Medical Karadži Health Information Center is honored to partner with one of the best cancer centers in Turkey - the Oncology Center at the American Hospital, part of the Wehby Koch Foundation.
Thanks to our experience, we can quickly arrange an appointment for a primary consultation. Helping you prepare for the mandatory specialist requirements, explaining everything down to the smallest detail so that you don't think about the organisational steps, but are relaxed and prepared.
Our Radiation Oncology Center is the product of a long journey that has led to a collaboration between American Hospital and the MD Anderson Cancer Center at the University of Texas. MD Anderson provides a world-class, multidisciplinary approach to the treatment and care of patients diagnosed with cancer. The guiding principle of our Center is to bring a standard of treatment and care based on the most advanced developments in cancer research, using the most advanced technologies. This approach to treatment and care is what sets MD Anderson Cancer Center apart from others in the world of radiation oncology.
MD Anderson Cancer Treatment Center
MD Anderson currently ranks first among cancer hospitals in the United States, according to a "America's Best Hospitals" survey conducted by U.S. News & World Report, having been in the top two since the survey's inception in 1990. The collaboration of American Hospital and MD Anderson is based on the understanding that the relationship will help bring MD Anderson's standard of cancer care to hospitals around the world.
Radiation therapy at American Hospital - MD Anderson Radiation Treatment Center, which opened its doors to patients on January 28, 2010, is based on the planned, controlled, localized administration of ionized radiation in prescribed doses. The goal of the radiation treatment method is to provide therapy within the radiation threshold. It will counteract and destroy disease cells at the site where the therapy is administered without damaging or reducing the function of healthy tissue. The amount of radiation to be administered is based on the diagnosis, stage, and indication for treatment. It is measured in the range 20-78 Gy (1 Gy = 1 joule of energy absorbed by 1 kg of tissue). As a treatment modality that is used in more than half of the total number of cancer patients, radiation therapy can be:
- "curative" (used for the purpose of effective treatment)
- "adjuvant" (in addition with other methods)
- "palliative" (to relieve pain associated with the disease, bleeding and other symptoms)
- "prophylactic" (preventive)
Radiation therapy at American Hospital - MD Anderson Radiation Treatment Center is led by Ugur Selek, MD, PhD, a tenured associate professor of Radiation Oncology at the MD Anderson Radiation Treatment Center at the University of Texas. Dr. Selek's team of medical radiation physicists, radiation therapy technicians and nurses work with a full range of radiation therapies:
- Comprehensive four-dimensional computed tomographic simulation (4DCT)
- Three-dimensional conformal radiotherapy (3DCRT)
- Intensity Modulated Radiation Therapy (IMRT)
- Image-guided radiotherapy (IGRT)
- Volumetric Modulated Rotational Therapy (VMAT-Smartarc)
- synchronized breathing radiotherapy
- cranial and extracranial radiosurgery
- partial breast radiotherapy
- prostate implants
- three-dimensional conformal brachytherapy
A natural collaboration with MD Anderson Cancer Treatment Center
The successful establishment of the MD Anderson Radiation Oncology Center (MDA-ROC) Program includes standardization of practices in treatment and clinical care. The formulation of the program ensures all clinical approaches, outlining criteria, establishing mechanisms for monitoring outcomes, and establishing follow-up procedures based on measurable benchmarks. This infrastructure seeks to facilitate the design of a "One Practice Model" that provides systematic medical and physical quality control. Standardized treatment ensures that every patient receives the same quality treatment in the Department - MD Anderson Radiation Oncology Center.
The equipment configurations (hardware and software) device data, calibration, and quality control testing of the MDA-ROC exactly match those of the MD Anderson Radiation Oncology Center, and this is supported by continuous communication and data transfer via an Internet connection. The most important part of the cancer treatment program is that it is led by an experienced radiation oncology specialist who is currently a faculty member at MD Anderson who received his training at the main campus in Houston.
The team of medical radiation physicists, radiation therapy technicians and nurses at American Hospital is also clinically trained in Houston. The basis of the "One Practice Model" is a system in which MD Anderson radiation oncology specialists at the main Houston campus present the outlines of their goals and plans to a panel of colleagues to receive recommendations and comments, which are later, upon consensus, accepted and how patients will be treated is determined.
Ensuring that the "One Practice Model" is mirrored in other MD Anderson Radiation Oncology Center programs is achieved through a routine teleconference held weekly or bi-weekly. At this teleconference, radiation oncology specialists who speak the same scientific language come together and make decisions. They are connected via an electronic planning screen where they discuss readings, contours, plans and dose fractionation.
Methods of treatment
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Intensity Modulated Radiation Therapy (IMRT)
Intensity-modulated radiation therapy is designed to control the intensity of the radiation, ensuring that the dose more precisely matches the three-dimensional shape of the radiation to the body. Intensity-modulated radiotherapy divides the radiation beam into thousands of rays that can enter the body from different angles with millimeter precision and concentrate in the cancer area. In this way, the target area can be exposed to higher doses, while radiation to surrounding healthy tissue is minimized.
The high degree of sensitivity of intensity modulated radiotherapy makes it possible to use higher, more effective and safer radiation doses than traditional radiotherapy techniques. The implementation of intensity-modulated radiotherapy requires careful planning to ensure an optimal dose-rate pattern that is appropriate to the indication. From this stage, to the quality control stage also requires a crucial combination of clinical experience, infrastructure and systematization.
