Report on training
I express my gratitude to Prof. Hideyuki Sakurai for accepting me for three month clinical training in PMRC, University of Tsukuba Hospital. The reason for my visit was to learn “Clinical applications of Proton Therapy in various organ sites”. On first day of my reporting Dr. Sakurai introduced the whole Radiation Oncology department including doctors, residents and physicists. Thanks for offering time in his busy schedule.
Prof. Sakae gave a small tour in department by showing Hitachi Pro-Beat Synchrotron, Giant Gantry and Proton treatment room. I acquired knowledge in uncertainities and respiratory gating in proton therapy from his lectures.
My daily schedule went with early morning case discussions in X-ray and proton conference rooms. I am grateful to Dr. Tony, for translating the cases into English during case discussions. Attending these conferences gave me many valuable academic inputs regarding proton therapy and made me desire to learn more.
I would like to thank Dr. Okumura for making me understand the significance of proton therapy in liver tumors. Thanks to Dr. Mizumoto, Dr. Ohnishi and Dr. Izumi for sharing their knowledge on proton therapy in pediatrics, lung, esophagus and prostate respectively.
Takei Sensei taught us the physics of proton therapy. He had shown us VQA (TPS), selection of beam angles in various organ sites and also energy selection. He practically demonstrated the making of collimators and bolus. He also showed phased plans of para-nasal sinus tumors, base skull tumors, esophagus, liver and pancreas. Thanks for his patience.
Miyamoto Sensei and his team demonstrated how patient is immobilized during CT simulation, usage of bladder scan in pelvic tumors, patient treatment on couch, matching DRR and treatment. The most fascinating is the approach towards pediatric patients. Before start of treatment for children, the team will interact with child and ask about their favourite cartoon character, color immobilization mask with cartoon character over it, the maze and walls of treatment room filled with cartoons, give toys to play and then show the treatment room. By the time radiation treatment starts child becomes acclimatized to the treatment room (thus avoiding anesthesia).
I specially thank to Hiroaki Kumada Sensei for taking us to Boron Neutron Capture Therapy (BNCT) Centre. Also explained how protons are accelerated and made collide with Beryllium target to produce neutrons. Still experiments are going on in animals with good results.
Dr. Murofushi allowed us to see interstitial brachytherapy and explained in detail about the steps and care to be taken while doing the procedure. Dr. Haruko Numajiri shown us hyperthermia and its radio-sensitization with proton therapy. Thanks to Dr. Sekino and Dr. Baba for their support and clearing my doubts.
I also explored Hiroshima, Osaka, Kyoto, Nara, Yokohama, Kanagawa, Tokyo, Nikko and Kusatsu Onsen. Japanese food is awesome and transport is punctual.
Last but not least, thank you so much to International Medical Centre and team, especially Makiko San and Kana San for their continuous support & assistance. They are so helpful since before my arrival and also after & during my stay. To them I convey my utmost respect.
Overall my three months of clinical training is an academic feast along with unforgettable Japanese culture and amazing nature.