Treatments Dr Ram offers

Dr Ram offers a comprehensive range of non-surgical treatments which includes radiotherapy, proton beam therapy, chemotherapy and immunotherapy.

Dr Ram aims for the best possible clinical outcomes for his patients in terms of survival and functional outcomes with reduced treatment-related toxicities. His extensive knowledge and experience mean he can personalise his patient’s treatment and use a combination of proven, innovative and advanced treatment techniques that use the most up-to-date and cutting-edge technology.

Navigating the treatment for cancer can be overwhelming and confusing. Here Dr Ram shares some of the treatment terms which you may hear during your journey. As a patient of Dr Ram, he will ensure you fully understand every aspect of the treatment he recommends.

Proton Beam Therapy

Proton Beam Therapy (PBT) is a type of radiotherapy using accelerated protons rather than x-rays to treat cancer. PBT delivers high-energy radiation selectively with great precision to tumour tissues and avoids surrounding normal tissues, particularly beyond the tumour thereby potentially reducing toxicities. PBT is used to treat children cancers and adult cancers which are close to critical organs such as cancers at the base of the skull, close to the brain, brainstem spinal cord, optic nerves, etc. PBT has been in use for more than 40 years in select centres in Europe, USA and Japan and recently in UK. There are several clinical trials currently undergoing comparing standard radiotherapy with PBT to define the benefit of PBT over standard radiotherapy.

Intensity-Modulated Radiation Therapy

Intensity-modulated radiation therapy (IMRT) is advanced high-precision radiotherapy which employs computer-controlled linear accelerators to deliver precise radiation doses to a malignant tumour. IMRT allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumour by selectively controlling the intensity of the radiation beam in multiple small volumes. IMRT also allows higher radiation doses to be focused on the tumour while minimising the radiation dose to surrounding normal critical structures. Each radiotherapy beam is divided into many small beamlets that can vary the intensity of radiation. This allows different doses of radiation to be given across the tumour.

There is research evidence to show that IMRT also has the potential to reduce treatment toxicity, even when higher doses are delivered to the tissue being treated. IMRT is now the standard radiotherapy treatment offered for most cancers worldwide.

Stereotactic Radiosurgery

Stereotactic radiosurgery (SRS) uses sophisticated, 3-D-computerised imaging to precisely focus photon (x-ray) beams, delivering a highly-concentrated dose of radiation to a precise target in a single session. Stereotactic radiosurgery is not surgery, there is no surgical incision involved and general anaesthesia is not required. SRS works by destroying the DNA of tumor cells, similar to other forms of radiation. Stereotactic radiotherapy(SRT) or fractionated stereotactic radiosurgery delivers the total dose of stereotactic radiation into several smaller doses of radiation, on separate days of treatment and consists of two to five treatments.

Intraoperative Radiotherapy

Intraoperative radiotherapy (IORT) is a radiotherapy technique that involves precise delivery of a large dose of ionising radiation to the tumour or tumour bed during surgery under direct visualisation of the tumour bed and the ability to spare the surrounding normal tissues from the tumour bed allowing maximisation of the dose to the tumour while minimising the dose to normal tissues. This results in an improved therapeutic ratio with IORT. Although introduced in the 1960s, IORT has recently seen a resurgence in popularity with the introduction of self-shielding mobile linear accelerators and low-kV IORT devices.

Electrons, low-energy X-rays and HDR brachytherapy are all different methods of IORT in current clinical use. IORT has demonstrated its efficacy in a wide variety of intra-abdominal tumours, recurrent colorectal cancers, early-stage breast cancers, recurrent gynaecological cancers, and soft-tissue tumours.

Chemotherapy

Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. Chemotherapy may be used in people with cancer in many ways:

Primary chemotherapy : To cure the cancer as primary or sole treatment for cancer.
Adjuvant chemotherapy: Chemotherapy can be used after other treatments, such as surgery, to kill any cancer cells that might remain in the body.
Neoadjuvant chemotherapy: Chemotherapy can be used to shrink a tumor so that other treatments, such as radiation and surgery, are possible.
Palliative chemotherapy: Chemotherapy may help relieve signs and symptoms of cancer by killing some of the cancer cells.

Common side effects of chemotherapy drugs include nausea, vomiting, diarrhea, hair loss, loss of appetite, fatigue, fever, mouth sores, constipation, easy bruising & bleeding. Many of these side effects can be prevented or treated. Most side effects subside after treatment ends.

Immunotherapy

Immunotherapy is a treatment that uses a person’s own immune system to fight cancer. This can be done by:

Stimulating, or boosting, the natural defenses of the immune system so it works harder or smarter to find and attack cancer cells
Making substances in a lab that are similar to immune system components and using them to help restore or improve how the immune system works to find and attack cancer cells

In the past few years, immunotherapy has become important in treating some types of cancer. Immunotherapy works better for some types of cancer than for others. Immunotherapy can be given alone or in combination with other types of treatment.

There are several main types of immunotherapy used to treat cancer such as:

Checkpoint inhibitors: These take the ‘brakes’ off the immune system, which helps it recognize and attack cancer cells.
Chimeric antigen receptor (CAR) T-cell therapy: This therapy takes some T-cells from a patient’s blood, mixes them with a special virus that makes the T-cells learn how to attach to tumour cells, and then gives the cells back to the patient so they can find, attach to, and kill the cancer.
Cytokines: This treatment uses cytokines (small proteins that carry messages between cells) to stimulate the immune cells to attack cancer.
Immunomodulators: These drugs generally boost parts of the immune system to treat certain types of cancer.
Cancer vaccines: Vaccines are substances put into the body to start an immune response against certain diseases and can help prevent or treat cancer.
Monoclonal antibodies : These are man-made versions of immune system proteins. mAbs can be very useful in treating cancer because they can be designed to attack a very specific part of a cancer cell.
Oncolytic viruses: This treatment uses viruses that have been modified in a lab to infect and kill certain tumour cells.

Low-level Laser Therapy

Low-level laser therapy (LLLT)/ Photobiomodulation (PBMT) is a form of light therapy which uses low-level lasers or light-emitting diodes (LED)s to the body. The application of low-power lasers relieves pain or stimulates and enhances cell function, improves tissue repair, and reduces pain and inflammation wherever the beam is applied. Usually applied by a doctor, therapist or technician, treatments take about 10 minutes and should be applied two or more times a week.

LLLT/PBMT has been used for many years on sports injuries, arthritic joints, neuropathic pain syndromes, back and neck pain and seems to reduce radiation-induced oral cavity inflammation, pain and the duration of radiation-induced inflammation and help patients recover sooner from these toxicities.

Dr Ramkumar took a holistic approach to my care. He was able to consider my whole life situation which included my baby and husband. He was both empathetic and pragmatic. At each stage of treatment he explained, with care and simple language, what was happening to my body. I couldn’t have asked for more. Thank you from us all.

Patient at University Hospital Southampton NHS Foundation Trust

Source: iwantgreatcare.co.uk

Contact Dr Ram

Dealing with cancer can be a difficult and emotionally challenging situation. Dr Ram always has your best interests and wellbeing at heart.

Make an enquiry or book an appointment today to see how Dr Ram can help.