures in place, Jordan is attracting patients from Europe due to the cost advantage. Its proximity to Europe, allows an opportunity for medical tourists from United States to couple medical care with leisure travel across Europe.

Image Guided Radiation Therapy in South Korea:

South Korea is the only medical tourism destination which has a specific and focused approach. The hospitals across the country specifically focus on medical and surgical oncology services and have gained tremendous experience and expertise in management of foreign patients visiting the country for oncology care.

Resources:
Cyberknife in India
Cyberknife at Anadolu Medical Center, Turkey
Chemotherapy Treatment (CHOP) Abroad
RCHOP Chemotherapy
Cyberknife Cancer Radiotherapy Overseas

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Medical Tourism Corporation facilitates IGRT cancer treatment in Europe, India and other overseas world-class oncology treatment destinations.