Cancer Treatment (Oncology)

Cancer Treatment (Oncology)

WE TEAM UP AGAINST CANCER!

We know fighting cancer might be the toughest thing you ever have to do. It’s a 24-hour-a-day job that can drain both your brain and your body.

Along with this tough journey, successful results require high pression and dedication. As Acıbadem Healthcare Group, we provide all necessary treatments with our multidisciplinary approach, experienced team and advanced technology.

The multidisciplinary approach based on a committed team work is the core of cancer treatment!

The most effective solutions in the treatment of cancer are obtained using a multidisciplinary approach. The consultation of physicians in different branches is extremely important in the diagnosis and treatment of cancer and requires close teamwork.

In multidisciplinary structures, specialists in different branches come together, reach a joint decision and share the responsibility. As a result, working with a multidisciplinary structure obtain more successful results in the treatment and follow-up of cancer that is in the field of oncology.

ACIBADEM Hospitals – team up for cancer patients with world class technology.

As ACIBADEM Healthcare Group, we have brought the latest technology to Turkey. With our highly developed technological devices and wealth of knowledge and experience we offer our patients state of the art technologies used worldwide on the diagnosis and treatment of cancer.

 

The Center of Cancer Treatment: Medical Oncology

Medical oncology is a branch of science which covers not only the treatment of cancer patients, but also cancer protection, cancer screening and early diagnostic applications.

Moreover, in cancer diagnosis and treatment, there is cooperation between various fields such as surgery and radiology. The approach to patients is planned as a multidiscipline in line with scientific data.

In medical oncology treatment planning changes based on:

  • The cell type of cancer,
  • The organ where it first appeared
  • The areas to which it has spread.

Types of Treatment Used in Medical Oncology

Chemotherapy (Medicated Therapy): Chemotherapy aims to destroy cancerous cells that grow in an uncontrolled manner due to some changes in their structures. In ACIBADEM Oncology Centers, we apply the most recent developments in this field to treat our patients.

Hormone Therapy: Hormonal drugs are used in the treatment of tumors that are sensitive to hormones, such as prostate and breast cancers.

Immunotherapy (Treatment via Immune System): Substances that the immune system naturally produces are used to identify and kill cancerous cells by alerting the body’s immune system.

Target-Driven Biological Therapy: One of the most important developments of the last decade in cancer treatment has been the development of highly effective biological therapies. This treatment relatively few side effects and which identify targets that are present in cancerous cells but not in normal

Targeting Cancer Cells: Radiation Oncology

Radiation oncology is the discipline that examines, through the use of ionizing radiation, the effects of radiation on the cancer, the behavior of tumors and also covers research in this field. Radiation oncology has two areas of application: Radiotherapy and Radiosurgery.

Radiotherapy (X-Ray Therapy)

Radiotherapy is defined as the treatment of the cancerous tissue or of some non-malignant tumors with radiation. It is also colloquially referred to as “radiation therapy” or “x-ray therapy”. The beams used in radiotherapy aim to stop cancerous cells from growing or to kill them.

Treatment Devices Used in the Application of Radiation Oncology:

Rapidarc

Rapidarc is a highly developed technology that provides greater comfort and ease for the patient by reducing the length of radiotherapy sessions from 15-30 minutes to as little as 2 minutes.

Trilogy

The Trilogy device allows accurate intervention by specialists in the shortest amount of time and to an ideal proportion. This means the patient receives the most accurate treatment in the shortest amount of time.

Brachytherapy

Brachytherapy is a method used to raise local control of the disorder by increasing the dose of radiation applied to the tumor before and after external radiotherapy.

Techniques Used in the Application of Radiation Oncology:

IGRT : Image Guided Radiation Therapy
IMRT : Intensity Modulated Radiation Therapy
Conformal Radiotherapy : 3D Conformal Radiotherapy
SRT / SRS : Stereotactic Radiotherapy / Stereotactic Radiosurgery

Fields of Application for Radiotherapy

Curative Radiotherapy:

In light of available information about the disease, it is applied in cases where the disease can be completely treated. It can be applied alone or with surgery and/or chemotherapy.

Palliative Radiotherapy:

Applied in cases where it is impossible to completely destroy the disease. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness.

