Five years of innovation and breakthroughs: UMIT Private Oncological Center's achievements in cancer treatment

Five years of innovation and breakthroughs: UMIT Private Oncological Center's achievements in cancer treatment

·       ACHIEVEMENTS, PROGRESS AND HOPE

·       TOTAL BODY IRRADIATION: MAXIMIZING CHANCES

·       OPPORTUNITIES THAT EXCEED EXPECTATIONS

·       JCI ACCREDITATION: QUALITY WITHOUT COMPROMISE

·       MIM: MOVING TO ADVANCED TOOLS

·       ESTRO: EXPERT RECOGNITION

·       REACHING A NEW LEVEL

·       STEPS FORWARD: MEETING CHALLENGES

Five years ago, the UMIT International Oncological Center of Tomotherapy opened its doors to patients for the first time, offering an innovative method of radiation therapy for cancer – tomotherapy.

Tomotherapy today is a real chance for cancer patients to receive less painful and more effective treatment. Access to the most modern cancer treatment method plays a crucial role in the fight against this serious disease.

Tomotherapy is a high-tech radiation therapy that provides accurate and individually customized radiation dose delivery to the tumor. This is especially important for patients, as each case of cancer is unique, and treatment should be as individualized as possible.

To date, UMIT Tomotherapy Oncological Center is one of the leading centers for effective cancer treatment in Kazakhstan, which has clear prospects for entering the foreign market. International accreditation and top-level specialists confirm the capabilities of the oncological center.

We talked with Yerzhan Mukataevich Shayakhmetov, the chief physician of the UMIT oncological center, about the work the Center's team has done and what it has achieved over the past five years.

ACHIEVEMENTS, PROGRESS AND HOPE

- Yerzhan Mukataevich, UMIT Oncological Center has been treating cancer with tomotherapy for 5 years now. What successes have been achieved over the years?

- On January 1, 2019, our Center began accepting the first patients. And since then, we have achieved significant results, positive growth dynamics not only in the number of treated patients, but also in the development of the Center itself.

During these 5 years, the UMIT Oncological Center of Tomotherapy:

·       was the first in Kazakhstan and Central Asia to successfully implement an innovative method of radiation therapy – tomotherapy.

·       passed the national accreditation of medical institutions of the Republic of Kazakhstan with the result "the highest category".

·       in 2021, received an accreditation certificate from Joint Commission International (JCI), one of the world's leading standardization systems in the field of safety and quality in healthcare.

·       became a member of the European Society for Radiotherapy and Oncology (ESTRO), a scientific organization that promotes the development of radiation oncology in all its aspects. In May 2023, the Center participated in the ESTRO23 Congress in Vienna, Austria.

·       introduced advanced artificial intelligence technologies into the workflow – MIM software for working with medical images.

·       created its own scientific department to summarize the results obtained over five years and to further develop and support scientific research.

·       as part of the state order, accepted 1,700 people for tomotherapy treatment.

Our Center is the only oncological center in Kazakhstan that:

·       for the first time, introduced and conducts on a regular basis a unique procedure of Total Body Irradiation (TBI), or total bone marrow irradiation in children with leukemia;

·       together with the National Scientific Medical Center (NSMC), performs simultaneous operations – one-time surgical treatment of two or more pathological conditions that do not have a single etiology (oncology + cardiac surgery, oncology + gynecology, oncology + abdominal surgery);

·       conducts radiation therapy of the main cancerous tumor and distant metastases in a single plan;

·       conducts radiation therapy for cancer patients with implanted artificial pacemakers (cardiostimulants, defibrillators);

·       along with other oncological medical institutions (Kazakh Research Institute of Oncology and Radiology), actively develops pediatric radiation therapy: craniospinal irradiation, total lung irradiation, brain irradiation with preservation of the hippocampus, radiation therapy under sedation.

We plan to enter the world stage and actively develop medical tourism, which is why our Сenter:

·       purposefully develops its own program "100 steps for the development of medical tourism" to attract foreign cancer patients for tomotherapy;

·       participated in international exhibitions in the field of healthcare in Azerbaijan, Uzbekistan, Tajikistan, and Kyrgyzstan. Actively cooperates with the Medical Tourism Association under the Akimat of Astana city;

·       represented the stand at the 28th Kazakhstan International Healthcare Exhibition - KIHE 2023, the largest in Central Asia.

