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asiri aoi cancer centre

Asiri AOI Cancer Centre

Bringing World Class Cancer Care Protocols to Sri Lanka

In Cancer Care, It’s the path that defines the destination. At Asiri AOI, we are taking comprehensive cancer care to the next level for our patients. We recognize that cancer treatment is complex from a multi modality clinical treatment to the intense emotional support for patients. We pledge to stand beside each of our patients and their families. We partner them at every step, addressing every single detail and delivering appropriate cancer treatment that is personalized and compassionate. Asiri AOI’s precision-driven cancer treatment regime is based on collaborative protocols with University of Pittsburgh Medical Centre, one of the leading providers of oncology treatment in the United States. At Asiri AOI we have a model of integrated care delivery that is individualized for each patient.

Our Comprehensive Cancer Care Centre offers the best in class care across Medical, Radiation and Surgical Oncology backed by high end radio-diagnosis PET services and pathology services. So, be it diagnosis or treatment, we have the expertise to handle every challenge in Cancer Care. With a multi-disciplinary team of highly qualified Clinical specialists, supported by trained and compassionate nursing staff, we are at the forefront of delivering excellence in Cancer Care.

International Standard Cancer Care

To many, cancer is seen as a single disease. The fact however is that 200 distinct types of cancer exist and each can be diagnosed at an early or late stage. What is required for effective cancer care is a collaborative multidisciplinary approach, wherein the Medical Oncologist, Radiation Oncologist and the Surgeons, collaborate together to decide on the best protocol for management of each case. At most times cancer patients require a treatment protocol that incorporates all these three areas. It is also very important that treatment is based on standardized clinical protocols and regimens. These protocols are developed using evidence gathered form treating thousands of cancer patients across the globe including South Asia.

At Asiri AOI we have launched a new generation Radiation Therapy Linear Accelerator, the most advanced in Sri Lanka and amongst a few in South Asia. Our tumour board consists of leading cancer specialists from the University of Pittsburgh Medical Centre, the only Cancer Centre in the country to offer this expertise.

Our team of Oncologists & Surgeons lead the field in terms of experience and qualifications. More importantly our nurses and paramedical technicians are dedicated to support every cancer patient and their family.

American Oncology Institute (AOI)

American Oncology Institute (AOI) is a leading provider of Oncology services in South Asia. It operates a chain of cancer hospitals in multiple cities across India and South Asia. AOI was founded in 2006 by a group of leading Oncologists with decades of experience at University of Pittsburgh Medical Centre (UPMC), with a vision to bring US treatment protocols in Cancer Care to the Asian sub continent. UPMC Cancer Centers, established in the late-1990's are now organized in a hub and spoke format in over 40 regional sites where over 200 oncologists provide care to nearly 75,000 cancer patients per year, including 25,000 new patients. Read More

AOI was started with an aim to close the gap between standards of cancer care in South Asia and the US through transporting the rich lineage of its parent organization in offering Precision Cancer Care.

AOI provides comprehensive cancer management that is powered by clinical excellence, world class technology as well as international pathways and protocols for treatment planning and execution, providing never-before quality in cancer care across India and South Asia. AOI currently operates across 10 Cancer Hospitals in 9 cities in South Asia, with a planned expansion to reach 20 Cancer Hospitals. With the rise of cancer incidence across South Asia, AOI’s core deliverable of Precision Cancer Care which is also powered by its world class tumour board led by specialists from UPMC has raised the bar of cancer care in the region.

Our mission is simple, to provide evidence based cancer care that meets the highest American standards for trust, transparency and technology, while putting the needs of patients first.

Why Choose Asiri AOI?

Clinical Excellence

Cancer treatment at Asiri AOI is managed by a highly experienced and talented multi-disciplinary team of Cancer Specialists in Medical, Radiation and Surgical Oncology, who are supported by a competent team of well-trained nurses, medical physicists and other support staff.

Technical Excellence

The AOI Cancer Centre is the only cancer treatment facility in Sri Lanka to house a PET Scanner. Powerful 4 Dimensional imaging technology helps the doctors examine tumors in great detail, enabling them to plan and deliver precisely targeted radiation treatment.

Precision Technology

AOI is the only facility in the country providing Radiotherapy machines using True Beam Technology, ensuring pinpoint accuracy of treatment, aimed directly at the tumor, while safeguarding the healthy tissue around it.