Scalpel-Free and Bloodless Surgical Treatment Using Beams: Radiosurgery

The fundamental aim in radiosurgery, one of the fields of application of radiation oncology, is to direct many low-energy beams to the diseased area. The aim is to shrink or kill the cancerous cells with intense beams while the surrounding healthy tissues are protected from the harmful effects of radiation.

Techniques Used in the Application of Radiation Oncology

SRS / SRT:

Stereotactic Radiosurgery (SRS)refers to the complete destruction of the tumor in one single session through high doses of radiation. When this therapy is applied in more than one session (generally 3-5 session) it is named as Stereotactic Radiotherapy (SRT).

MRIdian – Viewray

MRIdian® Linac is the world’s first radiotherapy device, with an integrated onboard MRI, for image guidance. This device can provide continuous and real time based imaging before and during the treatment.

Viewray Process

As conventional radiotherapy, patient is placed on table. MRI is performed for targeted tissues. Tumoral region and surrounding healty tissues can be detected and visualized clearly with the aid of MRI. If targeted tissues and surrounding  tissues are radiated with precise dose then treatment begins. Real time based imaging helps physicians to control the treatment process during irradiation.

What are the advantages of Viewray?

  • Improves tumor visibility and patient alignment,
  • Tracks tumors and manages tumor and normal organ motions.
  • Provides real time – on table adaptive radiotherapy planning
  • Accurately records delivered radiation dose
  • Enables continuous and real time soft tissue imaging during the treatment
  • Provides recording video during the treatment and enables to see all treatment process and progress

Which Diseases Can be Treated With Viewray?

Breast, Periaortic LN, Lung, Kidney, Bladder, Pelvic LN, Head/Neck, Bile Duct, Stomach, Cervix, Adrenal Gland, Orbit, Bone, Spleen, GYN Pelvis, Thorax, Aortic Arch, Pancreas, Heart, Prostate, Mesenteric, Abdomen (Soft tissue), Neck LN, Rectum, Parotid Gland, Pelvis, Spine, Esophagus, Thyroid, Colon, Liver, Extremity, Mediastinal LN, Pelvis, Soft Tissue Pelvis, Superclav, Brain, Uterus, Flank, Gall Bladder, Lingual LN, NAsopharynx, Ovaries, Rib, Thymus.

CyberKnife® Robotic Radiosurgery System

CyberKnife® is a robotic radiosurgery system that can treat with highly sensitive precision, even to within a millimeter. With this system cancerous region in the brain or in the body can be treated with high doses by using radiation beams focally. In this procedure the healthy tissues can be protected at maximum levels against side effects of radiation.

Device Features

CyberKnife® uses computer controlled robot technology that turns around the patient and performs the treatment by applying radiation from hundreds of angles. Differently from standard stereotactic radiosurgery methods, CyberKnife® determines the precise location of the target with its imaging system and radiates precisely by combining the guidance system with computer-controlled robot system.

Areas of use

The tumors of any size in the brain and head-neck area can be treated with CyberKnife®. It can be used in the treatment of malign and benign brain tumors and metastases.

CyberKnife® can be used to treat conditions throughout the body, including tumors of the prostate, lung, brain, spine, head and neck, liver, pancreas, kidney, and certain gynecologic indications, arteriovenous malformations and some functional diseases.

Liver and lung cancers in which the tumor is moved with respiration can be safely treated with CyberKnife®.

Advantages

  • CyberKnife® is an alternative method to surgery, there is no surgical operation needed.
  • Provides patients with an a highly precise treatment alternative for the treatment of the tumors that require a complicated operation or are inoperable.
  • Is able to treat the cancerous areas in the brain or body, especially those that are not easy to reach with high doses, by using radiation beams focally.
  • Offers a short treatment option with only 1-5 sessions.
  • Is a painless therapy; no anesthesia is required for the therapy.
  • Can treat multiple tumors simultaneously.
  • Provides real-time monitoring of patient movements.

Treatment Process

During the treatment with CyberKnife® a water-soluble plastic mask will be placed on the face of the patient. The mask and special beds are used instead of the methods used to immobilize the head or the body.

