DEPARTMENT OF RADIATION ONCOLOGY

DEPARTMENT OF RADIATION ONCOLOGY

During the Year 2017-18 the Regional Cancer Centre at Kamala Nehru Memorial Hospital, Allahabad continued its efforts towards cancer control in the region, including Uttar Pradesh, North & western Bihar and Madhya Pradesh and adjoining regions. In addition to the treatment and teaching programmes, the department’s community oriented programmes have received wide appreciation from the people of the state and neighboring states. The dedication of the staff, effective patient care, and prompt treatment, has resulted in attracting more patients to the centre.

RCC KNMH has excelled in its performance and has earned a reputation as one of the leading Radiation Oncology Centers of national importance.

Substantive achievements have been made in the fields of cancer awareness, prevention, early detection, management, follow up, palliative care, pain relief, and cancer research, which are highlighted separately in the activities of the various departments. Brachytherapy wing has independent operation theatre and HDR treatment facilities. Optimized interstitial and intracavitary HDR treatment available with full utilization of the Unit with patient benefit.
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ONGOING PROJECTS

 

  1. Hospital Based Cancer Registry (HBCR)

Monitoring cancer incidence and Cancer Treatment practices are important for planning, implementing and evaluating cancer control programmes. A Hospital Based Cancer Registry (HCR)  is a system of proper coding, compilation and analysis of information on cancer cases  seen in the RCC. The HCR ensures that all cases passing through the cancer Hospital are captured and coded systematically. Repeat admissions and follow up information is also included. The HBCR is the focal point for many activities and have helped to generate good data on the case load, resources etc.

All the cases have been completely coded as per the ICDO-3 guidelines from the last five years and the data prevalence to cancer. The details are given in Table I a & I b for male and female cancer patients separately.

  1. Patterns of Care and Survival Studies

Indian Council of Medical Research supported Project on patterns of care & survival study started in the year 2014 with HBCR.  The data from HBCRs of India has shown that Cancer of Cervix (28%) and Breast (16%) in women are most common and cancer of Head and Neck region constitute about 30 % of all cancer in males and females.  Realizing the problem of follow-up of cancer patients wherein huge number of patients drops out from regular follow-up visits. ICMR initiated pattern of care and survival studies on three of the most common cancers i.e Cancer of Cervix, cancer of Breast and Head and Neck Cancers.sfusion (53). 50 cases put on palliative care.

States %
Bihar 0.39
Chhattisgarh 0.12
Haryana 0.06
Jharkhand 0.12
M.P. 0.78
Mizoram 0.02
New Delhi 0.06
Odisha 0.04
Rajasthan 0.04
Uttar Pradesh 98.39

OBJECTS OF THE PROJECT:

  1. To obtain core identifying and diagnostic information in all patients in the particular    center / Institution with cancer cervix / breast / head and Neck.
  2. To record details of clinical stage and types of treatment of patients included.
  3. To have periodic follow-up and record the patient and disease status in all patients suffering from these cancers so as to have clinical stage and treatment based on survival on these sites of cancer.

In the year 5150 patients were registered which included cancer cervix (n=346), breast (n=323), and head & neck (n= 1210). Sex ratio was 106 males per 100 females. Details are given in Table 1c.

  1. Population Based Cancer Registry (PBCR) 

In coordination with National Centre for Disease Informatics & Research (Indian Council of Medical Research) National Cancer Registry Programme, Bengaluru, RCC KNMH signed agreement to start Population Based Cancer Registry.

PBCRs collect a complete summary of the patient’s history, diagnosis, treatment, and status for every cancer patient in the defined region. These are useful for knowledge on cancer burden, etiological studies, and effectiveness of cancer control activities.

The Project was launched on 10th March 2018, at Regional Cancer Centre, KNMH Allahabad. A meeting of Government, Private Hospitals, Diagnostic and Pathological centres was held at RCC, KNMH on 10th March 2018. The prominent participants of the meeting were Principal, MLN Medical College and Heads of departments of Medical College, District Hospital, T.B. Hospital, and Nazreth Hospital. The Private Hospitals, Diagnostic and Pathology centres of Allahabad district were also participated in the meeting. The objective of the meeting was to brief participants about the programme and their cooperation in sharing of the data of cancer patients reporting in their centres to the project PBCR.

A workshop for staff employed under the above project held on 21st – 22nd March 2018 at NCDIR-NCRP. The training focused on cancer registration, cancer terminologies and coding as per ICD-O-3 and methods of data collection including hands on exercises. Participants actively involved in all the interactions. The software team explained, clarified the common data entry errors & doubts by software demonstration.

   4. Pain & Palliative Care Unit.

A Pain & Palliative Care Unit started in December 2011 sponsored by Jiv Daya Foundation. The objective of the Unit is to improve quality of life of the patients at terminal phases. The Unit has one Medical Officer, one Counselor and one Nurse. Total 1069 patients (590 males and 479 females) were enrolled for treatment in the unit. 797 were new cases. 657 patients were from rural areas and 412 from urban areas. Maximum number of patients had head, neck & mouth cancers (120) followed by gall bladder (94), breast (82), lungs (72), and cervix (61), and tongue (60). 243 patients were given Morphine tablets, 119 were new patients.

