Brachytherapy facility an important development in Africa’s fight against cancer
Specialised cancer treatment unit established at Johannesburg private hospital
A newly launched brachytherapy facility with advanced technology at a Johannesburg hospital provides patients from around Africa with significantly more options for the treatment of various kinds of cancers, and is “an important new tool in the fight against the disease”.
This is according to Dr Niveditha Singh, an oncologist who practises at Netcare Rand Hospital in Berea, Johannesburg, where the brachytherapy facility was officially opened today. “Netcare Rand Hospital Oncology Centre has introduced sophisticated high dose rate [HDR] brachytherapy technology that is currently not widely available in South Africa or, indeed on the continent,” adds Dr Singh.
“This new technology enables doctors to use this form of therapy to treat a range of different types of cancer including cervical, uterus, breast, oesophageal, lung, rectal, skin and others.”
Dr Singh explains that HDR brachytherapy is an effective form of cancer treatment, which involves placing a sealed radioactive source very close to, or in contact with, cancerous tissue, in order to destroy or reduce the size of tumours.
“The brachytherapy unit at the hospital incorporates a state-of-the-art SagiNova HDR Afterloader, Co- 60 Source, which offers a number of advantages over earlier technologies. It enables clinicians, for example, to better spare tissue around diseased sites, improve local control of disease and ultimately to deliver improved medical outcomes for cancer patients.
“In addition, HDR brachytherapy enables doctors to use a higher total dose of radiation to treat a smaller area in a shorter time than is possible with external beam radiation treatment. The highly radioactive source is placed inside a slender tube called an applicator, and is directed to the diseased site that is to be treated.”
Dr Singh explains that, as these radioactive sources have a high radioactive strength, they are able to deliver a strong dose of radiation safely to a localised area. “HDR brachytherapy is, in other words, a form of internal radiation therapy, which uses ionising radiation to destroy cancer cells in a highly targeted manner,” she adds.
“The oncology centre at Netcare Rand Hospital, which has been providing care to patients since 1991, will initially be using this HDR technology to mainly treat gynaecological cancers such as cervical and uterine cancers, but will later be expanding its applications to treat other types of cancers,” adds Dr Singh.
“HDR brachytherapy can be used as a stand-alone treatment or we can use it in conjunction with other treatments such as external beam radiotherapy, surgery and chemotherapy, depending on the requirements of each particular case, which is always unique. This means we are able to carefully tailor our treatment approach.
“HDR may also be recommended post-operatively to reduce the risk of reappearance of cancer in high-risk patients.”
According to Dr Singh, a CT (computerised tomography) scanner has also been installed at the facility. “This enables us to visualise diseased areas more precisely and clearly, improve our diagnosis, and accurately plan the radiation to optimise treatment.”
Lindiwe Fokazi, unit manager at the oncology centre at Netcare Rand Hospital, says that a set of international HDR brachytherapy treatment guidelines have been implemented by the medical physics team at the centre to ensure that patients receive high quality clinical care.
According to Fokazi, HDR brachytherapy can be used in the following types of oncology cases, among others:
- Cervical cancer – This type of cancer may be treated by a combination of pelvic external beam radiotherapy and brachytherapy. HDR brachytherapy is a necessary component in the curative treatment of cervical cancer. It can also be administered as additional treatment of the vaginal cuff after hysterectomy in patients with an intermediate or high risk of recurrence.
- Endometrial cancer – Brachytherapy may be used on its own or in conjunction with external beam radiotherapy.
- Endo-bronchial radiation – The use of brachytherapy is well established for palliation or easing of cough, dyspnoea (shortness of breath), pain and haemoptysis (coughing up blood in the sputum) in patients with advanced or metastatic lung cancer.
- Oesophageal radiation – HDR brachytherapy is often used to stop the bleeding that may occur in oesophageal cancer cases, and also help palliative dysphagia, which is difficulty or discomfort in swallowing.
“Over the last 25 years the oncology centre at Netcare Rand Hospital has become a trusted cancer treatment centre for patients. It has for long been our aim to establish the facility as a treatment centre of choice for patients from around the African continent, and our new brachytherapy unit takes us a step further in this regard,” concludes Fokazi.