Comprehensive Guide to Radiation Therapy in India

The radiation therapy cost in India starts from USD 3500 to USD 8000 depending on the type of radiation technique utilized and the stage of cancer. It has a success rate of is 90-80% in the first and second stages of cancer. It takes about a few weeks to 2 months to recover from the side effects of radiation therapy.

Radiation therapy or radiotherapy is a common treatment for cancer. In this, high-powered X-ray beams are used to destroy cancer cells. It can be used separately or in conjugation with chemotherapy or surgery.

Cost of Radiation Therapy in India

What is Radiation Therapy?

Radiation therapy is also called radiotherapy, X-ray therapy, and irradiation. The cells in the body develop and grow normally, however, cancer cells mutate, divide, and grow faster than normal cells. Radiation works by making tiny breaks in the DNA inside the cancer cells. The cell’s mechanism is disturbed and it cannot grow and divide further, and die. Normal cells can be damaged in this process but recover afterward and resume their mechanism. The radioactive substances can be given by mouth or veins. The substances travel in the entire body and collect in the tumor area.

There are a few types of radiation therapy internal radiation therapy, external beam radiation therapy, image-guided radiation therapy (IGRT), intensity-modulated radiation therapy (IMRT), proton therapy, volumetric modulated arc therapy (VMAT), 2D conventional technique (2D CT), gamma knife, etc.

Types of Radiation Therapy and Their Cost 

1. External Beam Radiation Therapy: It is the major kind of radiation therapy done for cancer treatment. In this, high-energy particles or rays are aimed at the tumor through a machine placed outside the body. The beams are given from outside the body which affects the cancer region but may affect some healthy tissues as well. It is most commonly done as an outpatient treatment. It is generally given 5 days a week but some patients may get it twice a week for several weeks. It costs USD 680-28,819.

• 3D Conformal Radiation Therapy (3D-CRT): It delivers the beams from various directions based on the size and shape of the tumor. This is done to reduce the damage caused by radiation to the normal surrounding tissues and destroy the cancer cells effectively.
• Intensity Modulated Radiation Therapy (IMRT): It is similar to 3D-CRT, but the strength (intensity) of the beam varies in specific regions. This helps in lessening the damage caused to the nearby cells and tissues. It costs USD 2,173-7,000.
• Helical Tomography: It is a kind of IMRT that delivers in a specific way. In this, the radiation is delivered through small beams from various angles of the body. This is done to make the radiation more cancer-area specific.
• Stereotactic Radiosurgery (SRS): In this, large doses of radiation are given to a small tumor region, generally in one session. It is used for brain or other tumors. After determining the precise location of the tumor in the brain, radiation beams are aimed at the region from various angles to cause prevent surrounding tissue damage. There is no cutting involved and hence, it is not called surgery. When this kind of treatment is done for other organs like the liver, spine, prostate, lung, and others, this is called Stereotactic Body Radiation Therapy (SBRT).
• Gamma Knife: In this, approximately 200 small radiation beams in a single time that creating a very large dose. It is generally a single session. It is not a surgical procedure. It costs USD 6,400-7,000.
• Image Guided Radiation Therapy (IGRT): Scans like MRI or CT are done prior to every treatment session. The tumor may move and not be in the same place as before like in the previous treatment. By using IGRT, the doctor can change the position of the patient or the aim of the beam wherever it is needed to make sure that the beam is focused on the cancer region effectively, and there is very little damage to nearby healthy tissues. It costs USD 5,000-7,000.
• MRI-Guided Radiation Therapy: It is also called MRI-guided adaptive radiation therapy, and combines a few features of SBRT, IGRT, and IMRT. The machine is called MRI-linac, in which a linear accelerator and an MRI scanner are combined. In this, MRI can be done before the treatment is given or while the treatment is in progress. If activities of the body like digestion or breathing move the tumor out of its original place, the radiation stops until it is directly in the path of the beam. This prevents healthy tissue damage.
• Intraoperative Radiation Therapy (IORT): This kind of external radiation is directly given to the tumor area or areas during the surgical procedure. It may be used in cases of high risk of recurrence or when surgery is not able to extract. A large amount of rad
• Proton beam radiation therapy: The beams consist of protons and not x-rays on the tumors. Protons only travel to a distance, unlike the photons that go through the body to expose the tissues to the beam both after and before they hit the tumor area. The tissue surrounding the before and after the tumor is exposed to very little radiation. It costs USD 14,490-28,819.

2. Internal Radiation Therapy: It is also called brachytherapy. An implant that is radioactive is put inside the body or near the tumor-affected area. The implant placement is a painless procedure. In this, a higher dose of radiation is administered in the smaller region. There are a variety of implants like wires, ribbons, pellets, capsules, tubes, seeds, or tubes that can be used. This is done to reduce the damage caused by radiation to normal cells. It costs USD 897-7,481.

• High-dose-rate brachytherapy (HDR): In this, a patient is put under a powerful radiation source for several minutes at a time. The radiation source is removed after ten to twenty minutes. It may be repeated twice a day over a period of a few days, or once a day over a period of a few weeks. The radioactive substance is not in the body anymore. The applicator may be left in its place or maybe put before every treatment.
• Low-dose-rate brachytherapy (LDR): In this, the implant emanates lower doses of radiation over a longer period of time. The implant may be left in place for a day to a few days and then removed. Some smaller-sized implants like pellets or seeds are left in their place and may never be removed. Patients may have to stay in the hospital for some time as their body gives off radiation for a few days.