Clinical Pathways & Protocols

Asiri AOI practices evidence based medicine to ensure precise outcomes. At Asiri AOI, we have created an environment where each treatment is planned based on international treatment protocols that are administered through decision support tools enabled by technology.

International Tumour board

AOI is one of the few or possibly the only chain of cancer hospitals in South Asia where an International Tumour Board is conducted weekly, during which leading Oncologsts from UPMC join for case discussions alongwith the local clinical experts to plan treatment for specific cases. Asiri AOI will offer the services of this International Tumour Board to its patients in Srilanka.

Centralised Treatment Planning

Our Radiation therapy department has a centralized treatment planning centre. Each treatment plan is prepared by highly trained physicists under guidance and supervision of a team based out of the United States. An accurate treatment plan is vital to ensure that there is optimum radiation being given to all parts of the tumour while sparing other normal tissue.

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What is Cancer?

Cancer is a term used for diseases in which abnormal cells divide without control and invade other tissues. Cancer cells can spread throughout the body via the blood and lymph system. When cancer cells move from their point of origin and invade other parts of the body through the bloodstream and lymph system, the process is referred to as metastasis.

Cancer is not contagious and often occurs due to a mix of hereditary and environmental factors. More than 200 different types of cancer exist. Most cancers are named after the organ or type of cell in which they originate. For example, cancer that starts in the cervix is called cervical cancer, and cancer that starts in basal cells of the skin is referred to as basal cell carcinoma.

Origins of cancer

All cancers originate from cells, the body's basic units of life. The human body is composed of about 100 trillion cells. Cells keep the body healthy by growing, dividing, and producing new cells when the body needs them. Normally, when cells become old or damaged, they die and new cells replace them. However, this process may be disrupted when cells divide and replicate uncontrollably, even if new cells are not needed by the body. This unnecessary cell growth may be the result of mutated or damaged genetic material, known as DNA. When this type of cell growth occurs, the result is an unneeded increase in the overall quantity of cells in the body. This increase in new cells can form a mass of tissue called a tumor. However, not all tumors are cancerous.

Tumors can be grouped into two categories

Benign:

These tumors are not cancerous and are rarely life-threatening. Often, they can be removed. After removal, regrowth of the tumors are not common. Additionally, these cells do not spread to other parts of the body.

Malignant:

These tumors are cancerous. Malignant cells can attack nearby healthy tissues. These cells also have the ability to metastasize or spread to other parts of the body.

Some cancers do not form tumors. Leukemia, a cancer of the marrow and blood, is a common example of such a cancer.

Cancer types can be grouped into broader categories

The main categories of cancer include:

Carcinoma

Cancers that originate in the skin or in tissues that line or cover internal organs.

Sarcoma

Cancers that originate in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

Leukemia

Cancer that originates in blood forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced, and enter the blood.

Lymphoma and Myeloma

Cancers that originate in the cells of the immune system.

Central Nervous System Cancers

Cancers that originate in the tissues of the brain and spinal cord.

Cancers in Sri Lanka

In Sri Lanka, the most prevalent types of cancer are:

Breast cancer

Cancer that originates in the tissues of the breast

Lip, Oral Cavity and Pharynx cancer

Cancer that originates in the mouth or throat.

Colon and Rectum cancer

Cancer that originates in the cecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum.

Esophageal cancer

Cancer that originates in the esophagus, the muscular tube that moves substances, such as food and water, from the mouth to the stomach.

Thyroid cancer

Cancer that originates in the thyroid gland. This is the 3rd most common cancer among women in Sri Lanka.

Cervical cancer

Cancer that originates in the cervix, the lower part of the womb in a female's reproductive system.

Prostate Gland cancer

Cancer originating in the prostate, a gland in the male reproductive system.

Trachea, bronchus and Lung cancer

Cancer that originates in the tissues of the lungs.

Ovarian cancer

Cancer that originates in the ovaries, the female reproductive organs that produces eggs.

Oncology Services available at Asiri AOI

Cancer Care Powered by Technology

It’s not just about expertise, protocols or skill. Cancer care is also about state-of-the-art technology. Asiri AOI supports every aspect of the treatment process with state of art medical technology and an advanced IT network for treatment planning.

Equipped with the world’s latest medical equipment with expert technicians, Asiri AOI stands at the forefront of cancer care excellence.

