Can sleeping inside an igloo-like machine for 30 minutes cure your brain tumour? Now, it can. Delhi’s Indraprastha Apollo Hospital has installed South Asia’s first ZAP-X machine that can precisely deliver radiation to kill brain tumours. It is non-invasive, pain-free and does not require a hospital admission unlike a traditional surgery. Costing the same as surgery, a single session will be enough in most cases. How does it work? The machine delivers high-intensity, focussed radiation to just the brain tumour with less than a millimetre precision, leaving the surrounding tissue undamaged. This kills the tumour, which later dissolves naturally. Dr John Adler, creator of the machine and CEO of Zap Surgical, said, “Radiosurgery is the most common procedure that neurosurgeons do in the US but globally less than one in 10 patients gets access. There is a huge gap. This machine was designed keeping in mind the rest of the world. Nearly a million people can benefit from this therapy in India.” What are the machine’s benefits over traditional surgery? Not only does it remove the need to get admitted to a hospital or go under anaesthesia, it improves patient outcomes because no post-surgery recovery is needed. The out-patient treatment is just done in a single session of 30 minutes to a maximum of one hour 30 minutes. According to doctors, multiple sessions are planned only when the tumour is too big or close to important structures in the brain. The precise, non-invasive nature of the technique means that the therapy can preserve all critical structures in the brain, including the brain stem, eyes, optic nerves and parts that control bodily functions. Who is it meant for? The treatment is not meant for every kind of tumour - huge tumours or those that have metastasised are unlikely to be operated with the new machine. The treatment is meant for those with a well-defined tumour of less than 3X3X3 cm - the therapy for bigger tumours is only restricted by the radiation doses that can be offered without poisoning. It will be better than a surgery for patients who have been diagnosed with a tumour deep in the brain, close to important structures, or incidentally (small tumours detected during scans for other issues). Not only does the machine treat tumours, it can also treat deep lesions in the brain or arteriovenous malformation (abnormal connections between oxygenated blood carrying arteries and deoxygenated blood carrying veins in the brain or the spine). How much will it cost? Doctors from the hospital said that the cost for treatment on Zap-X will be equivalent to traditional surgery, with the added benefit of no post-operative costs. Outside India, the cost is about $4000. How does it differ from radiotherapy used in cancers or other radiosurgery techniques? Radiotherapy harnesses the power of radiation to treat cancers but it is more diffused and is helpful in scenarios where a tumour has metastasised. As Dr Adler said, “Radiotherapy is like the sunlight, the impact is low and the exposure time is high. Radiosurgery - and technologies like Zap-X - are akin to using a magnifying glass to concentrate the radiation to a particular point. The intensity is very different,” he said. Other radiotherapy techniques such as cyberknife and gammaknife also use the same principle, he explained, but they are not primed for the treatment of the brain alone. The other benefit of the therapy is that it does not require a radioactive source to be housed in a separate concrete building to contain the radiation. In fact, one person can be with the patient at the time of the treatment on Zap-X.
