Technology

A CT scan is a diagnostic imaging test used to create detailed images of internal organs, bones, soft tissue and blood vessels. The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. CT scanning is often the best method for detecting many different cancers since the images allow your doctor to confirm the presence of a tumour and determine its size and location. It can monitor changes in tumour size and assess patient response to cancer therapy as well.

General x-ray uses low dose x-rays to produce pictures of the body's internal structures. X-rays are the oldest and most frequently used form of medical imaging. An x-ray may detect a tumour in an organ such as the lung, diagnose fractured bones, look for injury or infection, and locate foreign objects in soft tissue.

Magnetic resonance imaging (MRI Scan) is a non-invasive test that uses a powerful magnetic field, radio waves and a computer to obtain cross-sectional images of organs, soft tissues, bones and virtually all other internal body structures. It is used to evaluate a variety of conditions, including tumours.

Digital mammography is a specific type of breast imaging that uses low-dose x-rays to detect cancer early – before women experience symptoms.

Ultrasound is a non-invasive method of obtaining images of organs and tissues using high frequency sound waves. It is also useful to provide imaging guidance to needle biopsies or to see and evaluate conditions related to blood flow.

A fluoroscopy is an imaging procedure in which a continuous, real-time x-ray image is projected onto a monitor. Fluoroscopy is used to examine the gastrointestinal tract to diagnose gastrointestinal cancer. It is also used to guide the placement of a peripherally inserted and central catheter (PICC) for chemotherapy.

PET/CT is a powerful imaging technique that combines both CT scan and PET scan using radioactive sugar (FDG – 18F-fluorodeoxyglucose) as the tracer. It provides comprehensive information on the abnormal activity and function of cells (obtained by PET) and precise location of these abnormalities in the body (obtained by CT). This leads to more accurate assessment of your current medical condition especially for cancer and infective / inflammatory disease.

SPECT/CT combines two imaging technologies – Gamma Camera which shows the biological functions in the body and Computed Tomography (CT) which shows detailed anatomical structures. It is useful for evaluating blood flow, gastrointestinal function, immune activity, thyroid function, tumours, cardiac function and more. The SPECT/CT also allows your doctor to see how your organs function, and to detect and monitor the activity of the disease.

We provide both routine and specialised chemistry testing such as those on lipid, liver, kidney function, tumour and cardiac markers, and metabolic and hormones.

Tests include but are not limited to blood count, blood film, bone marrow and trephine biopsy, coagulation, blood grouping and antibody screening.

We offer routine and complex specimen testing with both basic and immunohistochemistry stains. Frozen section and second opinion services are also available. Cytopathology tests include liquid based cytology, pap smear, fine needle aspiration cytology, and fluid cytology.

There are many types of treatment for cancer. Your treatment depends on the type of cancer you have, how advanced it is and your general health.

Some people might have only one treatment, but most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. Understanding your treatment and its side effects can help you to cope with cancer.

A biopsy is surgery that removes a small piece of tissue from the abnormal area. The tissue is then sent for pathological investigation to determine the type of cancer and how slowly or quickly it may grow.

Localised cancer that is contained in one area can be removed through surgery. Chemotherapy or radiation therapy may be administered before or after the surgery.

Da Vinci Surgical System

The da Vinci Surgical System consists of an ergonomic surgeon console, a patient-side cart with four interactive arms, a high-performance vision system and proprietary EndoWrist® instruments. The da Vinci Surgical robot is completely under the control of the surgeon. It translates your surgeon’s hand movements at the console in real time, bending and rotating the instruments while performing the procedure. The tiny wristed instruments move like a human hand, but with a greater range of motion. The da Vinci vision system also delivers highly magnified, 3D high-definition views of the surgical area. The instrument size makes it possible for surgeons to operate through one or a few small incisions. Potential benefits include but not limited to faster recovery, minimal scarring, less pain, less blood loss and fewer complications. Common applications of the da Vinci Surgical robot are in cancer, urology, gynecology and gastroenterology diseases.

Surgery may remove some, but not all of a cancer tumour. Debulking is used when removing an entire tumour might damage an organ or the body. It removes the tumour as much as possible, followed by chemotherapy or radiation therapy.

Palliative surgery is used to relieve side effects caused by a tumour in individuals with incurable illness and improve their quality of life while lengthening their lifespan. Read more about Palliative Care here.

