Medical Oncology in Turkey

Medical oncology is the branch of medicine that specializes in the diagnosis, treatment, and management of cancer. Oncology is a complex field requiring a thorough understanding of cancer biology, treatment modalities, and patient management. Advances in research continue to improve diagnosis and treatment options, leading to better outcomes for patients.

 Medical Oncology

• Chemotherapy: The use of cytotoxic drugs to kill fast-growing cancer cells. Different regimens are tailored based on the type of cancer and individual patient factors.
• Targeted Therapy: Drugs designed to target specific molecular abnormalities that are driving cancer growth (e.g., HER2 inhibitors in breast cancer, EGFR inhibitors in lung cancer).
• Immunotherapy: Treatments that harness the body’s immune system to fight cancer, such as checkpoint inhibitors (e.g., Pembrolizumab) and CAR T-cell therapy.
• Hormone Therapy: Used for cancers that are hormone-sensitive, this treatment blocks the body’s natural hormones (e.g., tamoxifen for breast cancer, androgen deprivation therapy for prostate cancer).

Surgical Oncology

Surgical oncology has evolved with advances in technology, leading to minimally invasive surgical options such as:

• Laparoscopic Surgery: A technique that uses small incisions and specialized instruments, allowing for reduced recovery time, less pain, and minimal scarring.
• Robotic Surgery: Utilizing robotic systems, surgeons can perform complex procedures with precision through small incisions.

Surgical oncologists often participate in clinical trials to evaluate new surgical techniques, adjuvant therapies, and treatment protocols aimed at improving patient outcomes. They may also contribute to research that helps advance the field of surgical oncology.

Surgical oncology is a critical component of cancer treatment, focusing on the surgical management of cancerous tumors. Surgical oncologists play a vital role in the multidisciplinary care of cancer patients, working to optimize the effectiveness of surgery while ensuring comprehensive support throughout the treatment journey.

Radiation Oncology

Radiation oncology is a branch of medicine that specializes in the treatment of cancer using radiation therapy. It involves the use of high-energy radiation to kill cancer cells or inhibit their growth, while sparing surrounding healthy tissue whenever possible.

• External Beam Radiation Therapy (EBRT): This is the most common form of radiation therapy, where high-energy beams (like X-rays) are directed at the tumor from outside the body. Techniques include:
• 3D Conformal Radiation Therapy: Uses imaging studies to shape the radiation beams to the contours of the tumor.
• Intensity-Modulated Radiation Therapy (IMRT): A more advanced form that allows for precise control of the radiation dose delivered to the tumor, minimizing exposure to surrounding healthy tissue.
• Stereotactic Body Radiation Therapy (SBRT): Delivers very high doses of radiation to tumors in fewer sessions, usually used for small tumors or metastases.
• Brachytherapy: Involves placing a radioactive source directly inside or near the tumor. This allows for a high dose of radiation to be delivered precisely to the cancer while minimizing exposure to surrounding healthy tissues. It’s commonly used for cancers of the prostate, cervix, and breast.
• Systemic Radiation Therapy: Involves administering radioactive substances that target cancer cells throughout the body. An example is radioactive iodine for thyroid cancer.

Before treatment, radiation oncologists conduct a thorough assessment, which may include:

• Imaging Studies: Such as CT scans, MRIs, or PET scans to visualize the tumor and surrounding structures.
• Simulation: This process helps in planning the precise angles, positions, and doses of radiation to optimize treatment.

• Linear Accelerators: Most external beam treatments are delivered using linear accelerators, which generate high-energy X-rays to target the tumor.
• Brachytherapy Equipment: Specialized devices are used to implant or place radioactive sources in or near the tumor.

Radiation oncology is a vital discipline in cancer treatment that utilizes high-energy radiation to target and destroy cancer cells. Radiation oncologists work as part of a multidisciplinary team to provide comprehensive cancer care, ensuring that each patient’s treatment plan is tailored to their unique needs.

