The hospital is having national level facilities for the complete treatment of all types of cancers. Radiotherapy , Chemotherapy(Medical Oncology) ,Onco Surgery and Palliative care are the main specialities for the comprehensive treatment of cancers. Nuclear medicine also plays a key role in both diagnosis and treatment of certain specific cancers.
Therapeutic Facilities
Radiotherapy is the main stay of treatment for most of the solid tumors. About 70%-80% of patients require radiotherapy either alone or in combination with surgery and /or chemotherapy. Radiotherapy can be delivered externally (Cobalt or Linear Accelerator with IMRT) or internally (LDR Selectron or Micro Selectron HDR Brachytherapy Machine). Radiotherapy may be curative, adjuvant and palliative.
Latest Radiotherapy Machine WIth IGRT installed
A high energy 6&15MV (600mu/min) along with 4-20MeV (600mu/min) electron energies linear accelerator is obviously a boon for cancer patients. ours is a first institute who have installed this equipment not only in M.P. but in central India as a whole. Earlier this very costly and extremely useful equipment was available only in metropolitan cities in the country. This highly sophisticated unit is linked with high speed Spiral CT & 3-D Treatment Planning System through Varis networking and thus fulfills optimum criteria for an ideal set up in Radiotherapy for best quality treatment by radiation. This equipment is now upgraded and equipped with advanced mode of high precision radiotherapy- Intensity Modulated Radiation Therapy(IMRT)
A most modern Teletherapy Cobalt unit Theratron 780c imported from Canada plays a vital role in treatment of cancers. Radiation treatment on this unit is carried out by utilizing most modern techniques, which gives better cure rate with minimal adverse effects. Radiation Dose delivery to patients is evaluated through this inter-comparison worldwide by IAEA.
In our country this is collaborated by Bhabha Atomic Research Centre, Mumbai. As per international standards of Dose delivery variation of +/- 5% is allowed. Our centre achieved the minimum variation of +/-0.4% in radiation dose delivery to our patients which is an improvement on international norms.
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This is the most modern remote after loading brachytherapy unit imported from Holland. With the help of this machine, radioactive sources are introduced in the body cavities of the patients. The sources remain inside the body for a calculated time and then removed. This mode of treatment is useful in treating cancers of various cavities such as uterus, cervix, vagina, rectum, anal canal, oesophagus, nasopharynx etc. This type of treatment gives concentrated dose (boost) to local tumour area and clinically insignificant dose to surrounding normal organs. A single patient requires treatment time from 15 to 20 hours.
In vivo/Online dosimetry is done using Dual diode/TLD dosimeters to verify the actual dose delivery to each and every patient who undergoes radiotherapy treatment.
Radiotherapy delivered at our hospital, as well as other cancer centres of the country, is monitored by Bhabha Atomic Research Centre, Mumbai. They have certified that the accuracy of dose delivery at our hospital is within the range of 0.4% which is considered to be even better than the accepted international standards.
The state-of-art high dose rate brachytherapy machine is also available. It has the added advantage of minimizing duration of treatment. Instead of hours’ treatment, treatment is given on this equipment within minutes. This equipments is extremely useful not only for treatment of carcinoma of cervix but is also a boon for the patients of soft tissue sarcoma, breast cancer, and head & neck cancer. With this machine, intracavitary as well as interstitial barchytehrapy is possible. The organ and function can be preserved , so that the quality of life is improved without jeopardizing the outcome e.g. in case of breast , there is no need to remove the whole breast , only breast lump is removed and boost is delivered to the lumpectomy site by interstitial implant. The institute , in fact, is having the entire range of Radiotherapy equipments bringing it at par with leading cancer institutes in the country
HDR Brachytherapy
Once it is decided to treat the patient by radiotherapy, the treatment is planned with the help of this equipment to concentrate the optimum dose to the affected site. With the help of MLC(Multi leaf Collimator), it is possible to have 3-D conformal radiotherapy so that the surrounding areas, which are otherwise normal, are saved from getting the unwanted radiation and at the same time , higher dose can be delivered to the tumor area. As a result, the chances of cure are high with minimal complications. This computerized device also helps in accurate dose calculation and distribution. It takes much less time and enables the specialists to start the treatment at the earliest. Eclipse 3D Treatment Planning System supplied by M/s Varian Medical System Pvt. Ltd. has been installed at Radiotherapy Department in March 2004. This is the only equipment available in the central part of the country which can do 3-dimensional treatment planning. The unit is networked with CT Scan and Linear Accelerator through Varis Networking which is the latest networking system available in India. All cancer patients who require Radiotherapy are scanned on CT Scan unit and the images are automatically transferred to this unique planning system through networking. The tumor area and the vital organs are delineated on each CT slice. The radiation beams are planned and dose volume histograms computed by this system provide the accuracy parameters. After careful evaluation of these data, the best treatment plan is selected and its all parameters are transferred to Linear Accelerator for execution of treatment. The treatment records of all patients are stored on Varis server, which is the heart of networking. Apart from this Multidata Treatment Planning system imported from USA is also functioning at the department. Another unit Theraplan-330 from Theratronics Canada has also been working which is also capable of doing all types of complicated radiation therapy plannings. These machines are looked after by very competent and qualified Medical Physicists who had their special training at Bhabha Atomic Research Centre, Mumbai and abroad.