The patient rests on a robot-controlled bed that can move on six directions. The image capture system of CyberKnife® determines and monitors the location of the tumor and changes the patient’s position if necessary. The patient doesn’t have to hold the breath and can breathe normally during the treatment. The patient does not feel anything during treatment and its acute side effects are almost none. The system compares computed tomography (CT) or magnetic resonance (MR) images of the patient taken before the therapy with the spontaneous images during the treatment. Radiation dose is adjusted after the determination of tumor coordinates.

Gamma Knife Icon

Gamma knife is one of the stereotactic intracranial radiosurgery technique that used for treating the brain tumors and other brain abnormalities as part of radiation therapy. In gamma knife radiosurgery, the targeted tissues receive a very high dose of radiation in a single session. The aim of this procedure is to stop the growth of the tumor.

The Gamma Knife Process

Treatment is planned according to the specific needs of individual patients and this customized process is very easy, fast, reliable, safe, and straightforward. The treatment begins by fitting the stereotactic frame to the patient’s head. This is easily done within minutes and requires only local anesthesia. Once the frame has been fitted, an imaging procedure suitable for the patient’s pathology (i.e. MRI, CT, angiography) is performed. These studies create a very detailed and precise map of the brain. Then the treatment is planned with exact precision using a special computerized planning program. The treatment is fitted to cover the target with an accuracy of less than a millimeter, while protecting the surrounding brain and nerve tissues with exquisite safety. Then the treatment is administered usually over a period of 30 minutes to one and a half hours. While the treatment is administered, the patient peacefully rests on the treatment couch and listens to music. Following treatment, the frame is removed and most patients are discharged from hospital on the same day. There is no need to return to hospital again after Gamma Knife procedures unlike most other surgical procedures. The patients continue with their routine life the way they did one day before the procedure.

What are the advantages of Gamma Knife treatment?

✓  It can eliminate the need for open surgery for many types of brain tumors.

✓  It does not require general anesthesia

✓  It does not require going to operating theatre.

✓  There are no incisions on the scalp or head.

✓  Normal brain tissues are exposed to very little radiation.

✓  Hair does not have to be cut and does not fall out.

✓  Patients return to their homes or work on the day of treatment.

✓  There is no recovery period.

Which Diseases Can Be Treated with Gamma Knife?

Patients with benign brain tumors:

  • Vestibular schwannomas (formerly known as acoustic neuromas)
  • Meningiomas
  • Pituitary adenomas
  • Skull base tumors
  • Chordomas
  • All other intracranial schwannomas
  • Glomus jugulare tumors
  • Craniopharyngiomas
  • Hemangioblastomas
  • Tumors of the pineal region

 Patients with blood vessel anomalies:

  • Arteriovenous malformation ( AVM)
  • Cerebral cavernous malformations
  • Cavernomas
  • Dural arteriovenous fistulas
  • Patients with malignant tumors:
  • Malignant melanoma
  • Uveal melanoma
  • Certain glial tumors
  • Hemangiopericytoma
  • Nasopharyngeal carcinomas
  • Patients with functional diseases:
  • Trigeminal nuralgia

Patients with movement disorders:

  • Tremor associated with Parkinson’s disease.
  • Patients who refuse open surgery
  • Patients unable to tolerate surgical procedures for reasons such as age or associated medical conditions.

Single Dose Radiation Therapy

In patients with breast cancer, radiation therapy can be completed with a single-dose application done using the Intra Operative Radiotherapy (IORT) method during surgery.

Single Dose Radiation Therapy Process

Single-dose-app1 Radiotherapy begins preferably after chemotherapy in patients who require it or at least 3 weeks after surgery in patients who are only treated with hormone therapy. In patients who will receive radiotherapy for the breast, tomography cross-sections with 2-mm increments are first taken using a computer for planning purposes. Later, arrangements are made to apply the necessary dose to the areas under risk in the breast that’ll receive radiotherapy while protecting the healthy organs (the heart, main arteries of the heart, lungs, other breast, etc. where the illness hasn’t spread). Once the plan is approved, the patient receives radiation treatment for 5 to 7 weeks, dependent on the condition of the illness and determined by the radiation oncology doctor. Other patients still receive a short-term treatment called hypofraction, which lasts 3 weeks.