In addition, on June 22, 2023, we, as part of a delegation with the National Scientific Medical Center and the Almaty Multidisciplinary Clinical Hospital, attended the Belt and Road conference organized by the Chinese Anti-Cancer Association at Xinjiang Medical University. This meeting laid a good foundation for comprehensive cooperation in the field of advanced cancer technologies with the participating countries of the Belt and Road project.

Also, for an integrated approach in the treatment of oncology, our Center:

·       in addition to radiation therapy – tomotherapy, has an outpatient chemotherapy room;

·       in partnership with the NSMC, carries out all types of surgical oncology;

·       has established an oncomammology center, and performs digital mammography with tomosynthesis;

·       has an endoscopy department (colonoscopy, video gastroscopy, bronchoscopy);

·       performs procedures in the laser surgery room using Asclepion MCL-31 erbium laser (Germany);

·       provides professional psychological assistance for cancer patients;

·       supports the work of an educational project to inform about all issues of oncology.

TOTAL BODY IRRADIATION: MAXIMIZING CHANCES

- Total Body Irradiation procedure (TBI) in a child, what is the significance of this event for young patients in our country?

- Our UMIT Tomotherapy Center introduced total bone marrow irradiation in children with chronic leukemia in November 2022. Conditioning radiation is performed before bone marrow transplantation, in partnership with the National Research Center of Mother and Child Health. The TBI procedure is considered a serious achievement, since not every oncological center, not only in the CIS, but also in the world, can implement this method.

If previously children with leukemia went abroad for bone marrow transplantation, now they can receive this help here in Kazakhstan. Before a bone marrow transplant, a child must undergo irradiation of bone structures, bone marrow of the whole body, and completely destroy all cellular elements so that oncogematologists can then perform a bone marrow transplant. As a result of using this technique, the survival rate of donor bone marrow is 80%.

This is a significant event not only for our oncological center, but also for the entire healthcare system of the Republic of Kazakhstan. We conducted the first master class together with invited specialists from the Federal State Budgetary Institution "Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology". And after that, our team has already performed five total body irradiation procedures. Two more children are currently preparing for the procedure.

OPPORTUNITIES THAT EXCEED EXPECTATIONS

- Yerzhan Mukataevich, what other unique procedures are carried out at the UMIT Tomotherapy Center?

- We carry out irradiation of almost all forms and nosologies (types of cancer) in oncology. We are the only ones in Kazakhstan who carry out radiation treatment for prostate cancer with metastases in skeletal bones: ribs, vertebrae, pelvic bones – in a single plan, that is, simultaneously the main tumor and metastases. The doctors keep in touch with all the patients who have undergone radiation therapy at our Center, and we see the results: they are socially adapted, living with preserved organ functions.

No one but us provides radiation therapy to cancer patients with severe cardiovascular pathology. Such patients are mostly elderly, many have implanted artificial pacemakers, cardiostimulants and cardiodefibrillators. And if, for example, such patients have esophageal cancer, then radiation therapy cannot be performed on other traditional linear accelerators. We can perform radiation therapy for esophageal cancer with the protection of these implanted cardiac devices.

Our team of medical physicists has achieved a reduction in the dose received by pacemakers to 0.1 – 0.3 gy for the entire period of treatment, despite the fact that by world standards the total dose can reach 0.5 gy. No oncological center in Kazakhstan, except ours, currently undertakes the treatment of such cancer patients with implanted pacemakers, since in general the presence of cardiac devices is a contraindication to radiation therapy. We take such patients for treatment at any age – the oldest patient was 91 years old.

JCI ACCREDITATION: QUALITY WITHOUT COMPROMISE

- UMIT Tomotherapy Center is the only private medical center in Kazakhstan with international JCI accreditation. Why is this important and what is the benefit for patients? How are you preparing for re-accreditation?

- We were accredited by Joint Commission International in 2021. JCI accreditation confirms the compliance of our Center with international standards of treatment, including the building itself, equipment, and all treatment rooms, all of which should ensure patient safety. Such accreditation gives us the opportunity to develop medical tourism, arouses the trust of patients, as the Center works according to international standards in the treatment of oncological diseases, including radiation therapy, chemotherapy, specialist consultations, etc.

