At KHCC, we strive to provide our patients with the highest levels of care using the most up-to-date technologies. This page shows some of the unique services at KHCC. These unique services depend on special training of the staff and availability of equipment. Others highlight the special position of KHCC as a leader in cancer research. Everything at KHCC is directed to improving our patients’ care delivered in the highest ethical standards.Bone Marrow & Stem Cell Transplantation (BMT)KHCC has the only comprehensive transplantation service in Jordan. Guided by the expertise of trained healthcare professionals who are supported by essential staff, resources, facilities, and state-of-the-art laboratory equipment; KHCC is able to offer bone marrow transplantation for children, adolescents and adults. Transplants are performed in 10 dedicated, specially equipped rooms. The clinical program involves both allogeneic and autologous stem cell transplantation. Umbilical cord blood and T-cell depleted transplants are also done.
BrachytherapyIn this type of radiotherapy, a radioactive source is placed inside the body for the treatment of cancer. High dose brachytherapy uses computer guidance to precisely deliver a highly radioactive source into the target area over the course of a few minutes. High Dose Rate (HDR) brachytherapy is a specialized type of internal radiation treatment that utilizes a single high activity radiation source that is computer controlled. This single source, or "smart seed", is able to deliver highly accurate brachytherapy treatments in a convenient outpatient manner. As with most brachytherapy procedures, an applicator is first inserted into the body directly into or very close to the tumor. The applicator is then connected to the HDR machine via a transfer tube. The HDR machine is a robot like, computer-controlled after-loader that houses the single highly radioactive source. The source is small (1mm x 3mm) and is laser welded to the end of a thin flexible stainless steel cable. The source then travels out of the afterloader into the applicator. It moves thru the applicator in 5mm steps, called dwell positions. The dose and distribution of radiation is determined by which dwell positions the source stops at and the length of time it dwells there. The HDR’s ability to vary the dwell positions, and dwell times, enables the radiation oncologist to optimize radiation delivery to the affected tumor while minimizing radiation exposure to normal tissues.
Breast Magnetic Resonance Imaging (MRI)A breast MRI is a noninvasive procedure that does not use ionizing radiation (x-ray) to examine the breast. In many cases, abnormalities detected by a mammogram are not clearly associated with certain diseases. In these cases, a breast MRI helps to make a more specific diagnosis before surgery; this is of special importance in young patients with dense breast tissue. This technology helps the surgeons identify the extent of the disease and the type of surgery that needs to be performed. After surgery, a breast MRI helps in differentiating between the operative scar and residual or recurrent tumor. This technology has been available at the center since August 2006, using the modern dedicated 8 channel coils MRI machine. About 200 images are taken annually at the center. The combination of excellent equipment and advanced use of technology, alongside our highly trained radiologists and technologists, whose dedication to the advancement of the field, make KHCC unique in studies.
Cancer RegistryAlthough KHCC is required to report to the Jordan National Cancer Registry, a collective decision was made to have a center based registry of our own. A special team was dedicated to registry research as it was realized that in order to have a better understanding of patients’ diseases, to maintain high standards of quality care and, to encourage research activities, KHCC had to gather more in depth information than that collected by the National Registry. KHCC’s cancer registry systematically collects, electronically stores, summarizes, and distributes information about cancer patients who are diagnosed and/or treated at the center. The data collected by the registry provides descriptions both the patient and the disease.In March 2006, the Clinical Research Unit was given the task to work on this crucial project. The unit’s team explored international programs and organizations, such as the Surveillance Epidemiology and End Result (SEER), Commission on Cancer (COC), and North American Association of Central Cancer Registries (NAACCR) to follow their standards and guidelines while abiding by the National Registry requirements in the items we report to them. The items were selected following the above standards, with some KHCC-customized items; by the multidisciplinary cancer registry committee’s representing all the medical departments at KHCC. An open source cancer registry software, Abstract-Plus, from the Center for Disease Control and Prevention (CDC), USA was adopted to be used in KHCC Cancer Registry.
Conformal Radiation Therapy Our department provides state-of-the-art conformal/precision radiation therapy, also known as 3-D Conformal Radiation Therapy (3DCRT). This treatment may be used for tumors throughout the body. The therapy uses multiple carefully positioned beams of radiation that allow the high dose region of the radiation plan to closely “conform” to the shape of the tumor, thereby minimizing the radiation to adjacent normal structures. 3DCRT is used extensively for patients needing treatment for cancers of the prostate, lung, head and neck, brain, GI tract and others. 3DCRT is made possible by the use of modern tumor imaging and advanced software tools. A detailed CT scan, with the patient in the treatment position, is obtained for the treatment planning process. On each CT image, the tumor and normal tissues are carefully outlined by the radiation oncologist. These outlines are then reconstructed and displayed as a 3 dimensional image on the computer monitor. This 3-D visualization allows the radiation oncologist to choose various radiation beam arrangements, and to carefully shape each beam to maximally cover the tumor with radiation, and minimize the radiation.