Accuracy of radiation dose delivery depends upon the patient’s position during the treatment. Any shift in orientation of patient’s treatment area can lead to in-homogenous dose distribution inside the irradiated area. In order to restrict any voluntary movement of patient, the mould is prepared for individual patient. This also helps in keeping the patient’s skin free from any markings.
With availability of entire range of equipments and a well knit team of highly competent Radiotherapist , Oncologist and technicians required for full and proper treatment of cancer the institute can legitimately claim to be at par with leading hospitals in the country.
This institute has got a separate Medical Oncology Department where Chemotherapy is administered as per international protocols. Chemotherapy is the administration of cytotoxic drugs and more recently biologicals to destroy the cancer cells. It is one of the multi- disciplinary approaches for the treatment of cancers and has become the mainstay of treatment for almost all malignancies especially in Leukemias (Blood Cancer), Lymphomas, Germ cell tumor and Choriocarcinoma ,Cancer Breast and Ovary to name a few. The department on a regular basis gives high dose chemotherapy as per the requirements.
A competent Medical Oncologist having the rare degree of D.M. is incharge of this important department. He is assisted by a team of Medical Officers intensively trained at Tata Memorial Hospital. The dedicated team works for twenty four hours taking care of all cancer patients and all chemotherapy related complications.
The institute is committed for an catheter care clinic ,which will take care of the central catheters on regular basis. Central line facilitates easy administration of chemotherapy and its supportive care , thereby avoiding frequent pricks to the patients. A trained doctor and staff nurse is engaged round the clock for this purpose. This is the only centre in central India to provide this facility to the patients.
Surgery is the mainstay of treatment for solid tumors and surgeon plays a leading role in the decision making of the treatment of these solid tumors.
Cancer surgery is a complex and highly skilled discipline requiring detailed knowledge of anatomy, physiology, and reconstructive procedures. Recognizing this fact, this hospital has given a strong emphasis on surgical discipline. To provide state of the art care to these patients, the hospital has a team of three qualified, highly skilled and competent surgeons, all of them having experience of working in various prestigious institutes of India like Tata Memorial Hospital, Mumbai and All India Institute of Medical Science (AIIMS), New Delhi.
The surgeons are well trained in different subspecialities of oncosurgery that includes head and neck, breast, thoracic surgery, gastrointestinal surgery, soft tissue surgeries, and gynecologic oncology. The department has two part- time consultants ,a plastic surgeon and an orthopeacian, to assist in different reconstruction procedures and bone tumors surgeries. The neurosurgeon and the urologist are on the hospital panel and are readily available for any neurosurgical and urological procedures.
The department is well supported by modern equipments, Operation Theatre and ICU.
The department also has an endoscopy setup and facilities for upper GI Endoscopy, Colonoscopy, Bronchoscopy, and Laryngoscopy are available. The surgeons are trained in flexible endoscopy and are assisted by medical gastroenterologist as and when additional help is required.
The department is performing all types of breast surgery including breast reconstruction; different head and neck surgery like commando operation, laryngeoctomy, Maxilectomy, thyroid and parathyroid surgeries, salivary glands tumor surgery; all Gastrointestinal Surgeries like esophagectomy, gastrectomy, pancreaticoduodenectomy, hemicolectomy and low anterior resections, gynecological surgeries like Wertheim’s operation, ovarian cancer surgeries; thoracic surgeries like chest wall resection ,lung resection; and various soft tissue sarcoma surgeries with reconstruction including microvascular surgery routinely.
