THE establishment of a cancer treatment centre with a Linear Accelerator (LINAC) at the Cornwall Regional Hospital in Montego Bay, St James will bring the western Jamaica Type A hospital (CRH) in line with other health-care institutions of its kind, not only in the Caribbean, but in the First World with the care of cancer patients.

Ground was broken for the treatment centre on Friday, November 6, 2015 with construction and commissioning set for early next year.

Manager, radiation therapy services at CRH, Audley Baxter, projects that by year-end, the hospital should be treating some 500-600 cancer patients annually — the majority of them, about 200, being men with prostate cancer, followed closely by women with breast cancer. The remainder will be patients with a range of other cancers.

The speed and accuracy of the machine will enable more people being treated. Also, the LINAC will enhance prognosis, allow for cleaner treatment of patients, and reduce problems such as incontinence and other morbidities associated with pelvic treatments.

CRH has been treating cancer patients using a single cobalt machine since opening its wards and clinics in 1974. It also used a deep therapy and a superficial machine, but they have since been discontinued.

The LINAC comes with electron capability. Instead of treating with pure X-ray, the radiation can be removed and a patient treated with electron.

Of note, by using pure electron, because of its short range penetrability, it goes a far way in treating things like scars and underlying affected nodes.

“The selectivity of electron beam enhances not just a patient’s health but their state of well-being, as its use reduces significantly the likelihood of a recurrent tumour along the scars in the future,” says Baxter.

“An even more important feature of the LINAC is the ability to regulate the delivered dose to selected areas of a tumour volume, based on the radiation intensity need, while reducing the impact on adjacent normal tissues,” he further explained.

The Linear Accelerator to be installed at CRH is tumour-specific.

Baxter explains that: “A tumour grows with irregular edges and different dimensions and this machine is capable of creating 3-D arranged ports that allows for detailed shaping, conforming with specific shapes of tumour volume targeted.”

“When you treat the anterior, the radioactive beam takes a certain shape, also when you treat the laterer it takes a different shape conforming with the tumour, avoiding good tissue being damaged. Consequently, you reduce morbidity by avoiding seminal vesicle and (for men with prostate cancer) likely preserve their sexual potency.”

In cases where radiation is needed, the LINAC allows for treatment with intensity modulated radiation therapy, in that it varies the intensity of radiation by treating the patient in an arc movement that allows for an even spread over the area of treatment, thereby avoiding the risk of over concentration in any one location.

The CRH Cancer Treatment Centre will be one of two established by the Government at a cost of just under US$15 million. Major funding is being provided by the National Health Fund, CHASE Fund, and the Tourism Enhancement Fund, however, the CRH centre had its genesis with a fund-raising drive launched by the Montego Bay Chamber of Commerce and Industry in partnership with the Jamaica Association of Administrative Professionals (JAAP).

The NHF is the implementing agency for establishment of both cancer treatment centres with Chief Executive Officer Everton Anderson also chairing the LINAC Project Steering Committee, co-chaired by the CEO of CHASE Fund, William “Billy” Heaven.

For the centre, CRH will also be getting a CT simulator, a C-arm mobile X-ray unit and a High Dose Radiation machine for brachytherapy, along with treatment planning system and related quality assurance equipment.