Diagnostics

Asiri AOI is the only facility in Sri Lanka to provide PET and CT imaging to diagnose malignancies and monitor response to treatment; Gamma camera; in addition to basic diagnostic equipment (CT/MRI/USS)

Treatment

We provide a complete portfolio of treatment options:

Surgical Oncology
Radiation Oncology
Medical Oncology

Palliative Care

Personalised palliative care through a multidisciplinary team and multi modality treatment

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Diagnostics

Discovery 600 PET/CT

Asiri AOI offers four dimensional (‘4D’) PET/CT, which combines the power of two imaging technologies and helps physicians account for variations in tumor size, shape and location when patients move or breathe. With it, doctors see the most complete and accurate images possible of a patient’s tumor and surrounding body structures. They use this information to ensure radiation treatment impacts only the tumor and not healthy tissue around it. Asiri AOI is the only center in Sri Lanka to have this powerful imaging modality.

A positron emission tomography (PET) scan is an imaging test that shows the metabolic activity (energy usage) of your body. A PET scan can give your doctor information about how your brain is working. It may be used to detect cancer, seizures, or Alzheimer's. In patients with memory disorders, doctors use PET scans of the brain to look for brain tumours that can be surgically removed.

Doctors often use the PET Scan diagnostic exam to detect cancer and measure the effects of cancer treatment. PET is very useful in detecting the activity of cancer, because malignant cells grow at a fast rate, they metabolize more sugar than normal cells. This can give your doctor a glimpse into how aggressive a tumour is or how its growth is slowed by therapy.

MRI

What is it?

An MRI (Magnetic Resonance Imaging) scan uses a large magnet, radio waves, and a computer to create a detailed, cross-sectional image of internal organs and structures in your body.

Your doctor can use this test to diagnose you or to see how well you've responded to treatment. An MRI scan differs from CT scans and X-rays, as it does not use potentially harmful ionizing radiation.

What is MRI used for?

MRI scanners are particularly well suited to image the non-bony parts or soft tissues of the body. They differ from computed tomography (CT), in that they do not use the potentially damaging ionizing radiation of X-rays. The brain, spinal cord and nerves, as well as muscles, ligaments, and tendons are seen much more clearly with MRI than with regular X-rays and CT; for this reason, MRI is often used to image knee and shoulder injuries.

In the brain, MRI can differentiate between white matter and grey matter and can also be used to diagnose aneurysms and tumours. Because MRI does not use x-rays or other radiation, it is preferred when frequent imaging is required for diagnosis or therapy, especially in the brain. However, MRI is more expensive than X-ray imaging or CT scanning.

CT Scans

What Is a CT Scan?

A computerized tomography scan (CT or CAT scan) uses computers and rotating X-ray machines to create cross-sectional images of your organs, bones, and other tissues. Like one piece in a loaf of bread, this two-dimensional (2D) scan shows a “slice” of the inside of your body. It shows more detail than a regular X-ray, allowing doctors to detect conditions like cancer.

They can help locate a tumour, blood clot or infection, and can guide treatment plans and procedures like biopsies, surgeries and radiation therapy.

Doctors can compare CT scans over a period of time to assess the effectiveness of ongoing treatments.

Digital X-Ray

Digital radiography / X-ray is a form of X-ray imaging, where digital sensors are used instead of traditional photographic film. This makes it much quicker and easier to digitally transfer and enhance images. Also, while traditional X-rays are considered safe, digital X-rays produce 80% less radiation. This means the patient receives much less radiation exposure with digital X-rays.

Mammography

A mammogram is an X-ray examination of the breast. It is used to detect and diagnose breast disease in women who either have breast problems, such as a lump, pain, or nipple discharge, as well as for women who have no breast complaints. It can be used to check for breast cancer in women who have no signs or symptoms of the disease.

The procedure allows detection of breast cancers, benign tumours, and cysts before they can be detected by palpation (touch).

Ultra sound scan (Sonogram)

An ultrasound scan uses high-frequency sound waves to create images of the inside of the body. Ultrasound scans are safe because they use sound waves or echoes to make an image. Ultrasound is safe, non-invasive, and does not use ionizing radiation.

Ultrasound scans are used during pregnancy to evaluate fetal development, and they can also detect problems in the liver, heart, kidney, or abdomen. They may also assist in performing certain types of biopsy.

Treatment

Medical Oncology

Focuses on treatment of cancer with chemotherapy, targeted therapy, immunotherapy, and hormonal therapy.

Surgical Oncology

Surgical oncology uses surgery to diagnose, stage and treat cancer. Surgical oncologists may also perform palliative surgeries to help control pain, increase a patient’s comfort level and manage cancer-related symptoms and side effects.