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Image-guided radiotherapy (IGRT)
Image-guided radiotherapy allows the use of routine imaging techniques to accurately establish the actual size, localization and coordinates of the tumor. In addition to allowing more accurate targeting of the tumor, the technique provides the advantage of revealing soft tissue images so that differences between the tumor and surrounding tissues can be observed over time.
Today, advanced technological methods, such as intensity modulated radiotherapy and image-guided radiotherapy, use narrower safety margins than traditional radiotherapy. Image-guided radiotherapy allows daily cross-checks of the images with those images on which the original therapy was based. Planar imaging is possible with the kilovoltage and megavoltage images provided by image-guided radiotherapy equipment. Volumetric imaging is achieved using on-site tomographic equipment.
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Four-dimensional computed tomography simulation (4DCT)
The latest development in diagnostic imaging is a four-dimensional radiotherapy (4DCT) method that adds the dimension of time to the image-guided radiotherapy method. Both the chest and abdominal organs move with each breath. Assessing this motion in therapy planning and tracking organ and tumor movements is the basis of four-dimensional CT simulation. Movement during respiration is viewed with a belt system or special camera that uses infrared markers that are placed over a block. When this is combined with a special type of tomography, the breathing cycle is divided into ten distinct phases.
The organ and tumor location is determined at each stage, allowing three-dimensional reconstruction to facilitate planning. Capturing the course of the respiratory cycle, in combination with four-dimensional planning, together offer alternatives:
- or to target the radiation at the moment of inhalation or exhalation
- or irradiation of the integrated tumor volume by tracking the movement of small or slow moving tumors through all phases of the respiratory cycle
In this context, respiratory tracking and four-dimensional planning can be used in almost all daily image-guided radiotherapy procedures.
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Stereotactic radiotherapy
Stereotactic radiotherapy is based on the principle of using groups of X-rays directed at the target from different angles to deliver maximum radiation to the target tumour, during which time irradiation of surrounding normal tissues is minimal. If the treatment is applied in more than one procedure, the method is called stereotactic radiotherapy or stereotactic radiosurgery if applied in a single procedure. In recent years, the application in 2-5 procedures has also started to be called stereotactic radiosurgery. Today, radiosurgery is used safely for various types of tumors in the brain and body.
Equipment for radiotherapy
There are two types of radiotherapy equipment designed to deliver the two fundamentally different types of radiotherapy, namely, external beam radiation therapy (EBRT) and brachytherapy. American Hospital - MD Anderson Radiation Oncology Center's Linear Accelerator and Brachytherapy Sector is equipped with advanced technology that offers:
- three-dimensional conformal radiotherapy (3DCRT)
- intensity modulated radiation therapy (IMRT)
- image-guided radiotherapy (IGRT)
- volumetric modulated rotational radiotherapy (VMAT-Smartarc)
- synchronized breathing radiotherapy
- four-dimensional radiotherapy
- cranial and extracranial radiosurgery
- three-dimensional conformal brachytherapy (3DCBT)
- partial conformal breast radiotherapy
- prostate implants
External irradiation
External irradiation refers to the delivery of radiation from an external source, without touching the patient, from some distance. Non-radiating linear accelerators (LINACs) use high-energy X-rays and electron clusters in the treatment of tumors.
Brachytherapy (internal irradiation)
Brachytherapy consists of placing temporary or permanent radiation sources in or around the target area of the disease. Three-dimensional conformal brachytherapy is administered using CT planning and appropriate applicators.
Centre of Radiation Oncology
Dr. Ugur Selek, Associate Professor of Radiation Oncology
Head of Department
Dr. Ugur Selek graduated from Hacettepe University School of Medicine in 1997. He completed his secondary specialization in radiation oncology in 2001 at Hacettepe University School of Medicine. From 2001 to 2003, Dr. Selleck served as a clinical resident in radiation oncology at the MD Anderson Cancer Center at the University of Texas. In 2003, Dr. Selleck was awarded the "First, Annual MD Anderson Center Radiation Oncology Resident Research Award." Dr. Selleck has concentrated on stereotactic radiation therapy for:
- tumors of the central nervous system
- the genitourinary system
- head, neck and lungs
in his experience as a specialist and later as an associate professor at the Faculty of Radiation Oncology of Hacettepe University. Dr. Selleck has served as a faculty member in the Department of Radiation Oncology at the University of Texas MD Anderson Cancer Center since January 1, 2009. He is currently the head of the MD Anderson Radiation Oncology Center of American Hospital in Istanbul.
Dr. Yasemin Bjolukbasi, Assistant Professor of Radiation Oncology
Dr. Yasemin Bjolukbasi graduated from Egge University Medical School in 1999 and completed her residency in 2004 at the same university. While working as a consultant in the Department of Radiation Oncology of Egge University between 2005 and 2010, she held the position of Deputy Director of the Cancer Control Unit of Egge University between 2007 and 2008. She completed her radiation oncology residency at the University of Texas MD Anderson Cancer Center between 2008 and 2009. She joined our team in 2010 and is currently a faculty member in the Department of Radiation Oncology at the MD Anderson Cancer Center at the University of Texas.
