Intensity modulated radiotherapy
Intensity modulated radiotherapy (IMRT) is an advanced mode of high-precision radiotherapy that utilises computer-controlled x-ray treatment system to deliver precise radiation doses to a malignant tumour or to a specific areas within the tumour. The radiation treatment area is designed to conform to the 3 dimensional shape of the tumour by controlling the intensity of the radiation beam to focus a higher radiation dose to the tumour while minimising radiation exposure of the surrounding normal tissues. IMRT also has the capability of “dose-painting”, a technique where different doses can be delivered to different parts of the treated volume. IMRT is especially useful in treating head and neck cancers.

Stereotactic radiosurgery (gamma-knife and x-knife)
Radiosurgery refers to the"fine" pencil beam of ionising radiation to kill cancer cells or to destroy their ability to grow in the brain.
Radiosurgery offers a non-invasive alternative for many patients for whom traditional brain surgery is not an option, and removes the physical trauma and majority of risks associated with conventional surgery. This procedure has the advantage of not requiring hospitalisation, ICU stay, or general anaesthesia (except in young children). Also, overall treatment mortality (including no risk of haemorrhage or infection) for most indications is reduced compared to that of conventional open microneurosurgery. It is also more cost-effective than open microneurosurgery.

Novalis Radiosurgery System
This system of delivering radiation therapy combines the advantages of radiosurgery and IMRT in addition to having an image tracking (guided) system to further enhance treatment accuracy. This involves an integrated treatment system that shapes beams of focused high-energy radiation from all angles to deliver non-invasive, precise treatments that shrink or control the growth of tumour cells of the brain as well as in the head, neck, spine, liver, lung and prostate. With the Novalis technology, potential harm to surrounding normal tissue is significantly reduced.

Internal Radiation Therapy or Brachytherapy
Internal Radiation Therapy or Brachytherapy is another form of radiation therapy where a small radioactive material is placed inside your body in or very close to where the cancer is. This is most commonly used in treating cancers in the cervix, uterus, vagina, head and neckregions and sometimes in the esophagus, lung, breast or prostate. This treatment can be given alone or in combination with external beam radiation therapy.

The use of Iodine-125 permanent seed implants for brachytherapy has been introduced. The procedure provides a new treatment option for patients with early prostate cancer.  The seeds work by continuously emiting  radiation for a short period of time to the prostate gland to kill prostate cancer cells and are not rejected by the body because of the titanium casing.

New developments in breast radiotherapy
Radiotherapy treatment techniques have evolved dramatically since then and have grown to become an integral part in the management of breast cancer. More so now that we are seeing earlier stage breast cancer with the advent of breast cancer screening. [ more ]

IMRT in cervical cancer – one for all, and all for one?
The primary aim of radiotherapy in the treatment of cancer is to deliver sufficient radiation dose to the cancer-bearing region and avoiding treating the adjacent normal tissue. [ more ]

IMRT - State of the art radiation technique for head and neck cancers
Radiotherapy plays an important role in the management of patients with head and neck cancers (HNSCC). In early-stage tumour, radiotherapy is often preferred because it is as effective as surgery in controlling the disease and is generally better in preserving cosmetic and organ functions. [ more ]

Tumour Board Files: Focus on late complications of radiotherapy
Mr. Tan was 45 when he was diagnosed with stage II nasopharyngeal cancer. It took him a while to accept the diagnosis as he had been in perfectly health before this. After explanation about the curability of his condition and the possible side effects from treatment, he agreed to 7 weeks of radiation therapy. The few weeks while he was on radiation were tough. He had a severe sore throat and ulcers developed in his mouth that made eating painful. [ more ]

Prostate Cancer: An Overview
Prostate cancer is malignant growth in the prostate gland. The prostate is a small, walnut-shaped gland that surrounds the bottom portion ("neck") of a male's bladder and about the first inch of the urinary tube (urethra), the channel that drains urine from the bladder. [ more ]

Radiation sensitivity

About 50% of cancer patients undergo radiotherapy as part of their cancer management regime. The Department of Radiation Oncology at the National Cancer Centre sees up to 2,000 of such patients annually. At present, a small but significant number of cancer patients – approximately 5 per cent – who undergo radiotherapy suffer from severe complications, which may be either immediate or manifest after some time post treatment. These may present itself in the form of diarrhoea, fibrosis of the skin, fistulas

At present, no one knows why this happens. For example, some patients could be genetically pre-disposed to such complications. However, this is what Dr Susan Loong and her team of researchers hope to understand, that is why do some patients have an exaggerated reaction to radiotherapy while others do not. This means studying the molecular mechanisms underlying radiation responses primarily in the normal tissue of a cancer patient.

Although still in the early stages of research, Dr Loong and her team hopes that in the long run, patients could be stratified and those who could potentially suffer from severe complications following standard doses of radiotherapy treatment could be identified. Such a discovery will have significant implications on how treatment will be delivered, moving towards more individualised treatments that will help to improve patient outcomes.