Advantages of Single-Dose Application

This method is used in an operating room using a safe and portable tool that operates in a linear and accelerated manner, only producing electron energy but not requiring too much protection for the personnel like traditional linear accelerators do. In addition to the surgical team carrying out the operation, a radiation oncology specialist and a medical physicist are also present in the operating room. This way, radiotherapy is completed at the same time as the surgery. A significant advantage for the patient is that there is no need to wait for the wound to heal following surgery, or to plan radiotherapy and visit the hospital each day for treatment. This way, the total duration of the treatment is also cut down.

During the operation, once the tumor in the breast is removed, the special applicator within the tool is placed in the area where the tumor is. Following necessary calculations, the high-dose radiation is given only to this area, completely protecting healthy tissue. Although single-dose application or using different methods to apply radiation only to the tumor area as opposed to the entire breast are methods that have become more globally accepted in recent years, single-dose application isn’t for every patient. The decision whether a patient is suited to receive this treatment must be made collectively by the radiation oncologist, the surgeon and the pathologist dealing directly with the patient. The patient’s age, the size of the tumor and other pathological qualities of the tumor play an important role in this decision.

Who Receives the Radiation Boost?

Patients under the age of 50-60 are not considered to be ideal candidates for single-dose application. In these patients, it is necessary to apply radiation to the tumor area following radiation application to the entire breast in the traditional method. Once the treatment of the entire breast area is completed within 25 to 28 work days, excluding weekends, instead of the entire breast, only the area where the tumor was removed is treated with radiation, which takes around 5 to 8 work days depending on the patient and the patient’s circumstances. Applying radiation to the area with the tumor is called a radiation boost. Thanks to the IORT method, the radiation boost is delivered as a single dose during the operation, after which the entire breast is subjected to radiation and the total treatment duration is cut down.

Applying Radiotherapy to the Nipple Complex

Breast-protective surgical treatment may not be suitable for some patients. In patients where the entire breast needs to be removed, the nipple and its surrounding area are left intact for a better cosmetic result. This is called nipple-sparing mastectomy. A single dose of radiation is applied to the nipple and the tissue right underneath using the IORT method to lower the risk of recurrence here.

Truebeam®

TrueBeam® is an advanced radiotherapy system combining the following advanced treatment options:

  • Image-guided radiation therapy (IGRT),
  • Stereotactic radiosurgery (SRS),
  • Stereotactic body radiation therapy (SBRT),
  • Intensity-modulated radiotherapy (IMRT),
  • RapidArc (a volume based intensity adjustable treatment that shortens the patient’s treatment period)
  • Gated RT in a single device.

Device Features

TrueBeam® can deliver any type of radiation, and it also can shape radiation according to the tumor structure, with IMRT and IGRT techniques as well as RapidArc and radiosurgery methods with the most sensitive imaging and application abilities.

Radiosurgery involves application of a dose that is as effective as a knife while minimizing the damage to the area surrounding application and destroying the target completely. The SRS technique, which focuses on a target in three dimensions with a high dose and is therefore able to achieve the same results as removing the target with surgery, can also be done with TrueBeam® STx. The SBRT technique in which tumors with a small volume in any part of the body are safely treated in fewer sessions (3-5) is also possible with this device.

Indications

All tumors that require radiotherapy can be treated safely with TrueBeam®.

TrueBeam® offers new possibilities for the treatment of cancer of the lung, breast, stomach, liver, prostate, brain, head and neck. bone tumors and soft tissue sarcomas in any part of the body can also be treated with radiotherapy via TrueBeam®.

It is especially useful for tumors located in the head and small volume tumors in the body and next to risky organs. It provides a suitable method for treating lung and spinal tumors and for second series radiation therapy.

Advantages

TrueBeam® is a system to treat cancer with speed and accuracy while avoiding healthy tissues and organs. The most important feature of TrueBeam® is that it can provide faster, safer and more effective treatment.

TrueBeam® makes it possible for radiotherapy to be applied to cancerous tumors without harming the surrounding tissues.