The hospital has one major and one minor operation theater. The Operation Theatres are equipped with all the modern facilities and equipments including latest Anesthesia Administering Machines, Remote Controlled Operation Table, Shadowless Lamps, imported Electric Cautery, Invasive and Non-invasive Monitors, Ventilator, one Operating Microscope, Micromotor with saw, mandibular plating reconstruction set and many other sophisticated instruments and equipments.
The hospital has taken up the construction of one new ultramodern operation theater complex (two major operation theatres) with attached four- bedded state of the art surgical ICU in near future to meet the rising number of patients and to provide them with one of the best cares available in the country.
The discipline of Anesthesiology plays a pivotal role in a superspeciality hospital, so also in an oncology institute. Especially in oncology, this discipline plays a major supportive as well as definitive role in patient management. Apart from managing operation theatre, intensive care unit, the department extends the acute pain management services with multimodal techniques and pharmacological therapies with latest continuous infusion techniques, conduction blockade for the postoperative acute pain of complex oncosurgical procedure and chronic pain management in cancer patients with multimodal approach, comprising of interventional pain management under imaging guidance.
Outside the operation theatre/intensive care unit, monitored anesthesia care is provided for patient’s safety during radiological and radiation oncological procedure, especially in children. In our institution adherence to safety protocol and training of personnel is particularly emphasized as this branch of anesthesiology medicine is growing very fast by leaps and bounds.
Implementation of anesthesia begins with preoperative assessment, investigations and preparation for optimization of medical condition, preoperative appropriate premedication and explanation of anesthetic risk to the patients.
In this discipline the axiom “first do no harm” holds more true than in any other discipline. Like the aim of World Federation of Societies of Anesthesiologist, our institution also strives to be at par in achieving and maintaining high standard of anesthesia care in operation theatre as well for anesthesia care procedures outside the operation theatre.
The institute is having expert experienced consultant anesthesiologists with well equipped theatre with advanced multi-channel monitoring system, infusion pumps, defibrillators, advanced anesthesia delivery units for preoperative and perioperative management of all major and supra major oncosurgeries. For this purpose , it has a well-equipped ICU with dedicated staff nurses and technicians.
Postoperative care remains the most important and critical aspect that determines speedy and smooth recovery of patient after a rigorous and complex cancer surgery. To provide highest degree of postoperative care, hospital has a state of the art intensive care unit equipped with all necessary modern, sophisticated Datex and Dragger multi-channel monitors, Evita -2 and Savina Dragger ventilators. There is round the clock presence of well qualified and trained medical, nursing ,technicians and para medical staff.
Interventional palliative pain management is being provided through interventional techniques with nerve located and USG/CT guided nerve and plexus blocks and also by continuous epidural analgesia with elastomeric pumps.
- RADIOTHERAPY
- Halcyon
- Linear Accelerator Clinac 2300 C/D with IMRT
- Theratron 780c (Teletherapy)
- Selectron (Brachytherapy)
- Micro Selectron HDR Brachytherapy
- Computerised Treatment Planning System (3D & other TPS)
- ORIFIT (Immobilization Devices )
- MEDICAL ONCOLOGY (CHEMOTHERAPY)
- SURGICAL ONCOLOGY
- Operation Theatre
- ANESTHESIOLOGY AND CRITICAL CARE
- Intensive Care Unit
The Department of Medicine has been working since the inception of the hospital. It consists , at present , of two Consultants. The cancer patient is not only suffering from malignancy but may have a number of other general medical problems like diabetes, hypertension, coronary artery disease, cerebrovascular disease, renal, hepatic disorders, asthma, tuberculosis etc which also require to be treated optimally to improve the quality of life.
A full coverage is given round-the-clock to all critical/ICU and palliative care patients for their clinical management. Department of Medicine has also been playing a prominent role in regular Cancer Awareness and Detection programs.
Various visiting consultants are closely associated with the hospital as part time consultants or in honorary capacity. Their expertise is solicited as and when required in case of system specific acute emergencies requiring extra or additional expert support.
Nuclear Medicine plays a vital role in the treatment of various disorders such as thyroid nodules, Goiter, Cancer thyroid, Neural crest tumors , pain palliation in intractable bony pain etc. Response to the treatment is 85 to 100% the department uses Strontium -89, I-131-MIBG, Samarium-153, Phosphorous-32, etc. for the treatment of various disorders. These radionuclides are being imported from Israel, U.K., Turkey, Poland, etc. In India , Board of Radio Isotope Technology & Bhabha Atomic Research Centre Mumbai ,is the sole supplier of radio-isotopes. The radioisotopes are useful in following conditions :
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Non Malignant
a) Toxic Thyroid
b) Radiation Synovectomy
c) Polycythamia vera -
Malignant
a) Ca. Thyroid
b) MIBG-Phaeochromocytoma, Neuroblastoma
c) Pain Palliation-Sr-89, P-32, Sm-53.
