Essence of Importing Technology in Diagnosis and Treatment of Cancer

Suresh Poudel

The success of any development effort of a country depends on its ability to absorb the outcomes of modern technology. This is true for all facets of economic and social activities. Generally developing countries lack such capacity. Often this lacking is due to inadequate infrastructure, human capital, finance, commitment of leaders and their willingness to do so. It is an undeniable fact that for setting a country into a path of development, it should focus on development of science and technology.

Experiences of developed countries show that they were once a fertile land for technologies.  Most of them are yet working hard to develop new technologies. Only those countries which have invested heavily in science and technologies are progressing leaps and bounds. They have been benefitted by their home made and imported technologies. Technology is the application of knowledge to practical purpose which ultimately innovates the way of performing task assuring a better outcome in what we do. As a developing country, it might not be possible for Nepal to invest heavily on development of science and technology; however it shall prepare itself to build capacity to absorb the recent outcomes of scientific development.

Since last century we have been using different machines in disease diagnosis and treatment. These machines are the outcomes of dedicated research and investments. Similarly ionizing radiations have been used for diagnosis and treatment of diseases. To improve the precision of diagnosis and treatment, the producers of such machines are using the recent and exotic research findings.  This has made the use   of such machine is expensive.

Regarding Cancer diagnosis and treatment, in recent years, there has been a huge development in the techniques of imaging and therapy. In imaging conventional X-Rays, Mammography, Angiography, Ultra-sonogram (USG) have been used for quite long. Magnetic Resonance Imaging (MRI), Computed Tomography (CT), SPECT, PET Scans machines are proving themselves as reliable machines for disease diagnosis.

Similarly radiotherapy has come a long way from the days when the treatment was started with X-ray tubes, Van de Graff generators and betatrons and cobalt-60 teletharapy units. Today we are using moderns LINACS and modern Brachy therapy machines. As special techniques in radiotherapy Stereotactic irradiation, Total Body Irradiation(TBI), Total Skin Electron Irradiation(TSEI), Intra Operative radiotherapy(IORT), Endo rectal Irradiation, Conformal Radiotherapy and Intensity Modulated Radiotherapy (IMRT), Image Guided Radiation Therapy (IGRT), Respiratory Gated Radiation Therapy(IGRT), PET/CT fused images, proton therapy and higher nuclide therapy at our avail although the use of most of them by a common patient has been limited by cost and shortage of manpower who has skills on using them. In addition, there are many equipments, chemicals and accessories used in medicines.

The price of these machines is generally high for the obvious reasons that they are the result of huge investment and dedicated efforts. But a mankind cannot stay away from being benefitted from such grace of human efforts. Many developing countries lack such services for the limitation of their resource. Nevertheless Governments of these countries should not make an excuse for high price to import such technologies to their country. They should find the ways to import these technologies to their country and hence start building a necessary infrastructure including skills and manpower to do that.  This will help every Nepali citizen to do cancer diagnosis and treatment at home than going abroad. This will help a country to assure the right of every citizen for health.

The writer is a member of Bangladesh Medical Physics Society (BMPS) and student of Gono University, Savar, Bangladesh.

On Occasion of 2nd International Day of Medical Physics

Suresh Poudel

On November 7, this year Medical Physicists around the world are going to celebrate 2^nd International Day of Medical Physics (IDMP) to mark the birth date of Marie Sklodowska- Curie, the pioneer researcher on radioactivity, who was born on the same day in 1867. The theme of IDMP 2014 is “Looking into the Body: Advancement in Imaging through Medical Physics.”  

Last year on the same day, to mark 1^st IDMP, a Symposium was organized at B. P. Koirala Memorial Cancer Hospital (BPKMCH), Bharatpur, Chitwan, Nepal. It had been a successful event. Nepalese Association of Medical Physicists (NAMP) is the professional organization of/for Nepalese Medical Physicists. NAMP is small in terms of its membership subscription. Nevertheless it has been an important organization to further the role of medical physicists in national context and in international arena. NAMP is a member of International Organization of Medical Physicists.

Although International Labor Organization (ILO) has listed medical physicists as health professions, it is the least heard profession in Nepal. Many of us even when we are in medical professionals do not know who medical physicists are and what exactly they do. So it has been urgent to make everyone clear about the role of Medical Physicist in Healthcare, particularly in diagnosis and therapy of cancer.

Medical Physicists are basically the physicists who apply their knowledge of physics to medicine. On the occasion of 2^nd IDMP, I found it relevant to highlight the role of Medical Physicists in medicine. According to American Association of Physicists in Medicine (AAPM) many medical physicists are heavily involved with responsibilities in areas of diagnosis and treatment, often with specific patients. These activities take the form of consultations with physician colleagues. Medical physicists play a vital role and often leading role on medical research team. Their activities cover wide frontiers, including such key areas as cancer, heart disease, and mental illness. In cancer, they work primarily on issues involving radiation, such as the basic mechanisms of biological change after irradiation, the application of high energy machines to patient treatment, and the development of new techniques for precise treatment. Similarly in teaching often medical physicists have faculty appointments at universities and colleges, where they help train future medical physicists, resident physicians, medical students, and technologists who operate the various types of equipment used to perform diagnosis and treatment.

Besides in hospitals, medical physicist is generally responsible for specification, acceptance, commissioning, calibration and Quality Assurance of all radiotherapy equipment; radiation measurement of beam data; calculation procedures for determination and verification of patient doses; physics content of treatment planning and patient treatment plans; supervision of therapy equipment maintenance, safety and performance; establishment and review of QA procedures, radiation safety and radiation protection in the radiotherapy department. Besides they have important roles in education and research.

To conclude, medical physicist is an important member of cancer diagnosis and treatment team. S/he is a person who conducts scientific research on physics and medicine and also does teaching and deals with radiation protection and safety issues inside and outside the hospitals.

The writer is a student of Gono University, Savar, Dhaka, Bangladesh and a member of Bangladesh Medical Physics Society(BMPS)