Whether a patient is a candidate for surgery depends on factors such as the type, size, location, grade and stage of the tumor, as well as issues related to the patient’s health, including age, physical fitness and other medical conditions.

Many patients may have cancer surgery combined with other treatments, such as chemotherapy, radiation therapy and/or hormone therapy. Nonsurgical treatments may be administered before or after surgery to help prevent cancer growth, metastasis or recurrence.

Radiation Oncology

Focuses on treatment of cancer with radiation.

What is Radiation Oncology?

Medical technology has improved tremendously in recent years, especially in the field of radiation oncology. Recent advancements in radiation therapy have revolutionized the treatment of cancer, leading to better clinical outcomes for patients. A specialty physician called a radiation oncologist manages and oversees each patient's radiation treatment. If you have been diagnosed with cancer, you may have the option of receiving radiation therapy as part of your cancer treatment. Your doctor will help determine if radiation therapy is right for you.

What is Radiation Therapy?

Radiation therapy, sometimes referred to as “radiotherapy,” is a type of cancer treatment that uses high-energy ionizing radiation to shrink tumors and kill cancer cells. It is a local treatment, meaning that it targets only the tumor, while sparing surrounding healthy tissue.

There are two ways radiation can be administered to patients:

External beam radiation

External beam radiation therapy delivers radiation through the use of a large machine called a linear accelerator that precisely aims radiation beams from outside of the body at the cancerous tumor.

Brachytherapy or internal radiation therapy

Brachytherapy is a type of radiation therapy in which radioactive particles known as seeds are placed within the body on the tumor or nearby the cancer cells.

*About half of all cancer patients receive some type of radiation therapy at some point during the course of their cancer care.

Radiation Therapy: A Walk-Through

There are six basic steps to radiation therapy that give patients an idea of what to expect.

1. Initial consultation

Consultation is the first step of the radiation therapy process. This involves an appointment with an oncologist, who reviews a patient’s medical records, pathology reports and radiology images and performs a physical examination. If, based on this review, treatment by radiation therapy is chosen, the patient will be offered an appointment for simulation.

2. Simulation

Following your initial consultation, you will undergo a ‘simulation’ process. The simulation allows the radiation oncologist to define the exact location and configuration of the treatment for your cancer or tumor. In order to accomplish this, special simulation CT scans will be taken in the department - depending on clinical indications this simulation process may be done at the PET/CT simulator combining both PET images with CT, or using a dedicated CT simulator. Sometimes, contrast is used to improve the quality of the information. For example, you may be asked to swallow a contrast agent or you may be injected with one, similar to when you have a diagnostic CT scan performed.

Please note that images obtained for simulation purposes are not usually given to patients - these are similar images to your CT / MRI / PET scans and are done specifically for the oncologist and radiation physicist to locate the tumor for treatment purposes only.

You will be placed in the treatment position, and often there will be customized ‘immobilization’ devices such as mesh masks, headrests, or form-fit body moulds to maintain your body position the same on a day to day basis.

The area on your body that requires treatment will be marked with a tiny tattoo ‘dot’. This will help with the treatment set and ensure that the radiation is directed properly each day. These marks should not be removed or washed away. Staff will discuss with patients how to protect the marks so they remain in place.

3. Contouring

This step of the radiation process involves the radiation oncologist where she/he uses the images obtained in the previous step to ‘contour’ the target volumes to be treated while avoiding at-risk normal organs/tissues. Following this the consultant will prescribe the dose on ARIA (internal online portal for treatment / consultation). Images are contoured using a combination of CT, PET CT and/or MRI images in addition to the dedicated CT images taken during the simulation stage.

4. Treatment Planning

The Physicist or Dosimetrist will plan the prescribed treatment with this information and the plan is later reviewed by the Oncologist to confirm it meets expectations. Once agreed and approved, the Physicist will prepare a Patient QA and Radiographer will irradiate a ‘phantom’ or an electronic portal imaging dosimetry, which is a part of the Truebeam® machine, before treating the patient. The data taken during this process will be reviewed by the physicist and approved if it meets specifications.

5. Treatment Delivery

"You will meet with the radiation oncology nurse to discuss issues related to radiation, including skin care and nutrition during treatment."