JCI is a kind of charter about how things should be. For example, let's take a parameter such as "client path". It should be as short as possible so that the client can easily find us. To do this, we maintain an active presence on social networks, on YouTube, on television, and in search engines. Our website is available in 4 languages: Kazakh, Russian, English and Chinese.

To date, only 1034 clinics worldwide have received such JCI accreditation. We can say that we are working on the country's image: there is a clinic in Kazakhstan that operates according to international standards. It is also important that the direction of medical tourism includes not only treatment, but also familiarization programs with historical sights of Kazakhstan.  

JCI accreditation is issued for 3 years. Next year we will confirm the accreditation. Although we comply with all JCI requirements by the entire team, from the sanitary service, call center, registry and to the medical staff, but the requirements are increasing every year. They constantly send us changes to the conditions, and we immediately implement them into work.

MIM: MOVING TO ADVANCED TOOLS

- Your Center implements MIM software and artificial intelligence technologies. What is this software and what role does it play?

- Before the introduction of the MIM software, the treatment planning process lasted 4-5 days, after the introduction it was reduced to 1 day. Then we upgraded it and reduced the treatment planning time to 1-2 hours.

What does it look like in practice? The patient sends information about his/her illness to our e-mail. Our doctors, as part of a multidisciplinary group, review each case and invite the patient to the Center for treatment. The patient undergoes an initial consultation with specialists and goes for a CT simulation, which produces a series of images of the tumor formation. Based on the images obtained, the MIM system outlines all organs in need of protection. If earlier this work was done by oncologists-radiologists using special programs on computers, now MIM itself does this work in literally 5-10 minutes. The radiologist only outlines the tumor itself – the area that needs to be irradiated. Then physicists start calculating the dose according to international treatment protocols.

After that, a "radiation map" is compiled, which is checked on a phantom - a special device that simulates the patient's body. The phantom is irradiated on a tomotherapy machine to provide radiologists with data. All this happens without human intervention, that is, human errors are minimized at all stages. The plan is drawn up correctly, the doses are selected correctly, critical areas are protected - and only then the patient can be taken for treatment.

This approach provided a sharp reduction in post-radiation complications in the form of esophagitis, gastritis, cystitis, dermatitis, etc.

The MIM program has a cloud database, each of our new cases is also uploaded to this database, and with each new case, MIM automatically learns from our experience and the experience of other clinics.

ESTRO: EXPERT RECOGNITION

- Specialists of the UMIT Tomotherapy Center took part in the international congress ESTRO 2023. Could you tell us, what kind of congress is this and what is its significance?

- ESTRO is the European Society for Radiotherapy and Oncology, which annually holds international conferences, bringing together specialists from all over the world. Scientific seminars, master classes, personal communication between doctors – all this greatly enriches specialists. For example, the head of the Medical Physics Department, Tanjas Shayakhmetov, talked with the inventor of the tomotherapy device, Dr. Thomas Rockwell Mackie.

Participation in such conferences gives us confidence that our Center is developing in the right direction. We work according to international protocols, which are updated weekly. I can say that we are not lagging behind world practice, and on some issues, we even anticipate changes, which confirms the level of work of our team.

The staff of the UMIT Center – radiation oncologists, medical physicists are ESTRO members.

REACHING A NEW LEVEL

- Yerzhan Mukataevich, who else does the UMIT Center cooperate with?

- We had a trip to Kyrgyzstan, Uzbekistan and Tajikistan, where we presented our medicine together with the NSMC. The best clinics in Kazakhstan took part in these trips and demonstrated their achievements. I have made presentations on these trips.

We have also started cooperation with the Medical Tourism Association of the Republic of Kazakhstan under the Akimat of Astana city. We are members of the Association and jointly attend international exhibitions by invitation.

We went to the exhibition in Baku, the capital of Azerbaijan, where we presented our own stand.

- As a result of your work, citizens of Kazakhstan have the opportunity to receive the most modern cancer treatment according to international standards, without traveling to foreign countries for this purpose.

- Not all of our citizens have the opportunity to travel abroad for cancer treatment. And even those who travel, for example, to popular clinics in Turkey or South Korea, can now hear from them the question: why did you come? You have an UMIT oncological center in Kazakhstan, where radiation therapy and chemotherapy are carried out at the highest international level.