5.Paediatric Cancer Initiative:

A Paediatric Cancer Unit started at RCC from May 2013 sponsored by Jiv Daya Foundation. The unit has Medical Officer, one Counselor and one data entry operator. Total 1718 patients (812 boys and 906 girls) were enrolled for treatment in the unit. 268 were new cases. 899 were from rural and 819 from urban areas. Maximum number of cases had Acute Lymphoid leukemia (233), Hodgkins lymphoma (82), Ewings Sarcoma (59) and non hodgkins lymphoma (52).  Parents were counselled for hygiene, care & support, nutrition, wound care, infection control, tube feeding. 08 cases referred for surgery. Treatment included chemotherapy (883), radiotherapy (67), and blood tran

Facilities available 

Bed Strength: The existing bed strength for RCC is as follows:

1. General  Beds (129):

Female Cancer Ward (Indira Ward)

Male Cancer Ward (Rajiv Ward)

Ward 5

Ward I  (Surgical & General Oncology)

Chemotherapy Ward

Isolation (Male & Female)

Paediatric Oncology Ward (Jawahar ward)

 

21

21

31

16

18

10

12

2. Cubicles
3. Private rooms for male and female

 

  1. RADIOTHERAPY       Linac Therapy, Teletherapy , Brachytherapy and Medical Physics manned by trained and experienced team of Radiotherapists, Physicists, Radiotherapy Technicians and Nursing Staff.

 

  2013-14 2014-15 2015-16 2016-17 2017-18
New cases given Radiotherapy 1357 1,504 1,911 1,812 1,865
Radiotherapy sittings 32,507 29,554 35,237 32,704 33,331
Radiation  exposures 80,297 74,189 101,979 93,091 88,681
Microselectron  HDR – Brachy Therapy         187         153         149        281       200
  1. SURGICAL ONCOLOGY Equipped with 04 major and 03 minor operation theatres to cater to the surgical needs of patients requiring abdominal surgery, mastectomy and Head & Neck surgery. Total 494 major and minor Onco Surgeries were performed.
  1. Medical Oncology   Day care Cancer Ward and O.P.D. Chemotherapy section operates daily for chemotherapy. A 18 bedded dedicated chemotherapy ward was inaugurated in 2012.
  2013-14 2014-15 2015-16 2016-17 2017-18
Chemotherapy given 23,225 24,164 26,219 28,959 31,706

 

  1. Free Paediatric Cancer Ward A 12 bedded separate Ward known as Jawahar Ward for Paediatric Cancer cases was established and inaugurated by Sri. Rahul Gandhi, Trustee.  Food and medicines are provided free to all the children admitted in these beds.

 

  1. Pain & Palliative Care Unit A Pain & Palliative Care Unit started from December 2011 with an objective to improve quality of life of the patients at terminal phases. Total 1069 patients (New patients = 797) enrolled for treatment in the year. It included more rural (n=657) than urban (n=412) patients. 243 patients were given Morphine tablets.

Major Equipment available in the Department –

 

1 Teletherapy Two Units of Cobalt 60 (Theratron 780-C)
2. Brachytherapy Micro-Selectron HDR System with Ir-192 source – One Unit.
3. Treatment Planning Systems:

a)       3-D TPS – Nucletron DICOM network

b)       Oncentra Treatment Planning System

c)       Prowess Treatment Planning System

3 Units

1 Unit

1 Unit

1 Unit

4. Mould Room equipment and accessories
5. Linear Accelerator (Siemens Artiste) with dual beam and electron
6. Octavius Detector
CANCER CONTROL PROGRAMME

Early cancer detection in a comprehensive manner has formed the basic functioning of the RCC from the very inception. It has been taken up in a systematic manner. In coordination with other NGOs and Community Health Centre, early cancer detection camps were conducted at hard to reach villages of Allahabad. Team of consultant screened the cases in the periphery and referred suspected cases to RCC KNMH. (Details given in Community Outreach Programme).

International Rose Day (September 21st) – The Day marked with the concern and care for cancer patients. In collaboration with the Rotary Club Allahabad Elite, Roses, fruits and sweets were distributed to cancer patients followed by Public Function at the RCC.

Breast Cancer Awareness Month (October) – Breast Cancer Survivors’ day was observed in the Hospital with the assembly of treated and cured breast cancer patients.

National Cancer Awareness day (November 7th) – The Birth Anniversary of Madam Curie on November 7 observed by organizing a public awareness programme and exhibition. GNM students presented a skit on ill effects of tobacco. Pamphlets and hand bills were distributed.

Paediatric Cancer Initiative

International Childhood Cancer Awareness Day was celebrated on 10th March 2018 with kites flying by children cancer patients, their parents, cancer survivors and staff in the hospital lawns. This was the fun filled celebration for the cancer children.    The theme for ICCD was Go Gold India – Mera Haq, Mera Bachpan, Mera Jeevan – I Deserve My Childhood My Life. Children also made kites by themselves, which had above slogan written. This advocates the governments that “Childhood Cancer should be a Child Health Priority in India”.

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