Unlike other radiation treatment centers in Sri Lanka, both the Consultant Oncologist and Radiation Physicist (in addition to radiographer therapists) are physically present at the treatment unit to ensure that the radiotherapy treatment planned is implemented correctly, on the first day of treatment implementation. From the first day of treatment onwards, you will be placed in the position for treatment using immobilization devices (exactly as used for CT simulation). Radiation therapists are responsible for positioning you correctly and for delivering the radiation dose prescribed by the radiation oncologist.

Verification images are taken on the first day of treatment and daily afterwards - unlike other radiotherapy facilities in Sri Lanka. It is our policy to take treatment verification images (i.e. KV X-rays MV images, or CBCT) daily, before each treatment to ensure accuracy of the treatment to be administered. These images confirm that the area of the body being treated has not changed position.

Radiation therapists view your body from monitors adjacent to the treatment room and can talk to you via intercom. Individual treatment sessions typically do not last long; often, you will be in the treatment room for no more than 20 minutes, and much of this time is used for accurate positioning. After your treatment, the technologists will help you get off the table and bring you to a patient exam room, when necessary. At this time, you will meet with the radiation oncology nurse to discuss issues related to radiation, including skin care and nutrition during treatment.

Over the course of radiation therapy, you will meet with your doctor at least once a week as well as the other members of the treatment team, including nurses. In addition, should you have concerns or symptoms that need to be addressed, you may meet with any of your treatment team members on any day at your request.

6. Post Treatment Follow-up

Upon completion of your treatment, a follow-up appointment will be scheduled to monitor your recovery and overall health. Additional diagnostic tests may be ordered at this stage. Reports on the status of your treatment and progress are issued to be shared with your primary physician.

What is Cervical Cancer?

This is the second most common cancer among Sri Lankan women. Cervical cancer occurs when cells in the cervix grow out of control. A group of abnormal cells together can form a malignant (cancerous) tumor. Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which cells that are not normal begin to appear in the cervical tissue. Later, cancer cells start to grow and spread more deeply into the cervix and to surrounding areas. Almost all cases of cervical cancer are caused by a virus called Human Papillomavirus (HPV). HPV can cause cells in the cervix to grow abnormally and become cancerous.

Some of the risk factors for Cervical Cancer include: (Human Papilloma virus (HPV) infection)

Lack of regular PAP tests
Smoking
Weakened immune system
Chlamydia infection
Diet
Being overweight
Use of oral contraception
Multiple full term pregnancies
Young age at the first full-term pregnancy: Women with their first full-term pregnancy before the age of 17 are twice as likely to develop cervical cancer
Family history
Diethylstilbestrol (DES): Use of this hormonal drug to prevent miscarriages increases the risk for cervical cancer

Common symptoms and signs of Cervical Cancer:

Abnormal vaginal bleeding

Bleeding that occurs between regular menstrual periods
Bleeding after sexual intercourse, douching, or a pelvic exam
Menstrual periods that last longer and are heavier than before
Bleeding after going through menopause

Increased vaginal discharge
Pelvic pain
Pain during intercourse

Diagnosis of Cervical Cancer

Although symptoms may suggest that cancer is present, the use of diagnostic imaging, biopsies and other tests can help confirm whether the cancer really exists. The following tests may be conducted in diagnosing cervical cancer:

Colposcopy
Cervical biopsies
Cytoscopy, proctoscopy and examination under anesthesia
Chest x-ray
Computed Tomography (CT) scan
Magnetic Resonance Imaging (MRI) scan
Positron Emission Tomography (PET) scan
Ultrasound

Treatment options for Cervical Cancer

Treatment options may consist of surgery, chemotherapy, radiation therapy, other localised therapies or any combination of these treatments

Surgery may consist of the following options:

Radical trachelectomy: Removal of the cervix, part of the vagina, and the lymph nodes in the pelvis
Total hysterectomy: Removal of the cervix and uterus
Radical hysterectomy: Removal of the cervix, some tissue around the cervix, the uterus, and part of the vagina

Chemotherapy uses anti-cancer drugs to kill or stop the growth of cancer cells
Radiation therapy uses high-energy radiation beams to eliminate cancer cells or stop them from growing. Radiation therapy consists of external beam radiotherapy and brachytherapy or internal radiation therapy

External beam uses localized high energy radiation beams to eliminate cancer cells and keep them from growing
Brachytherapy uses a radioactive substance, usually in the form of seeds which are placed directly into or near the cancer which helps to shrink the tumor

What is Breast Cancer?