With TrueBeam® it’s possible to treat the tumor with a high dose in a very short time, while monitoring and compensating for tumor motion. The radiation therapy period that is reduced increases the accuracy of the treatment and the comfort of the patient. A conventional intensity-modulated treatment would typically take 10 minutes; with TrueBeam® it takes less than two minutes. Complex radiosurgery typically takes 40 minutes to an hour; but it can be completed in 5-20 minutes using TrueBeam®. And with TrueBeam® the added radiation given to patients is 25% less than other imaging systems.

Treatment Process

TrueBeam® has been designed with patient comfort in mind. It rotates around the body of the patient to deliver radiation therapy from nearly any angle. It is quiet during operation and has communication technology that enables interaction between the patient and the clinicians operating the equipment. Most treatments take just a few minutes a day, which means less time on the treatment couch and reduced motion during treatment.

Application Fields of Surgical Treatment

Curative surgery is also applied within the scope of surgical oncology. However, the preliminary condition for applying curative surgery is that the disorder is limited to the organ or lymph nodes where it first appeared. Tumors may be completely removed from patients, provided that their boundaries are well determined. However, there are cases where the tumor cannot be completely removed. In such cases, debulking surgery may be applied to minimize the bulk. Moreover, removal of metastases which are low in number improves the patient’s chances of a sound recovery.

Robotic Surgery with “da Vinci”

Laparoscopic operations that are performed with “da Vinci” surgical robot are defined as Robotic Surgery. These operations provide a great deal of advantages to the patient. In addition to the common advantages of all laparoscopic operations such as less pain, minimized scars on the skin, shorter stay in the hospital; there occurs less bleeding and the success rate of the operation is higher. “da Vinci” robotic surgery is performed especially in these major areas; Gynecology, Gynecologic Oncology, Urology, Cardiac and Vascular Surgery, General Surgery and Ear-Nose-Throat surgery.

The First Step Towards Accurate Treatment: Radiological Diagnostic Methods

Accurate radiological diagnosis is an essential part of deciding how treatment should be performed. Modern techniques and advanced technology are of paramount importance when performing radiological diagnosis, as well as an experienced radiology staff.

As well as qualified radiology staff, it is essential that techniques applied with advanced technology are used in accurate diagnosis. As ACIBADEM Healthcare Group, we are working according to this principle and closely following developments in medical science, constantly changing its diagnostic equipment in all ACIBADEM Hospitals and outpatient centers with new high-tech equipment.

Cutting-Edge Technology in Diagnostics:

For Rapid And Reliable Diagnosis: PET-CT

The PET/CT device is used to identify tumors in their early stages, particularly for cancer treatment, and to determine whether these tumors are malign or benign. The device is also used in the diagnosis and treatment of neurological and cardiological disorders.

Pet/CT In Early Diagnosis

PET/CT offers many significant advantages in early diagnosis. It offers the opportunity to identify many disorders at the beginning phase. In pre-PET/CT periods, it was determined only by biopsy whether nodules in the body are cancerous or not, whereas now it is determined at a high rate of precision with PET/CT.

PET/CT In Metastasis

PET/CT also offers a significant advantage for the determination of whether the disease spread to adjacent tissues or lymph nodes in many cancer types, i.e. whether there is metastasis or not. Since the entire body is visualized at the same time thanks to the images taken via PET/CT, it is also possible to evaluate whether the cancer has spread to another organ. Thus, PET/CT is highly advantageous in determining, for instance, whether a tumor in the lung has spread to other internal organs, the adrenal glands or the lymph nodes (whether there is metastasis or not), in other words for determining the extensity of the disorder which is known as staging.

INTRAOPERATIVE 3 TESLA MRI

An imaging technology which is only used at ACIBADEM Kozyatağı Hospital in Turkey, Intraoperative MR facilitates the complete removal of the tumor by providing images during brain surgery. It thus eliminates the risk of a second operation that would be required, due to tumor residues.

Advantages of 3-Tesla MRI:

 ✓ Generates more robust information than low-Tesla systems

The 3-Tesla MRI device generates faster data with higher resolution during and after the operation, and provides physicians with more reliable information than that obtained from low-Tesla MRI systems. The device achieves this thanks to its strong magnetic field. By generating a magnetic field twice as strong as the magnetic field of the 1.5-Tesla MRI device, which had been used previously, it receives more signals from tissues.

