Treatment options
Surgery
Surgery is often the first stage of cancer treatment and in the
case of breast cancer can take the form of a simple lump removal
(lumpectomy) to the more complex breast mastectomy with
reconstruction.

The Bupa Cromwell Cancer Centre has a team of Oncological surgeons
who work closely with the Medical and
Clinical Oncologists most of whom come from the leading NHS
teaching hospitals in London.
Following surgery, patients are cared for by specialist nursing
staff and referred to the Specialist Clinical Support Services
available at the Bupa Cromwell as appropriate. For example breast
cancer patients may be referred to the Breast Care Nurse who can offer prosthesis
fitting as well as support and management of Lymphoedema.
Radiation therapy
The three radiation therapies regularly
performed at the Bupa Cromwell Cancer Centre are:
Brachytherapy
Brachytherapy (also known as Permanent Seed Implant Therapy) is
widely established in the USA and Europe as one of the preferred
treatments for early prostate cancer.

Brachytherapy involves the use of state-of–the art computer
planning software to implant radioactive seeds into the prostate.
Anywhere from 50-110 seeds containing iodine are inserted through
needles directly into the prostate through the perineum – the skin
between the scrotum and the rectum.(see illustration)
Until recently, Brachytherapy has been carried out as a two
stage process, whereby the planning stage is carried out a few
weeks before the implant of the seeds. However, recent advances
have enabled the Hospital to introduce a one stage procedure where
both stages are combined to minimise patient
inconvenience.
Once the seeds are in position, they produce a uniform ‘sphere’
that treats the prostate cancer. After several months the seeds
become inert and leave the titanium shell, which will not cause any
problems or be felt by the patient.
Advantages of Brachytherapy:
- Simple, short procedure
- More convenient than the traditional two stage approach
- Rapid return to normal life
- Allows high doses of radiation to the prostate whilst
minimising the risk of damage to the bladder and bowel
- To date, clinical evidence suggests it is as effective in the
long term as other treatment options
- Impotence is much less likely than with other treatment
options.
You can download a brochure on Prostate
Brachytherapy (PDF) at Bupa Cromwell Hospital, or
download the Brachytherapy
Patients Guide (PDF).
More information on Prostate Brachytherapy is available from:
www.cancerresearchuk.org.
Gamma Knife
surgery
Gamma Knife Surgery is regarded as the most effective treatment
for single and multiple brain metastases, which can occur as
‘secondaries’ in patients with melanomas, breast and lung cancers.
Despite the use of the term "knife", the treatment is actually
non-invasive.

The Gamma Knife projects up to 192 radiation beams onto a very
small volume with great precision, allowing tumours in deep
sensitive areas of the brain to be treated with minimal risk of
complications and damage to healthy tissue. The Gamma Knife is also
effective for the treatment of many other types of malignant and
non-malignant brain tumours. Only one treatment is required and
unlike conventional brain surgery, patients can usually expect to
resume their normal activities the following day.
Download the Gamma
Knife brochure (PDF).
Gamma Knife surgery - a patient's guide
A 12 page patient guide has been designed to explain in detail
the treatment process you will experience whilst undergoing Gamma
Knife Radiosurgery at Bupa Cromwell Hospital. Download the
Gamma
Knife Surgery patient's guide (PDF).
Visit the Cromwell Gamma Knife Centre
website.
TomoTherapy
TomoTherapy is the most advanced, integrated
cancer treatment system available.
The TomoTherapy Hi·Art System® is a new,
revolutionary way to treat cancer with radiation. Using this system
the physician can check the location of a patient's tumour before
each treatment, then deliver painless and precise radiation therapy
based on a carefully customised plan. The TomoTherapy Hi·Art System
delivers a very sophisticated form of intensity-modulated
radiotherapy (IMRT).

TomoTherapy literally means ‘slice therapy’ and gets its name
from tomography, or cross-sectional imaging. The equipment used for
TomoTherapy looks much like a computed tomography (CT) system: the
patient lies on a couch that moves continuously through a rotating
ring gantry. The gantry houses a linear accelerator, which delivers
radiation, in the shape of a fan beam, as the ring is turning. With
the couch moving at the same time as the gantry is rotating, the
radiation beam makes a spiral (or helical) pattern around the
patient, targeting tumours with optimal levels of radiation while
minimising the dose to healthy areas.
The advantage of TomoTherapy is having a radiation treatment
beam projected into the tumor continuously as it rotates means
physicians can adjust the size, shape, and intensity of the beam to
target the radiation to the size, shape, and location of the
patient's tumour.
Find out more from our TomoTherapy Hi-Art
System Patient Guide (PDF).
Chemotherapy
Chemotherapy is the intravenous use of drugs
to destroy cancer cells. The type of chemotherapy treatment given
for cancer depends on many things, particularly the type of cancer.
Often chemotherapy is used in conjunction with surgery and/or
radiotherapy.

The Chemotherapy Day Unit at the Bupa Cromwell
provides outpatient treatment from a dedicated team of nurses using
the latest drug therapies. The appropriate therapy will be agreed
with you by your Oncologist and will depend on the type and stage
of your cancer.
Chemotherapy drugs can be administered orally,
or intravenously (for long term drug therapy), via PICC
(Peripherally Inserted Central Catheter). Normally these lines are
inserted under anaesthesia, but at the Cromwell we have a Nurse Led
PICC Service which means there is no need for anaesthetic.

A Chemotherapy Nurse Specialist supervises all
administration of chemotherapy to ensure compliance with all best
practice guidelines.