Eighteen cancer patients are availing radiation therapy service at the national referral hospital since the service began on January 1.

Radiotherapy In-charge Dilliram Adhikari said that of the various cancer patients availing the services, a majority are rectal cancer patients.

“Unless it is a complicated case, we can now provide radiation treatment to cancer patients in the country,” he said.

Radiation therapy uses high-energy radiation to shrink tumors and kill cancer cells. He said the introduction of radiation therapy service at the hospital in Thimphu has made the lives of cancer patients convenient, as they don’t have to experience the hassle of travelling to India for treatment.

Most cancer surgeries are carried out in the national referral hospital, after which the patients are referred abroad for radio and chemo therapies in the past.

“Most of the referred patients are villagers who also get a culture shock when sent abroad. With the treatment available in the country, the patients psychologically feel better.”

The total dose of radiation treatment is divided into fractions and is given in a day. The treatment a patient has to undergo in a day depends on the patients’ treatment plan. An oncologist develops a patient’s treatment plan.

At least 14 cancer patients avail the service every day from Monday to Friday.

Dilliram Adhikari said radiation therapy is given with curative and palliative intent.

He said curative treatment is given to eliminate a tumor, preventing cancer recurrence, or both. “In such cases, radiation therapy may be used alone or in combination with surgery, chemotherapy, or both.”

Palliative treatments are given to relieve symptoms and reduce the pain caused by cancer.

Dilliram Adhikari said the team conducts quality assurance test and machine performance audit on Saturdays, which is why few patients are treated on Saturdays.

Medical physicist with the national referral hospital, Tandin Phuntsho, said qualitative tests has to be performed on the machines everyday because the machine has to deliver high radiation precession. “We also have standard operating procedures.”

The hospital board approved the introduction of radiotherapy service in the country. The hospital took about two years to study, negotiate and get the approval to introduce the service.

Diliram Adhakari said since the hospital doesn’t have human resource capacity, the service is outsourced to an international aid organisation, CARE Australia for 12 years. Two years have been completed.

A radiation oncologist, a medical physicist and a project manager from CARE Australia are in the country to provide the service.

The firm installed linear accelerator (LINAC), a machine that is used for external beam radiation treatments for patients with cancer, at the hospital. The machine is imported from Germany.

A local team consisting of two radio technologists, radiographers and nurses each, and a physicist work with the CARE Australia team.

Tandin Phuntsho said there are several checks to be done before the radiation therapy is given to a patient. “If one of our integrity checks fail, the machine will not deliver the service so we have to find the problem.”

Patients’ treatment details are recorded and kept in a system to ensure that one is given an extra dose or miss a dose for patients. Moreover, statistics are important for research, he added. “We are still learning from our counterparts. We hope to take over the service after 10 years.”

Dechen Tshomo