Dharamshila Hospital & Research Centre

Dr S Khanna Executive Director

Until the early '90s, North India did not have a hospital to provide exclusive cancer care under one roof. Patients had to go either to the 25-bed cancer wing of AIIMS, New Delhi or the overcrowded Tata Memorial Hospital in Mumbai. Dharamshila Cancer Foundation and Research Centre was therefore registered as a NGO to start North India's first state-of-the-art comprehensive cancer care and research centre.

The first phase of Dharamshila Hospital and Research Centre (DHRC) with 100 beds was commissioned in July 1994. New facilities with an additional 250 beds were commissioned in October 2007, making it the largest cancer hospital of North India. The Hospital has a turnover of Rs 30 crore.

Holistic Cancer Care

The Hospital provides state-of-the-art diagnostic facilities and complete treatment radiation, surgery, chemotherapy, rehabilitation and palliative care under one roof. Most diagnostic and therapeutic procedures are available here.

The department of radio-diagnosis and imaging offers facilities for nuclear scans, digital spiral CT scans, mammography, ultrasonography, echocardiography, endoscopies, digital radiography, CT and ultrasound-guided procedures. PET-CT will be installed shortly.

The department of pathology offers facilities for cytology, histopathology, frozen sections, immunohistochemistry, tumour markers, haematology, cytochemistry, biochemistry, clinical pathology and microbiology.

The department of radiation oncology has two linear accelerators with IMRT capabilities, microselectron HDR with TCS remote after loading brachytherapy equipment for providing intraluminal, intracavitary, interstitial and surface mould radiation in 10-15 minutes, compared to two-three days by conventional methods; three treatment planning systems (including 3-D eclipse TPS) and inverse planning system, amorphous silicon online treatment port verification system and mould room facilities.

The department of surgical oncology has seven modern operation theatres, fitted with laminar flows, and hepafilters and endoscopy suite to offer all types of diagnostic and therapeutic endoscopies. The department performs full range of cancer surgeries including routine, high risk and emergency surgeries.

The department of haematomedical oncology provides chemotherapy, immunological/biological therapy, hormonal therapies, targeted therapies, neutropenic care, nutritional therapy, blood and blood component therapy, palliative and supportive care. These core departments are supported by consultants from anaesthesiology, cardiology, dental, dermatology, diabetology, ENT, endocrinology, emergency services, gynaecology and obstetrics. Other supporting specialities include gastroenterology, gastro intestinal surgery, general, neuro, paediatric and laparoscopic surgery, internal medicine, nephrology, and neurology. For post-operative continuing therapy, the Hospital can also call on specialists from ophthalmology, orthopaedics, occupational therapy, paediatrics, plastic and maxillo facial surgery, psychiatry, pulmonology, physiotherapy, pharmacy and urology. Thus almost all imaginable consequences are catered for in one location.

Around 200-300 patients visit the Hospital everyday. At present, the Hospital has 50 full-time doctors and a panel of 60 visiting consultants in addition to 250 full-time and 150 outsourced employees. Since the new facilities were commissioned on October 20, 2007, about 100 additional employees have joined.

Single Window

Says Executive Director Dr S Khanna, "The USP of the Hospital is complete cancer care under one roof, state-of-the-art infrastructure, dedicated and committed staff. We also review every patient with a tumour board consisting of medical oncologists, surgical oncologists, radiation oncologists, gynaecological oncologists, pathologists, radiologists and imaging experts to chalk out detailed treatment plan as per standard treatment protocols, with just single consultation fee."

"We also ensure that there is no over treatment or under treatment, minimal hospitalisation, personalised services with positive attitude, compassion and smile, competitive rates with transparent billing, maximum cure rates and addition of quality to life,"she enumerates.

Pioneering Therapies

"We are North India's first and largest cancer hospital. It is the first cancer hospital of India, certified for implementing integrated Quality and Environment Management Systems conforming to ISO 9001:2000 and ISO 14001:2000 standards by TUV Germany," says Dr Khanna.