Breast cancer is the most prevalent type of cancer affecting the Sri Lankan population. Breast cancer comprises 25% of all female cancers in Sri Lanka. There are different types of breast cancers but the one which begins in the milk duct (Ductal Carcinoma) is the most common type of breast cancer. Similar to other cancer types, in breast cancer too, the cancerous cells in the mammary glands multiply abnormally and develop into a tumor and then begin to attack lymph nodes or are carried to different parts of the body.

Some of the risk factors for Breast Cancer, include:

Gender: Breast cancer is 100 times more common among women than men. This is because women possess more of the hormones estrogen and progesterone, which is linked to the development of cancer
Genetic inheritance: An estimated 5-10% of breast cancer cases are considered hereditary or mutations that have been passed on from parent to child. Defects in BRCA 1 and BRCA 2 genes are the most common cause for hereditary breast cancer. These particular genes help prevent cells from mutating or growing abnormally
Increased number of menstrual cycles: Women who have had more menstrual cycles due to starting at an early age (before age 12) or go through menopause at a later age (over age 55) are at an increased risk
Aging
Family history
Personal history with breast cancer
Dense breast tissue
Previous chest radiation exposure
Benign breast conditions
Women having no children or having their first child after the age of 30
Use of oral contraceptives and hormone replacement therapy
Increased alcohol consumption
Being overweight
Minimal physical activity

Common symptoms and signs of Breast Cancer:

Irregular lump in one or both breasts
Swelling of all or part of the breast, even if no lump is detected
Skin irritation or dimpling
Pain in the breast or nipple

Diagnosis of Breast Cancer

Although symptoms may suggest that cancer is present, the use of diagnostic imaging can help confirm whether the cancer really exists. The following are imaging tests that may be conducted in diagnosing breast cancer:

Diagnostic mammograms are x-rays of the breast where several images are taken of the area in question. Advanced diagnostic centers offer digital mammograms where the images are recorded, viewed and stored on a computer. Also, the use of digital mammography can allow for images to be sent electronically to other physicians or hospitals.
MRI scans of the breast use radio waves and a strong magnet in reproducing detailed images of the body. MRIs can be used in combination with mammograms in detecting cancer for high risk individuals or can be used to better assess an abnormal area.
Breast ultrasound is a test that uses sound waves to create an image of organs and tissue within the body. Ultrasounds are typically used to differentiate between benign and cancerous tumors. Breast ultrasounds should be used in combination with mammograms.
Ductogram is a test that examines the ducts where nipple discharge occurs. This is done by injecting contrast medium into the affected duct. An image is produced of the duct structure displaying any abnormalities.

Treatment options for Breast Cancer

Treatment options may consist of surgery, chemotherapy, radiation therapy, hormone therapy or any combination of these treatments.

Surgery is performed in order to remove the tumor in the breast and possibly surrounding tissues and nearby lymph nodes
Chemotherapy uses anti-cancer drugs to kill or stop the growth of cancer cells
Radiation uses high-energy radiation beams to eliminate cancer cells or stop them from growing. Radiation therapy consists of external beam radiotherapy and brachytherapy or internal radiation therapy:
- External beam uses localised high energy radiation beams to eliminate cancer cells and keep them from growing
- Brachytherapy uses a radioactive substance, usually in the form of seeds which are placed directly into or near the cancer which helps to shrink the tumor
Hormone therapy is a treatment that targets specific hormones linked to the cancer cells by blocking the properties associated with cell growth

What is Lung Cancer?

Lung cancer is one of the leading cancers in Sri Lanka and usually originates in the airway passages of the respiratory tract. It can also begin in other parts of the lung such as the cells in the bronchioles and alveoli. In 2010, an estimated 11 836 patients died of cancer in Sri Lanka. Among these deaths, approximately 764 were men diagnosed with lung cancer.

The most common types of lung cancer are small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Although highly uncommon, both cell types can simultaneously be affected with cancer. Approximately 85-90% of lung cancers are diagnosed as NSCLC.