NOTE: External beam radiation is given to kill cancer cells in a larger area in the tumor region, while internal radiation therapy delivers a boost or a higher dosage of radiation to destroy the major mass of tumor cells.

Success Rate of Radiation Therapy in India

It has a success rate of 90-80% in the first and second stages of cancer. It takes about a few weeks to 2 months to recover from the side effects of radiation therapy. It can be given before or after the surgery depending upon the requirement. Sometimes surgery cannot be performed in advanced stages or the tumor may be located in such a location that it is impossible to reach through surgery, here radiation can prove to be useful. At advanced stages, radiation therapy can shrink the tumors and relieve the symptoms.

• The extent of cancer: Cost depends on the stage of cancer. If it has spread to other organs, then the dosage required will be higher, and hence, the cost of treatment increases.
• Treatment method: The cost of EBRT varies from internal radiation therapy. In EBRT, X-rays are used while internal radiation therapy is a more sensitive procedure that involves implant placement. Also, the kind of EBRT used affects the cost.
• Anesthesia charger: If anesthesia is used in the procedure, then the cost may be higher. Also, radiation procedures involving anesthesia are costlier in hospitals than in a doctor’s office.
• Secondary procedures: Cancer treatment may require some additional secondary treatments for any other related conditions. The cost may be affected by this.
• The number of sessions: Generally, advanced-stage cancer patients need multiple radiation sessions. This is required because all of the cancer cells cannot be destroyed in one session, and also, when the patient cannot bear higher doses of radiation.
• Required dosage: Higher doses of radiation cost more than lower doses.
• Type of hospital: The cost of radiation therapy is less in government hospitals than in private hospitals.
• Duration of hospital days: Sometimes radiotherapy may be accompanied by chemotherapy or a secondary procedure, then an overnight stay in the hospital is required. This impacts the radiation cost directly.

How is Radiation Therapy performed?

>>Before

For internal radiation therapy, one may require imaging tests and a physical exam. For external radiation therapy (EBRT), it requires a planning procedure called a simulation (for customizing one’s treatment).

Simulation involves:

• One is positioned on the table exactly as one will be in position during the treatment sessions. In this, a mask or mold may be used to hold one’s body in place. It is made sure that the body is in the correct position, and then the patient receives small permanent or temporary dots or markings indicating where the radiation should be given.
• A CT scan or an MRI scan is done to know the exact location of the tumor. This helps in customizing X-rays for targeting the tumor.

>>During

• Internal radiation therapy generally takes place in a specially built room or hospital for outpatient treatment. The radiation implant may be inserted using a flexible tube known as a catheter. This procedure requires anesthesia. The radioactive fluid is delivered through an IV.
• In EBRT, the patient is positioned during a simulation. The machine is moved around the patient but never touches them. The operator is in a separate room and communication between the patient and them takes place through an intercom. The appropriate doses are delivered to the tumor.

>>After

• In internal radiation therapy, one can go home on the same day after a short recovery time. Sometimes, a patient needs to stay in the hospital as they still emit little amounts of radiation from their bodies. After IV radiation, small amounts of radiation may be secreted through sweat, blood, and urine. Others are at risk of exposure.
• In EBRT, the patient can go home and carry out their regular activities. There is never a risk of radiation exposure to others.

Top Hospitals For Availing Radiation Therapy in India

>>Sarvodaya Hospital and Research Centre, Faridabad

Sarvodaya Hospital and Research Centre have been accredited with NABL and NABH credentials. It has a 500-bed capacity and 65 ICU beds. Special oncology centers for all kinds of cancer have been a recent addition. It has technologies like 500 MA X-Ray, 128 Slice CT scans, Mammography facilities, 1.5 Tesla MRI, Cancer Centres, etc.

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>>Apollo Spectra Hospitals, Delhi

Apollo Spectra Hospitals has been accredited with JCI. It has a 50-plus bed capacity across different locations in Delhi. It provides services like health checkups, radiology, consultation, rehabilitation, and physiotherapy. It has a world-class infrastructure and 5 modular operation theaters.

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>>Yashoda Hospital, Hyderabad

Yashoda Hospital has been accredited with NABL and FICCI credentials. It has 1710 bed capacity across 3 of its own hospitals and 3 cancer institutes. It houses high-tech labs and modular operation theaters, Digital X-Rays, Ultrasonography, CT 64 Slices MRI, etc.

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>>Max Super Speciality Hospital, Vaishali

Max Super Speciality Hospital has been accredited with NABH and NABL credentials. It has a 370-plus capacity and 15-plus specialties. 14 high-end modular operation theatres, 3D (4D) imaging, 3.0 Tesla digital boundaries MRI, Da Vinci Xi Robotic System, etc.

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>>Apollo Hospitals Bannerghatta, Bangalore

Apollo Hospital has been accredited with NABH and JCI credentials. It has a 250-bed capacity. It also houses The Minimal Access Surgery Centre (MASC) center of excellence. It has technologies like 120-slice CT angiogram, 3 Tesla MRI, Digital Fluoroscopy, 4-D Ultrasound for 4-dimensional sonography, Gamma Camera, etc.

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References

• https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation/basics.html
• https://www.pancreaticcancer.org.uk/information/treatments-for-pancreatic-cancer/radiotherapy-for-pancreatic-cancer/what-are-the-advantages-and-disadvantages-of-radiotherapy/