Tomotherapy 

omotherapy is an advanced form of radiation therapy that combines the principles of computed tomography (CT) imaging and intensity-modulated radiation therapy (IMRT) to deliver precise radiation treatment to cancer patients. Here’s a closer look at tomotherapy, its technology, and its applications:

Key Features of Tomotherapy

1. Integrated Imaging:
   • Tomotherapy uses CT imaging to provide detailed anatomical information about the tumor and surrounding tissues. This imaging helps radiation oncologists visualize the target area accurately, allowing for better treatment planning.
2. Helical Delivery:
   • The treatment is delivered in a helical (spiral) fashion, rotating around the patient. This allows for multiple beams of radiation to be delivered from different angles, which helps conform the radiation dose to the shape of the tumor while sparing healthy tissue as much as possible.
3. Intensity Modulation:
   • Tomotherapy employs IMRT techniques, which enable the modulation of radiation intensity. By varying the dose delivered from different angles, it can target complex tumor shapes and sizes more effectively.
4. Real-Time Imaging:
   • Some tomotherapy systems can perform real-time imaging during treatment, allowing for adjustments to be made if the patient’s position changes or if there are any variations in the target anatomy. This ensures that the radiation is delivered accurately to the intended target.
     

Applications of Tomotherapy

Tomotherapy is used to treat various types of cancers, including but not limited to:

• Head and neck cancers
• Prostate cancer
• Lung cancer
• Gynecological cancers (like cervical and uterine cancers)
• Central nervous system tumors
• Breast cancer

Gamma Knife Radio Surgery

Gamma Knife Radiosurgery is a specialized form of radiation therapy that uses targeted gamma radiation to treat brain lesions, tumors, and other abnormalities within the cranium. Despite its name, it is not a surgical procedure in the traditional sense, as it does not involve any incisions. Instead, it is a non-invasive treatment option designed to precisely deliver high doses of radiation to specific areas of the brain. Here’s a detailed overview of Gamma Knife Radiosurgery, its technology, applications, and benefits.

Precision Targeting:  The Gamma Knife system uses multiple finely focused beams of gamma radiation that converge at a specific target within the brain. This allows for the delivery of a high dose of radiation to the tumor or lesion while minimizing exposure to surrounding healthy tissue.

Non-Invasive: The procedure does not require any surgical incision; hence, there is no physical cutting of tissues, leading to reduced trauma and a shorter recovery time.

Frame-Based System: A metal frame is typically attached to the patient’s head to ensure accurate positioning during the treatment. This frame maintains the patient’s head in a fixed position, allowing for precise alignment of the radiation beams.

Fractionation Options: While traditional Gamma Knife treatments are often delivered as a single session (stereotactic radiosurgery), some cases may involve fractionated treatments over several days to enhance safety and effectiveness.

Gamma Knife Radiosurgery is primarily used to treat conditions involving the brain, including:

• Brain Tumors: Both benign (e.g., meningiomas, acoustic neuromas) and malignant tumors.
• Arteriovenous Malformations (AVMs): Abnormal connections between arteries and veins that can lead to hemorrhage.
• Trigeminal Neuralgia: A chronic pain condition affecting the trigeminal nerve in the face.
• Metastatic Lesions: Secondary tumors that originate from cancers in other parts of the body and spread to the brain.
• Acoustic Neuromas: Benign tumors on the vestibulocochlear nerve.

• Minimal Side Effects: Due to its precision, GKRS typically results in fewer side effects compared to traditional radiation therapy.
• Outpatient Procedure: Most patients can go home the same day without the need for an overnight hospital stay.
• Quick Results: Many patients experience symptom relief or tumor shrinkage within weeks to months after the procedure.
• Preservation of Function: It helps maintain the function of surrounding healthy brain tissues, allowing patients to retain more of their cognitive and neurological functions.

Cyber Knife Radio Surgery

CyberKnife Radiosurgery is a non-invasive treatment option that uses advanced robotic technology to deliver high-dose radiation precisely to tumors and other abnormalities in the body. Developed by Accuray Inc., the CyberKnife system is particularly known for its ability to treat cancers and lesions in various locations, including areas that are difficult to reach with other treatment modalities.