It is the only Hospital in India treating brain tumours with interstitial implants using microselectron HDR with TCS (brachytherapy). Dharamshila is the first cancer hospital in India giving intra-arterial, intra-hepatic chemotherapy by continuous method using electronic pumps. It is also the first hospital in India to perform awake craniotomy in a brain cancer patient. It has the first medical oncologist of India trained in DNB Medical Oncology (2001-2004)-Dr Meenu Walia.

Laurels Received

The Hospital is in the process of getting accreditation from National Accreditation Board of Hospitals (NABH). "All our manuals and documents have been approved. The pre-assessment for accreditation has already been done. The final assessment is due shortly," says Dr Khanna. The Hospital is certified for implementing integrated Quality and Environment System as per ISO 9001:2000 and 14001: 2004 standards.

Some of the awards/recognition the Hospital has received so far are: First Vijay Gujral Award from the External Affairs Minister on September 16, 1992 for Cancer Information Service Project; Scroll of Honour from the Director General Health Services, Ministry of Health and Family Welfare on May 26, 1993 in recognition of humanitarian services rendered to community with devotion through distinguished carrier dedicated to the discipline of Cancer Prevention; Delhi Gaurav (Prestige of Delhi) by Delhi Government in 1997 for pioneering work adding to the prestige of Delhi; Human Care Award of the Millennium by Chief Minister of Delhi Sheila Dixit on December 20, 1999; and Millennium Award to Intellectuals and Thinkers by the Ambassador of China on December 29, 1999.

Teaching and Training

To alleviate the country's acute shortage of trained cancer specialists, nurses, technicians and other support staff, the Hospital trains cancer specialists (medical oncologists, surgical oncologists and radiation oncologists) through a three-year full-time, doctorate programme (DNB), recognised by the National Board of Examinations. It also trains nurses, technicians and paramedics to provide high quality support services. It holds continuous medical education (CMEs) programmes for doctors. It has organised 136 CMEs to sensitise doctors in Delhi, NCR, UP, Haryana, Rajasthan, Himachal Pradesh and Uttaranchal.

Using Information Intelligently

IT is used in OPD registration, admissions, discharges and billing, material management, pharmacy, finance and accounts, medical records, census and cancer registry. "We are also planning to start telemedicine shortly," says Dr Khanna. Last year, the Hospital spent Rs 20 lakh on IT. The next annual budget earmarked for IT is Rs 60 lakh.

Spreading Global Wings

Medical tourism is fairly high on the Hospital's agenda. "We are in touch with all the embassies and are receiving patients from Pakistan, Nepal, Afghanistan, Nigeria, Bangladesh etc. We had visited Singapore, Malaysia and Indonesia in 2004 with Federation of Indian Export Organisations (FIEO), set up by Ministry of Commerce, Government of India and realised that we required to strengthen and expand our infrastructure. Now that we have expanded from 100 beds to 350 beds, we shall be actively pursuing medical tourism in collaboration with insurance companies and other relevant agencies," says Dr Khanna.

Raising Awareness

"Dharamshila Hospital provides free consultations, diagnosis and treatment facilities to patients below poverty line and highly subsidised treatment to low income groups, spending around Rs 2-3 crore," says Dr Khanna. The Hospital has organised 237 cancer awareness campaigns for the public. During these campaigns, it organises screening of short films and distributes pamphlets, booklets and posters. The Hospital has organised 151 free cancer detection camps and organises free cancer screening months (October-November) every year. "This year, we spent Rs 2 lakh on breast cancer awareness," says Dr Khanna.

Upgrading Technology, Technicians

Dharamshila Hospital is planning to commission a bone marrow transplant unit and PET-CT, spending around Rs 20 crore. Telemedicine is also in the pipeline. "The expansion will be funded by internal accruals, donations and bank loans," says Dr Khanna.

In addition to DNB programmes in oncology, the Hospital also intends to start DNB programmes in anaesthesiology, pathology, radio-diagnosis and imaging and several other specialities.