Chemotherapy Day Ward
A chemotherapy day ward with full integrated sterile intravenous therapy preparation unit opened in 1960. The Chemotherapy Day Ward is located within the radiation oncology department. It opens on Saturday through Wednesday, 7.5 a.m.-5 p.m and delivers chemotherapy and supportive treatment to cancer patients. The Chemotherapy Day Ward consists of a reception, a waiting area, a clinical workstation, 25 beds, and 2 rooms for chemotherapy administration. It provides services including chemotherapy infusion, IV hydration, administration of blood products, antibiotics, and treatment so they are better able to manage illness, side effects and course of treatment. The specialist nurses with Certification administer cancer chemotherapy perform venous cannulation. The nursing practice model is based upon the team nursing model. Inherent in this model is the formation of a collaborative relationship amongst the different levels of nursing staff within each practice. The charge nurse and other nursing staff assume responsibility for the functioning of the unit.
The Radiotherapy Process
The patients for whom radiotherapy is indicated are identified after visiting one of our Clinical Oncologists. This is the start of a patient’s radiotherapy process.
The patient’s position, treatment area and radiation beam directions are customized for each patient. They are defined using x-ray fluoroscopy on a radiotherapy simulator by a Radiation Oncologist assisted by a Radiotherapy Technologist. The areas to be treated are marked on the patient’s skin.
The length of time each field should deliver radiation is calculated by a Physicist or Dosimetrist based on the prescribed dose and the beam and patient geometry and is check by another.
The radiation treatment is typically given in 20-30 visits (fractions) to reduce normal tissue damage. The patient is set-up by Radiotherapy Technologists normally guided by a Physicist on the first treatment fraction.
The patient is regularly seen by a Radiation Oncologist during the course of the treatment and also on follow-up visits.
The Radiotherapy Equipment
In addition to two radiotherapy simulators to help design the treatment, the Department has different machines that produce and deliver radiation to the patient. They offer radiation beams of different types and energies:
- Very deep-seated targets (such as pelvic and abdominal tumours) are preferably treated on a medical linear accelerator (linac) delivering high-energy (9 MV) x-rays.
- Less deep tumours (eg, of the head and neck) can be treated using gamma-rays from our two Cobalt-60 teletherapy units.
- Superficial and shallow tumours are treated using 120 kV x-rays of a superficial unit or electron beams from the linac.
- Suitable gynecological tumours are treated using intracavitary brachytherapy with multiple Cs-137 sources.
The purchase of an additional dual-energy linac is planned.
The commissioning and quality control (QC) of radiation equipment used in radiotherapy
The Physicists and Dosimetrists in the Physics Section perform acceptance testing and commissioning of new equipment and their subsequent periodic QC. These checks are carried out daily, monthly or yearly depending on their nature and importance.
The equipment used by the Physics staff includes:
- scanning water phantom system
- standard dosimetry water phantoms
- various types of ionization chamber and electrometer
- in-vivo dosimetry system with diodes
- radiation field checker for daily QC
- radiographic film and processor
- brachytherapy treatment planning software package
- dosimetry check sources
- radiation survey meters