Pain and Palliative care is a newly emerged speciality which is extremely useful for terminally ill patients. It considerably helps in controlling the pain and various other sufferings of such patients and also plays a key role in raising the morale of the patients and their family members to fight the disease. The hospital has a full-fledged Palliative Care Department. In addition to well-organized indoor facilities, a duly trained mobile team also provides door-to-door free palliative care to such patients who are physically and financially unable to come to the hospital. What is most noteworthy in this context is that a Hospice is also coming up in Shahpura area of Bhopal, which will further strengthen the palliative care activities of the institute. This centre will be first of its kind in the state. There are few such centers in the country.
Home care service is provided by the department free of cost to such patients whose disease is at terminal stage and live in vicinity of Bhopal through mobile unit.
Hospice is a concept rooted in the centuries-old idea of offering a place of shelter and rest, or “hospitality” to weary and sick travelers on a long journey. Hospice is a philosophy of care. The hospice philosophy recognizes death as the final stage of life and seeks to enable patients to continue an alert, pain-free life and to manage other symptoms so that their last days may be spent peacefully with dignity and quality. The hospital is setting up a full fledged Hospice first of its kind in the state. Known as “Karunalaya” in Shahpura area of Bhopal the palliative care services will be further strengthened as a result of this unique center. This hospital is among the few institutes in the country where Palliative Care Department is working with specialists and expert team
Without a proper research nucleus no hospital can achieve higher skill in this age of ever growing frontiers of knowledge. The hospital has a full fledged research department which has been established mainly with the support of Atomic Energy Department, Govt. of India. DRDO (Defence Research and Development Organisation, Govt. of India) is also providing additional support. The hospital has also been getting support from MP Science and Technology Council from time to time.
The institute has a well-equipped Research Department, which is the first of its kind in Madhya Pradesh. Among the prominent organizations that have provided support to various research activities of the hospital include Atomic Energy Commission, Govt. of India, Defense Research and Development Organization (DRDO), Indian Council of Medical Research (ICMR), Department of Science and Technology (DST) and M.P. Council of Science and Technology (MPCOST). The department’s two major research projects are in quite advanced stage. They relate to the formulation of cheaper and very effective alternative medicines based on “Tulsi” (Ocimum Sanctum) and “Ashwagandha roots”. This will help to reduce the side effects of Chemotherapy and Radiotherapy. Tulsi, the sacred plant of India, is well known for its medicinal properties and is used in Ayurveda for millennia. Another medicine under formulation is based on Aswagandha to isolate chemicals that can fight radiation. This project has been proposed to ICMR for clinical trials on human beings.
The clinical trial of the drug has attracted wide national and international attention. Presently its clinical trials are going on in Jawaharlal Nehru Cancer Hospital & Research Centre, Bhopal, Tata Memorial Hospital, Mumbai and Kasturba Medical College, Manipal. The results are very encouraging. In-depth studies are being conducted , under a separate project ,to assess whether the MIC gas (which had caused world’s biggest industrial disaster in Bhopal in 1984) has any relation with the incidence of cancer. The study is likely to be completed shortly.
Apart from various research projects of vital importance on hand, the research department also offers advanced research training to doctoral and post graduate students particularly in Biotechnology, Bioinformatics ,Genetics Medical Microbiology, Biochemistry, Pharmacology, Botany and Zoology. The Department of Research is also involved in cancer diagnostic field such as cancer Cytogenetic (Karyotyping), Pedigree Analysis, Electrophoretic diagnosis for multiple Myeloma and Haemoglobinpathies. It is recognized by Barkatullaha University and Rajiv Gandhi Technical University Bhopal.
The Human Ethical Committee is headed by Justice G.G. Sohani , former chief justice Patna High Court and Animal Ethical Committee is by Dr. Neelkamal Kapoor , head of the department of pathology GMC Bhopal.
