European Multidisciplinary Cancer Congress (EMCC) 2011, 23-27 September, Stockholm

Advancements in radiation oncology and medical physics

Dr Nuria Jornet – Hospital de la Santa Creu i Sant Pau, Barcelona, Spain


Dr Jornet, Nouria, tell us about your work as a radiation oncologist.

In fact I am a medical physicist so I am working mainly in radiation oncology but I belong to a medical physics department which covers the three areas – nuclear medicine, radio diagnostics and radiation oncology and I am working in Barcelona at Sant Pau hospital.

And you are hosting the ESTRO meeting next year, by the way.

I am hosting, yes. I am very involved in ESTRO also; I am involved in the meeting but also I am a member of the education and training committee and the physics committee in ESTRO.

So what are the big issues in medical physics?

In general? The big issue mainly nowadays is to implement all the new technology that is coming up into the market which is huge, there are big advances each year. You have to evaluate them before buying them to see that they are cost effective; if you buy them then you have to implement them in the clinic in a safe way so it means quite a lot of pressures that have to be made and you have to train all the people, radiation oncologists and technologists, how to use this new technology.

And what kind of technologies are there, give me an example? I’m just a medical oncologist, I don’t understand.

Well we can make the difference between delivery, how we deliver radiation to treat patients, so we have new types of linear accelerators. You know that if you go to the technical exhibition in ESSO 31 you will see a huge number of new treatment units, new treatment techniques coming into the market to tell something. I don’t want to talk about one brand in particular but you are doing a lot of arc therapy now; that is coming more and more into the market. Also robotic arms to treat patients and also then you have all the protons and hadron therapy that is growing in Europe.

But that’s expensive and very specialised and very small centre. Do you have a centre in Barcelona?

Yes, in Spain the centres are very small, it’s not like in North Europe when you have one centre with twelve treatment units. In Spain we have more small centres, around three or four treatment units each so it’s quite different. We don’t have protons and I don’t think we will have protons for the future due to the economic crisis.

It looks as if it’s a little bit further away now. So delivery is a big issue, what else for medical physics?

Delivery one and the other one is imaging. So imaging now is becoming more and more important because we control treatment delivery with imaging and then we need imaging to make contouring of the tumours and to follow what is happening with radiation therapy. This is coming more and more into radiation oncology departments, the equipment itself and also the images, how we work with those images. So all the quality control of these images, to improve image quality, to reduce dose to the patient, because obviously if we control the patient each day with a CT scan, it means that we are increasing the dose to this patient. So we have to know which is this dose and how we can reduce it without losing image quality.

But you don’t just use CT, you use PET and MR as well.

Yes, and ultrasound also.

And ultrasound, really?

Yes, that was only for an example because the problem with CT is the dose, obviously if you use MRI you get right off this dose. But it’s difficult to get in-room MRI to control patients, that’s expensive, this is under research nowadays.

Thank you very much indeed, it’s really interesting and we’ll see you in Barcelona.

OK, looking forward to it. Thank you.