Some of the risk factors for Lung Cancer include:

Tobacco smoke: Tobacco smoke is the leading cause of lung cancer. Smoke from cigarettes, pipes, or cigars release harmful substances that can damage lung cells when inhaled. The more a person is exposed to smoke, the greater the likelihood of developing lung cancer.
Radon: Radon is a radioactive gas that you cannot see, smell or taste. It forms in soil and rocks. People working in mines may be exposed to Radon. Extended exposure to Radon can damage lung cells.
Asbestos and other substances: Exposure to asbestos, arsenic, chromium, nickel, soot, tar and other substances can cause lung cancer. The risk is highest for those with years of exposure.
Air pollution
Family history
Older age

Common symptoms and signs of Lung Cancer:

A cough that does not go away or gets worse
Chest pain that is often worse with deep breathing coughing or laughing
Hoarseness
Weight loss and loss of appetite
Coughing up blood or rust-colored sputum
Shortness of breath
Feeling tired or weak
Infections such as bronchitis and pneumonia that don’t go away or keep coming back
New onset of wheezing

Diagnosis of Lung Cancer

Although symptoms may suggest that cancer is present, the use of diagnostic imaging can help confirm whether the cancer really exists.

The following are tests that may be conducted in diagnosing lung cancer:

Chest x-ray
Computed Tomography (CT) scan
Magnetic Resonance Imaging (MRI) scan
Positron Emission Tomography (PET) scan
Bone scan
Bronchoscopy and Biopsy

Treatment options for Lung Cancer

Treatment options may consist of surgery, chemotherapy, radiation therapy, other localised therapies or any combination of these treatments.

Surgery may consist of a pneumonectomy, lobectomy, or segmentectomy where all or part of the lung is removed. In some instances, the nearby lymph nodes may be removed for observation
Chemotherapy is a systemic therapy that uses anticancer drugs to kill or stop the growth of cancer cells
Radiation therapy consists of external beam radiotherapy and brachytherapy or internal radiation therapy
External beam uses localised high energy radiation beams to eliminate cancer cells and keep them from growing
Brachytherapy uses a radioactive substance, usually in the form of seeds which are placed directly into or near the cancer which helps to shrink the tumor
Other therapies can include radiofrequency ablation, photodynamic therapy, laser therapy and stent placement

Our food should be our medicine and our medicine should be our food.

- Hippocrates

There are many risk factors that can lead to the development of cancer. Some risk factors are not within control, such as inherited genes or family history, however many are controllable and if avoided can drastically lessen the likelihood of developing cancer. A vital way to prevent cancer is by practicing healthy dietary habits and maintaining a good weight. According to the American Cancer Society, approximately one-third of all cancer deaths are attributed to poor diet, lack of regular exercise and obesity.

Food intake

In order to manage a nutritious lifestyle, it is important to understand how foods are prepared and processed. Moreover, maintaining a well-balanced diet should consist of consuming a variety of foods, reducing food portions and eating wholesome plant foods every day. It is important to always be conscientious of your food choices when achieving and maintaining a healthy weight.

Dietary Habits and Cancer

Scientific research and studies have proven that certain dietary practices directly correlate with developing diseases over time, such as cancer. The risk of developing cancer, namely cancers of the lung, mouth, esophagus, stomach, digestive tract, head and neck can be averted when a diet is consistently rich in fruits and vegetables. On the contrary, eating foods high in saturated fats, such as red meat, are linked to specific cancers such as gastrointestinal cancers.

Overweight and obesity have been associated with greater risk for cancers of the breast, colon and rectum, endometrium, kidney, pancreas and esophagus.

10 Tips for Eating Healthy

Eat wholesome plant foods
Avoid or limit the intake of red meats and processed meats with added preservatives
Consume a variety of plant foods including vegetables, fruits, nuts, beans and whole grains. The less these plant foods are processed or cooked, the greater you will benefit from their nutrients
Increase fiber consumption which will help to clean the digestive tract before cancer causing cells can develop
Avoid or reduce the intake of bad fats, like saturated and trans fats. Saturated fats are mainly found in animal products such as red meat, milk, cheese, butter, ghee, and eggs. Trans fats are processed vegetable fats that are hydrogenated to help preserve them
Consume unsaturated fats or good fats like nuts and avocados or cook with olive oil
Limit eating fried foods and packaged foods
Often eat fish that is prepared in a healthy way
Drink at least two liters of water everyday
Avoid consumption of alcoholic drinks

For more information call us 077 379 6702

Stereotactic Radiosurgery (SRS)

What is Stereotactic Radiosurgery (SRS)?

Stereotactic radiosurgery (SRS) is a non-invasive treatment technique used primarily to remove or wear away tumors in the brain and for certain other conditions.