✓  Works more rapidly

The 3-Tesla MRI device works much quicker than other devices. This is especially important during brain surgery. The system allows the surgeon to take images during the operation at any required moment without waking the patient and without closing the surgical area. In particular, it addresses surgeons’ concerns about obtaining correct information on the size and direction of the tumor if it is in a place difficult to reach. The chances of operational success improve as images may be evaluated during the operation.

✓   Eliminates the risk of a second operation

Various risks may arise in operations in which intraoperative MRI is not used. In these operations, residues cannot be identified due to the fact that they are so small that they cannot be seen with a microscope, or they are of the same color as the brain tissue. As such, there is a 30-40% probability of residues being left over in brain tumor operations. The patient is taken into intensive care after the operation. Whether or not residues are present may be determined based on MRI images taken 24 hours after the period of intensive care. In the event that any residues are identified in the MRI, a second operation will take place. Here, thanks to its intraoperative feature a second operation is not required as residues may be fully identified and removed during the operation.

✓   Zero probability of residues

Thanks to the 3-Tesla MRI device, there is no chance of residues being left in the brain after the operation. All residues that may be omitted are identified with the images the device takes. Thus, the surgeon has reliable information when it comes to removing these residues as well. One of the worst results of leaving residues is that the tumor may grow again from these residues. The growing tumor may compromise the patient’s quality of life or even threaten the patient’s life again. Another satisfactory result of the complete removal of the tumor is that it further delays the recurrence of malign brain tumors.

   Accurate identification of operation area

   Operation-related side effects are eliminated

DIGITAL MAMMOGRAPHY WITH TOMOSYNTHESIS

A mammography device which delivers excellent two- and three-dimensional image quality at the lowest required dose. With its two dimensional and multi slice three dimensional tomosynthetic imaging capacity, it offers groundbreaking possibilities in the early diagnosis of cancer.


Related Patient Stories

Jasminko Huseincehajic, Oncology, Bosnia
Jasminko Huseincehajic, Oncology, Bosnia

I came to Acibadem Maslak Hospital in order to find a cure for my lung cancer. I decided to apply to Acibadem hospital with a recommendation of my friend who has previously been treated there. I was impressed with Acibadem from the first day of my arrival to the airport, as I was welcomed by […] Read More
Georghe Dumitra, Gynecologic Oncology, Romania, March 2009
Georghe Dumitra, Gynecologic Oncology, Romania, March 2009

Dear Acıbadem Team, We thank you for your hospitality; I, my aunt and my grandmother are from Romania. We came to Turkey for treatment and my grandmother was your patient for a 20 days period of time. You made us feel like home here. My grandmother thanks also from all of her heart to her […] Read More
Amra Kurtagiç, Interventional Radiology, Bosnia
Amra Kurtagiç, Interventional Radiology, Bosnia

Acibadem Hospital is a first class institution with its professional staff. Special thanks to Olcay Cizmeli , Severcan Eralp who has been extraordinarily patient and Burak Yildirim for their excellent assistance. Severcan Eralp organized everything perfectly for us, offered her help every necessary time. Also hospital facilities are great, extra clean. Acibadem Hospital has extraordinarily […] Read More

Related News & Articles

3 Important Aspects That Radiotherapy Patients Need To Know
3 Important Aspects That Radiotherapy Patients Need To Know

Radiotherapy is an important component of oncology treatment and contributes successfully to increasing patients’ life expectancy. Technologies have evolved much so that today it is possible to irradiate and treat tumors more accurately, with fewer side effects, and healing chances of over 90 percent. There are some important issues that radiation patients should be aware […] Read More
Latest Therapies For Pancreatic Tumors
Latest Therapies For Pancreatic Tumors

Every day, approximately 1,200 people worldwide receive the diagnosis of pancreatic cancer. Thus, out of the total of 18 million cancer cases registered globally in 2018, nearly 450,000* were patients with malignant tumors located in one of the most important glands in the body: the pancreas. It has two important roles in the body, besides […] Read More
×
Search