CyberKnife can treat various types of cancers and conditions, including:

1. Brain Tumors: Both benign and malignant tumors, including metastatic brain lesions.
2. Spinal Tumors: Effective for tumors near the spinal cord and vertebrae.
3. Lung Cancer: Treatment for inoperable lung tumors, including early-stage non-small cell lung cancer.
4. Prostate Cancer: Non-invasive option for localized prostate cancer.
5. Liver Cancer: Treatment for primary and metastatic liver tumors.
6. Kidney Tumors: Suitable for small, localized kidney cancers.
7. Pancreatic Cancer: Can be used for palliative treatment of pancreatic lesions.

Advantages of CyberKnife Radiosurgery

• High Precision: The integration of robotic technology and real-time imaging allows for highly targeted radiation delivery.
• Non-Invasive: Patients avoid the risks associated with traditional surgery, including longer recovery times and hospital stays.
• Flexibility: CyberKnife is adaptable for treating tumors in various locations throughout the body.
• Minimal Discomfort: Most patients experience little to no pain during treatment, and side effects are typically mild.

True Beam Radio Surgery

TrueBeam Radiosurgery is an advanced form of radiation therapy used to treat cancerous tumors and other abnormalities in a highly precise and non-invasive manner. This technology is part of the TrueBeam system developed by Varian Medical Systems. It effectively combines high-dose radiation delivery with advanced imaging techniques to target tumors with exceptional accuracy while minimizing exposure to surrounding healthy tissues.

Applications of TrueBeam Radiosurgery

TrueBeam Radiosurgery can be utilized for a variety of cancer types and conditions, including:

• Brain Tumors: Both benign and malignant tumors.
• Lung Tumors: Stereotactic body radiation therapy (SBRT) for early-stage lung cancer.
• Prostate Cancer: Effective treatment for localized prostate cancer.
• Liver Tumors: Non-invasive approach to treat both primary and metastatic liver cancer.
• Spinal Tumors: Precise targeting of tumors situated near critical spinal structures.
• Other Types of Cancers: It can be used for tumors in various other locations within the body.

Advantages of TrueBeam Radiosurgery

• Precise Targeting: The system minimizes damage to surrounding healthy tissues and organs.
• Non-Invasive: TrueBeam radiosurgery is a non-surgical option that avoids the need for incisions.
• Quick Treatment Times: Many patients can complete their sessions in a matter of minutes, allowing for convenient scheduling.
• Real-Time Adaptability: The system can adapt to changes during treatment, ensuring optimal delivery even with patient movement.

MR Linac Radio Surgery

 MR Linac Radiosurgery is an advanced treatment modality that combines magnetic resonance imaging (MRI) with linear accelerators (linacs) to deliver highly precise radiation therapy. This innovative technology allows for real-time imaging of tumors during treatment, enabling clinicians to adapt radiation delivery to changes in tumor position and shape, enhancing the overall effectiveness of cancer treatment.

Applications of MR Linac Radiosurgery

The MR Linac system is particularly beneficial for treating:

1. Abdominal Tumors: The real-time imaging helps track tumors affected by breathing motion.
2. Pelvic Tumors: Enhances treatment for prostate cancer and gynecological malignancies.
3. Brain Tumors: Provides accurate targeting for complex cranial treatments.
4. Reirradiation: Allows for safe delivery of radiation to previously treated sites.

Advantages of MR Linac Radiosurgery

• Enhanced Accuracy: Continuous imaging ensures high precision in targeting tumors, reducing radiation exposure to surrounding healthy tissue.
• Dynamic Adaptation: Treatment plans can be adjusted based on real-time imaging, improving patient outcomes.
• Improved Patient Comfort: Many patients experience less anxiety because MR imaging is non-invasive and the procedure is painless.
• Clear Visualization: The quality of MRI images allows for better differentiation between tumor and healthy tissues.

If you have specific questions about oncology treatments, its management, or anything related, feel free to ask! We will be pleased to help you with our wide hospital & clinic network all over the Turkiye.