Radiosurgery is most suitable for small, well-defined tumors that can be seen on imaging, such as a CT or an MRI scan. Despite the use of the word "surgery" in its name, radiosurgery does not involve removing the tumor with a surgical knife. Instead, a focused high-intensity beam of radiation is used to target a tumor while minimizing dosage to healthy tissue. First developed in 1949 by the Swedish neurosurgeon Lars Leksell to treat small targets in the brain that were not amenable to conventional surgery, SRS is gaining increasing prominence.

How does SRS work?

SRS works by using highly focused beams of powerful radiation to overwhelm cancer cells. Radiation damages the DNA in cancer cells, interrupting their ability to reproduce. When the damaged cancer cells attempt to divide, the tumor shrinks or dies. Normal cells, however, can recover from radiation more easily.

Similar to external beam radiation therapy, radiosurgery is performed with a linear accelerator, or linac. The linac generates a high-energy radiation beam focused precisely on the tumor. The beam is delivered from many different angles to target each part of the tumor and deliver the prescribed amount of radiation.

Radiosurgery is sometimes used as a palliative treatment when curing the cancer is not possible.

What are the benefits of SRS?

There are no incisions, no stitches and therefore, no post-surgical recovery time
No blood loss, no ICU and no post-surgical complications
Treatment is delivered in only one to five sessions

How soon can the patient return to daily routine?

SRS is performed on an outpatient basis, so the patient can usually return to his or her normal activities the day following treatment.

What are the conditions commonly treated by SRS?

Over the years, SRS has evolved to treat a variety of neurological and other conditions. Some of them include:

Brain tumor: SRS is often used to treat noncancerous and cancerous brain tumors, including meningioma, chordoma, and chondrosarcoma. May also be used to treat cancers that have spread to the brain from other parts of the body.

Arteriovenous malformation (AVM): AVMs are abnormal tangles of arteries and veins in your brain. SRS destroys the AVM and causes the affected blood vessels to close off over time.

Trigeminal neuralgia: A chronic pain disorder of one or both of the trigeminal nerves, which relay sensory information between your brain and areas of your forehead, cheek and lower jaw. SRS treatment for trigeminal neuralgia targets the nerve root to disrupt these pain signals.

Acoustic neuroma: A benign tumor that develops on the auditory nerves leading from inner ear to the brain. SRS may stop the growth or minimize the size of an acoustic neuroma with little risk of permanent nerve damage.

Tremors: SRS may be used to treat tremors associated with functional neurological disorders such as Parkinson's disease and essential tremor.

Other cancers: SRS may be used to treat cancers of the liver, lung and spine.

Precision cancer care at American Oncology Institute

In recent years, cancer treatment and therapies have progressed significantly. Countless patients have been cured, while others' lives have been extended far longer than expected with these advanced treatment options. Asiri AOI provides comprehensive cancer management powered by a multi-disciplinary team, clinical excellence, world class technology as well as international protocols. Asiri AOI stands at the forefront of treatment excellence offering precision cancer care for all types of cancers for all age groups and genders.

* Procedures will be done subject to clinician’s decision.

CHARACTERISTIC	CONVENTIONAL RADIOTHERAPY	SRS/SBRT
Dose / Fraction	1.8 - 3 Gy	5 - 45 Gy
# Fractions	10 - 40+	1 - 5
Target Definition	CTV / PTV	GTV
Margin	Centimeters	Millimeters
Physics-Dosimetry Check	Indirect	Direct
Required Setup Accuracy	TG40-conventional	TG40 - SRS
Treatment Accuracy and Tracking	3-point laser positioning Port films	Intrafraction stereo imaging Optical arrays / head frames

Asiri AOI Cancer Centre

American Oncology Institute (AOI)

Why Choose Asiri AOI?

Clinical Excellence

Technical Excellence

Precision Technology

Clinical Pathways & Protocols

International Tumour board

Centralised Treatment Planning

Cancer Care Powered by Technology

Diagnostics

Treatment

Palliative Care

Discovery 600 PET/CT

Medical Oncology

Surgical Oncology

Radiation Oncology

What is Radiation Oncology?

What is Radiation Therapy?

There are two ways radiation can be administered to patients:

There are six basic steps to radiation therapy that give patients an idea of what to expect.

1. Initial consultation

2. Simulation

3. Contouring

4. Treatment Planning

5. Treatment Delivery

"You will meet with the radiation oncology nurse to discuss issues related to radiation, including skin care and nutrition during treatment."

6. Post Treatment Follow-up

Phenomenally Different

HD 120 MLC - 2.5 millimeters

Multiple Energy Support