Our Center is in partnership with all oncological dispensaries in Kazakhstan. Many difficult cases, such as tumors of the medulla oblongata, which are very difficult to irradiate, are immediately sent to us. For 5 years, almost all oncologists in Kazakhstan have learned about us and, if necessary, send their patients for treatment to us, to the UMIT tomotherapy center. This is a great progress of our small private oncological center.

- From what other countries do people come to you for cancer treatment? Where do patients most often learn about the capabilities of the UMIT oncological center?

- We try to be present in all communication channels – social networks, YouTube, television, news sites from different countries with press releases in the languages of these countries.

We have developed the program "100 steps for the development of medical tourism" in our medical center, where we have identified all the stages step by step.

Unfortunately, there are still barriers in this direction. For example, the law on medical tourism has not been adopted at the state level and, accordingly, taxation issues have not been regulated. As a medical center that accepts foreign currency payments from foreign tourists, we are subject to taxation.

During the pre-crisis period, medical tourists from America, France, and neighboring countries came to us. China is also interested in tomotherapy services at our Center. Requests are received from Russia, CIS countries, Eastern Europe, and Central Asia. We consider each case, hold correspondence, and invite patients for treatment. Compared to last year, the increase in requests amounted to 200%.

STEPS FORWARD: MEETING CHALLENGES

- Yerzhan Mukataevich, could you tell us about the plans for the development of the UMIT oncological center in the next few years.

- We define our field as early diagnosis of cancer, therefore, in addition to the department of tomotherapy, we have opened an oncomammology center, an endoscopic department. We have everything we need for an early diagnosis of cancer.

The unique trade product that we offer to the international community is tomotherapy.

Since radiation therapy is usually combined with chemotherapy, we have opened an outpatient chemotherapy room. Surgical treatment of oncology is carried out within the framework of cooperation in the NSMC. Therefore, we provide radiation therapy and chemotherapy to a cancer patient who has come to us for treatment, and, if necessary, we carry out surgical interventions within the framework of oncological surgery – this includes neurosurgery, gastrointestinal surgery, oncogynecology, oncourology.

We undertake the treatment of cancer patients with concomitant cardiovascular pathology and in need of coronary artery bypass grafting. First, cardiac surgeons perform an intervention, and as soon as they finish, oncosurgeons step in and operate on the tumor simultaneously, under the same anesthesia. Similarly, patients with concomitant diseases of other systems are operated on, that is, two serious pathologies are treated under the same anesthesia. Such types of interventions are not performed in any clinic in Kazakhstan.

In the near future, we plan to upgrade one of the tomotherapy devices, which will significantly reduce the treatment time. When we first started, the preparation and treatment of one patient lasted up to 50 minutes. But gradually, with the accumulation of experience, the time was shortened, and now we have reached 20 minutes. After the upgrade, we hope to reduce the time to 10-15 minutes. Of course, with the preservation of the quality of treatment, in compliance with all safety standards and all international treatment protocols. By reducing the preparation and treatment time, we will be able to receive many more patients who need tomotherapy.

We also plan to launch a total body irradiation procedure for adult patients, which requires increasing the aperture of computed tomography from 70 cm to 90 cm.

After the upgrade, we will have a synchronization function with breathing. Tumors of mobile organs, such as lungs, liver, are very difficult to irradiate without such synchronization. The upgrade will allow radiation therapy to be performed more accurately.

Also, one of the priorities is the further development of medical tourism. We have passed the preparatory period, and now we will actively develop in the global market.

In addition, it's time to create a research department and summarize our experience in cancer treatment.

Our mission is this: cancer is not a sentence. We have organized psychological support for cancer patients and are conducting educational work among patients to convey the main idea: cancer is easier to treat in the early stages.

I am very proud of our team. Our team is close-knit, friendly, always supporting each other, always striving for new knowledge. I sincerely believe that our center will become known all over the world as one of the leading scientific medical centers for cancer treatment.

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You can make an appointment at the UMIT International Oncological Center of Tomotherapy by phone:

+7 (7172) 95-44-84

+7 (702) 201-94-44

+7 (777) 201-44-44

Address: UMIT International Oncological Center of Tomotherapy, 42/1 Abylai Khan ave., Astana.

For citizens of the Republic of Kazakhstan, tomotherapy is available by quota, according to the system of Statutory Free Medical Assistance. For foreign patients, tomotherapy treatment will be paid.