The hospital has a vibrant academic environment, which is further enriched by the growing participation of eminent experts in various scientific and academic seminars and conferences. Postgraduate students of various medical colleges are provided advanced training/ observership in the institute in different departments in general and Radiotherapy and Radiodiagnosis Department in particular as per their requirement under an arrangement made by Medical Education Department, Govt. of Madhya Pradesh. . Apart from Ph.D it has several other short term technical courses. The Barkatullah University and Rajiv Gandhi Technical University Bhopal have granted recognition to these courses. The hospital also conducts paramedical courses duly recognized by M.P. Paramedical Council and Barkatullah University.
| This specialty is of immense utility in regard to early detection and prevention of cancer. It has therefore been treated as a priority area. Free cancer detection camps and awareness meetings in urban and rural areas are organized by the Social Oncology Department on regular basis with special focus on early detection and familiarizing people about the symptoms of cancer. A series of Workshops, photo and poster exhibitions, video shows are also held. Literature in various forms is also distributed free on such occasions highlighting symptoms and necessary preventive measures.Under a special project one free detection camp was held every week in each ward of this area thereby covering as many as 36 wards, which constitutes nearly half of Bhopal.
Counselling of Cancer patients and their attendant, Lymphadema Management is also done under this department by well experience counsellor. On bed Educational support also provided to cancer patients |
In case any organization/individual is interested in disseminating useful information on cancer or holding awareness and detection camps/meetings / workshops they are requested to contact –
Convenor,
Social Oncology,
Jawaharlal Nehru Cancer Hospital and Research Centre,
Idgah Hill,
Bhopal-462001
Tel. (91) 0755-2665720, 2666374, 4255680,4255682
Fax: (91) 0755-2738325
Email:[email protected]
Highly impressed by Community Oncology activities, World Health Organization (WHO) have sanctioned a special anti-smoking project to the institute. Under this project , Tobacco Cessation Clinic has been set up which is providing specialized services to the people for motivating them to give up smoking and tobacco chewing. Besides applying psychological inputs, medicines are also distributed free by the clinic to the addicts. This clinic is the first of its kind in M.P. and is rendering useful service. The number of beneficiaries is going up day by day. The Ministry of Health, Govt. of India has highly appreciated the work of this clinic among school and slum children and has asked the institute to prepare a document suggesting guidelines for further action and activities to be followed at the national level.
Full fledged and well equipped physiotherapy facility both for indoor and outdoor cancer patients by qualified and experienced physiotherapist
Facility for Ultrasonic , short-wave diathermy TENS, Muscle Stimulator (MS) , Vibrator for chest PT , shoulder wheel etc.
Dietary support by qualified and experienced dietician to help both for indoor and outdoor cancer.
The institute has a large team of qualified, experienced and dedicated team of Consultants, doctors, nurses and other para-medical staff belonging to all the concerned disciplines. Almost all the consultants have previously worked in leading national institutes and have got advanced training in some of the famous international institutes. The hospital is utilizing the training facilities of Tata Memorial Hospital on a regular basis. This has greatly helped this institute to ensure that those engaged in treatment are fully conversant with latest procedures and innovations.
The State Govt. has granted special recognition to the hospital with the reimbursement facility to all categories of its employees. This is available even if the patient comes directly to the hospital i.e. no reference from Govt. Hospitals are required. Govt. of India and several leading public sector undertakings such as BHEL, Railways, Eastern, Western, Southern Coalfields Ltd., BSNL, ESI , ECHS and Central Govt. Health Scheme (CGHS) have also granted reimbursement facility to their employees. This list continues to lengthen.
The Government of Madhya Pradesh have already recommended to the Public Health Ministry, Govt. of India to accord Regional Status (Regional Cancer Centre) to our hospital in addition to Gwalior. The hospital’s development would get further impetus as and when this status is granted. The recommendation was made in view of very large catchment area of this institute and its central location besides its very impressive performance. In this context, it may be mentioned that this institute is having patients from all parts of Madhya Pradesh including Gwalior and Indore regions.
Tata Memorial Hospital, Mumbai, country’s top most cancer hospital regularly refers patients of this region to our institute, which is yet another indicator of the hospital’s high credibility.
The rates are displayed in the reception hall and are considered fair.
The hospital building as well as its campus has sufficient scope for further expansion to meet growing requirements. The building, designed by the Kothari Associates New Delhi and constructed by Capital Project Administration Government of M.P., is one of the most environmentally friendly hospital buildings in the entire state. It can even claim to be one of the best in the country from this angle as well from the point of patients convenience.
Jawaharlal Nehru Cancer Hospital & Research Centre Bhopal
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