The Varian TrueBeam™ STx is a revolutionary innovation in cancer treatment. It expands radiotherapy treatment options for even the most challenging cancer cases in the lung, breast, head and neck, abdomen, liver and other regions.

The system uses sophisticated 3D imaging to target and treat tumours of all shapes, sizes and locations with pinpoint accuracy. Images can be generated using 25% less x-ray dose. These images are used to fine-tune a patient’s position prior to and during the treatment process.

The precision of the system is measured in increments of less than a millimetre. This accuracy is made possible by the system’s sophisticated architecture, which synchronises imaging, patient positioning, motion management, beam shaping and dose delivery. The system performs accuracy checks every ten milliseconds throughout the entire treatment.

It offers the following therapy options:

A. 3D Conformal Radiation Therapy

Three-dimensional conformal radiation therapy uses a CT simulator to create three-dimensional maps of a tumour and the surrounding tissue which helps oncologists use the targeting information to focus precisely on the tumour, while avoiding healthy surrounding tissues.

B. Intensity-modulated Radiation Therapy (IMRT)

IMRT is an advanced mode of high-precision radiotherapy that uses computer-controlled linear accelerators to deliver precise high radiation doses to a malignant tumour or specific areas within the tumour while minimising the dose to surrounding normal critical structures. IMRT allow the radiation dose to conform more precisely to the three-dimensional (3-D) shape of the tumour by modulating – or controlling – the intensity of the radiation beam in multiple small volumes.

C. Volumetric Modulated Radiation Therapy (VMAT)

VMAT is an advanced form of IMRT that delivers a precisely-sculpted 3D dose distribution with a 360-degree rotation of the gantry in a single or multi-arc treatment. VMAT can deliver the dose to the entire tumour in a 360-degree rotation, typically in less than two minutes. It uses special software and an advanced linear accelerator to deliver IMRT treatments up to eight times faster than what was previously possible. The algorithm ensures treatment precision, helping to spare surrounding healthy tissue.

D. Image-guided Radiation Therapy (IGRT)

IGRT is the use of frequent imaging during a course of radiation therapy for the purpose of improving the precision and accuracy of the delivery of treatment. It is used to treat tumours in areas of the body that move, such as the lungs.

E. Stereotactic Radiosurgery (SRS)

SRS is a non-surgical radiation therapy used to treat functional abnormalities and small tumours of the brain. It can deliver precisely-targeted radiation in fewer high-dose treatments than traditional therapy, which can help preserve healthy tissues.

F. Stereotactic Body Radiation Therapy (SBRT)

SBRT is a non-surgical radiation therapy used to treat tumours on the body. It can deliver precisely-targeted radiation in fewer high-dose treatments than traditional therapy, which can help preserve healthy tissue.

HDR allows clinical oncologists to deliver the radiation quickly during an outpatient procedure. In HDR, applicators are placed in or adjacent to the cancer tissue after which a computer driven apparatus, called a remote after loading device, transfers the radiation source through the catheters to the tumour site. The source remains in place for a predetermined amount of time. When the desired dose has been achieved, the remote afterloading device withdraws the radioactive source.

This innovative therapy is administered at the time of surgery (lumpectomy or colorectal surgery), following cancer removal. INTRABEAM IORT is delivered using a miniaturised radiation device which is inserted into the tumour bed. Therapeutic radiation is then directed immediately and precisely right where it is needed most – the location where the cancer was removed. Localising the radiation on the tumour bed is effective because studies show that this is where cancer is most likely to recur.

The Gamma Knife is not a conventional surgical knife in the traditional sense. In fact, there are no knives or scalpels involved, no incisions made. This “knife” refers to an array of 192 precise beams of gamma radiation that produces a powerful dose of concentrated radiation when converged at the treatment site. It targets tumours and abnormalities, stunting their growth and shrinking them over time while sparing the surrounding healthy brain tissues.

This advanced radiation technique provides an outpatient treatment option to patients suffering from brain conditions that typically requires surgery. It is an alternative method for a number of conditions whereby an open neurosurgery may be highly risky or not practicable. It can be used to treat a number of neurological disorders including brain metastases, arteriovenous malformations, facial nerve pain (trigeminal neuralgia), meningioma, acoustic neuromas, gliomas and pituitary tumours.