Setting Up A Radiation Therapy Department

2016 was probably one of the most challenging but fulfilling years of my life

Honestly, I did not know what to expect. I mean, how hard could it be to set up a Radiotherapy Department? Who was I kidding, really?

Looking back – it was one heck of a challenge, and mind you, it was an even bigger challenge running it! But that sense of satisfaction, when you browse through old pictures or notes that you have made to yourself then, serves to bring back the memories of the journey of how it all began.

Back in early 2016, on my first visit to the ‘department’, the building was still being built. It was more a construction site than a department, really. Dusty, dreary, and dangerous. We had to don our safety vests and helmets as we navigated the makeshift steps and half-done concrete that are now pillars to an amazing structure. As they (my then manager and director) took me around on that site tour, I could begin picturing the possibilities as they explained their vision of the department to me.

Being so clinically inclined – I had thought that starting a department would mean mostly;

• choosing our future radiotherapy machines (I think this is one of the best parts!!)
• developing new Standard Operating Procedures (SOPs)
• designing new patient charts / sheets
• curating radiotherapy workflows
• devising departmental level radiotherapy protocols
• and…getting your own team of radiation therapists!

Honestly, that is just the tip of the iceberg!

We started off with a small team of 5, all women (Girl Power!). The pioneering team consisted of us three, from the Radiotherapy Department and two other colleagues spearheading the Nuclear Medicine division. We initially worked out of a small spare room, in an adjacent building to where our then-future department was being built.

That small spare room, was where all the magic happened!

Imagine – building your first home, but from the ground up. Where it is just rooms and walls of bleak concrete, and wires streaming down and across from the ceilings, and you are tasked with making this your future home. So where do we begin? We had the responsibility of choosing tiles, paint, flooring, light fixtures, colour themes and also new furniture!

But my, was it challenging! We had to paint, tile and furnish an entire department with our minds, our only frame of reference being tiny swatches and booklets and mountains of catalogues of what you could mix and match with. And if all that shopping and imagining were not enough, imagine all the paper work that comes with it! It definitely wasn’t just clicking “Add to Cart” and checking out. Every square inch of that department had hours of thought and conversation behind it.

And once the machines were in, we were tasked with verifying that the levels of radiation that the machine produces were accurate – a process we call machine commissioning and acceptance. As a radiation therapist, I was privileged to experience this process along with my other two colleagues who are medical physicists! Perhaps the best part of this process for me: I got to open BOXES AND BOXES of ‘presents’! It was like Lego on a larger scale; where I got to set up the immobilization devices fresh out of the box, put up electron applicators into our newly built cabinets, and ‘decorate’ our new bunker.

• 

• 

• 

• 

• 

Before ‘Going Live’…

For a new radiation therapy department in Malaysia and also whenever a department gets a new radiation therapy machine installed, representatives from the Radiation Safety Division of the Ministry of Health would come for a site inspection before licenses for use can be issued to said department. In order to prepare for this process, documents have to be ironed out, SOPs have to be clearly defined and the department has to look as ready as it would be on the first day of operation. Staff members handling the radiotherapy equipment should have also completed and received training prior to the inspection.

Once the approval was granted, we were then open for business! Of course, it wasn’t just the 5 of us running the show – we expanded our team! As we recruited more team members into the family, the department grew and so did the number of patients. Personally, there are no words to describe the amazing tenacity and talent of the pioneering team.

From the Clinicians to the Physicists, Oncology Nurses, Nuclear Radiographers, Radiopharmacists, Support Staff and even our own team of Radiation Therapists – everyone was helpful, supportive, and definitely a team player. We all had our ups and downs – but most importantly, we had each others’ back. Truthfully, it was the patients that kept us going. We strive to give them our very best and also to be the pillar of support they required to power through their journey in radiation therapy.

This would be a memory and experience that I will always cherish and will be forever grateful for.

I can’t help but add these too! Missing all of you – you know who you are! 🙂