Making radiation therapy safer

There was a time, not long ago, when cancer patients in the Cayman Islands had to travel off island to receive necessary radiation treatments.

That ended in March 2023 with the opening of the Gene Thompson Radiotherapy Centre in Camana Bay. Not only did the opening make receiving radiation therapy easier and more convenient, but it also made it safer for those receiving the treatments, says Health City’s Senior Consultant Radiation Oncologist Dr. Vikas Roshan, who heads up the Radiotherapy Centre.

“There is a common perception that radiation therapy is damaging for the body overall,” he says. “The word ‘radiation’ conjures up all sorts of negative imagery, especially related to people dying and causing permanent damage. The truth is those perceptions are no longer reality when it comes to treatment for cancer here.”

Dr. Roshan says that the processes and equipment used at Health City ensure a targeted treatment that is as non-invasive as possible. The first phase involves simulated radiation planning without the patient present. A medical physicist then develops a detailed treatment plan that considers every angle degree. For example, the curve of the radiation beam will be considered to treat a breast cancer case to ensure that the lung is spared.

 “To avoid side effects, we do a lot of work like how to plan the beam angles, where is the entry, where should it exit, and we keep working on the plan continuously, even right up to the moment the treatment starts,” Dr. Roshan says.  

Once the patient comes in, a mould is prepped, which is to be worn to ensure the patient remains perfectly still during treatments. The moulds are similar to beanbags.

The patient will then undergo a computed tomography scan – better known as a CT scan – which is an X-ray imaging procedure.

“We then send all images to the computer and give the relevant commands such as ‘give this much radiation to this area but none to this area,’” Dr. Roshan said.

Following planning, a final CT scan is completed and fused to the earlier scan. When they are accurately matched, then the treatments can begin.

Dr. Roshan explained that treatments are provided Monday to Friday, and Health City can treat between eight and 10 patients, one at a time. On Saturdays, quality assurance checks are done to ensure everything goes smoothly during the following week for patients and there are no breaks in treatments.

Treatments take only between 10 to 15 minutes and patients do not see, smell or feel anything.

Patients are made to feel comfortable throughout their treatments. The spacious treatment room features floral artwork, and patients lie on a “couch” that can be rotated 90 to 180 degrees so that treatment can be targeted correctly.  

There are several cameras set up in the room at different angles and a microphone. A patient has only to raise a hand or call out and the staff will pause the treatment. Often patients listen to their own music while receiving treatment or go to sleep. The room is very quiet during the treatment and the lights are dimmed to ensure maximum comfort.

There are two kinds of radiation machines used at Health City, as well as specialised equipment to target specific issues such as skin cancer or other areas of the body.  

Superficial treatments can also be completed. All skin tumours can be treated with electron therapy.  

“We can treat the tumour without giving any side effects,” says Dr. Roshan. “This is a different thing we are offering.”

Soon, the centre will bring in new equipment to complement the treatments available, Dr. Roshan says.

“A 4D CT scan maps the respiration of the patient so that the radiation can be switched on and off, depending on where the chest wall is,” he said. “This will allow them to see the motion of the tumour inside body. Depending on the motion, then we can target them.”

This article was first published in the April/May 2025 print edition of Camana Bay Times.