Home ChemotherapyThere are many types of chemotherapy drugs that have to be continuously administered through the veins for periods ranging from 2 days up to 6 months! In many hospitals, patients have to be admitted to the hospital to receive such drugs. However, at KHCC we have introduced smart pumps, called CADD pumps that allow us to safely and effectively administer such drugs in an outpatient setting so that patients are able to continue living their lives as normally as possible.The program was started in 2003, with just 5 pumps. Today, there are over 30 CADD and new disposable pumps used. Altogether, these have allowed for chemotherapy to be administered at home to over 50 patients per month. Without these pumps, 30 additional beds would be needed in the center to make sure that the patients recieve the chemotherapy sessions needed to continue and complete treatment.
Institutional Review BoardThe doctors at KHCC are committed to offering our patients the most advanced and effective treatments for cancer. This sometimes requires that our patients participate in what is known as a clinical trial or study. There are many types of clinical trials. For example, some trials offer patients who are not responding to standard therapies—an opportunity to try new medications. In other trials, we test if new combination standard drugs will provide a better response for the patient; there are clinical trials in which we are testing if new drugs are better than the old drugs or have fewer side effects. In addition, sometimes improving on the quality of care that we provide requires that we ask patients to complete questionnaires that tell us more about their experience with the disease, symptoms, and types of treatment.The doctors at KHCC are also committed to respecting patient rights and welfare. That is why we have established a special type of research committee at KHCC called the Institutional Review Board (IRB). The IRB is sometimes referred to as the research ethics committee. This committee approves the start of any research endeavor at KHCC before its start, to make sure that the proposed research trial will not harm patients and will provide them with a real opportunity to improve their outcome. In addition, the IRB reviews the research during its conduction to ensure that patients are well informed about their rights to freely choose participation in research. The committee also confirms that the doctors are following all the steps necessary to guarantee the safety and confidentially of the patients throughout the duration of the study. The IRB is required to review any reports of adverse side effects that result from the trial. The committee may stop the study if they believe that there are risks that outweigh any benefits. Lastly, the IRB ensures that the results of the studies are communicated to patients as to whether or not the results are likely to benefit them.The IRB has been created to ensure that our patients rights and welfare are protected during research trials. The IRB is approved by the Jordan Food and Drug Administration and by the United States federal government.
Limb Salvage SurgeryWhen bone or soft tissue cancer (sarcoma) affects a limb, the traditional treatment is to amputate that limb. At KHCC, we do everything possible to save the limb and restore its function without the need for amputation. To do this, we enlist the skills of an orthopedic surgeon trained in musculoskeletal oncology and the proper management of the patient using other modalities including chemotherapy and radiotherapy. Most important is the use of reliable prostheses and the implementation of aggressive rehabilitation therapy after surgery. At KHCC, all cases of bone tumors are discussed in a multidisciplinary clinic where the input of all disciplines is taken in consideration as part of the decision making process.
MIS: Minimal Invasive and Laparoscopic SurgeryMIS is a new approach in the field of surgery. Through small incisions, the surgeon is able to perform major surgeries (including: radical nephrectomy, partial nephrectomy, radical prostatectomy, radical adrenalectomy, RPLND, and radical cystectomy). Many patients may benefit from this technology irrespective of their age or body habits. This technology is particularly useful in dealing with genitourinary tumors where rigid and flexible nephroureteroscopies (instruments that visualize the ureters and bladder) enable us to reach and treat upper tract and ureteric tumors in a less invasive and organ sparing way. The day case endoscopy unit, for flexible cystoscopic procedures, offers minor procedures like check cystoscopy, biopsies, fulguration of small tumors and the removal of DJ stents on a day basis without the need for anesthesia of hospital stays. Many of these services have only recently been introduced at KHCC. Any patient who has early and localized tumors is a candidate for such treatment, irrespective of his age or body habitus. This comprehensive service is the only one of its kind locally and among very few in the region. It is a comprehensive MIS service with state-of-the-art facilities and adequate expertise to make it feasible and reproducible.
PET/CT scanPositron Emission Tomography (PET) is a noninvasive imaging technique that creates three-dimensional images of the heart, brain and whole body. PET scans are mostly used in the diagnosis of cancer, especially lung cancer, colon cancer, head and neck cancers and lymphoma. However, it can also be used for heart disease, dementia and seizures. PET uses "metabolic imaging", it detects changes in cells as they use energy to grow. It is good at identifying rapidly growing cells, such as cancer cells. PET scans can show cancers before anatomical changes are visible and can distinguish scar tissue from active tumors. Primarily used as a diagnostic tool, PET allows physicians to measure a variety of body functions and chemistry in a safe way. If surgery is indicated, PET scanning can show physicians where to operate. Unlike X-ray, CT or MRI scans that show the shape, size or position of organs or tissues, PET shows their chemical activity and can be used along with these other diagnostic tools to give physicians more detailed information about their patients. A new machine was installed at KHCC in November 2005 and the service was officially launched on 10/04/2006 by His Majesty King Abdul Allah Ben Al Hussein.
Play Therapy and Play RoomIllness and hospitalization can be a major source of stress for young children. They meet many strangers and have to undergo many tests and procedures. We ensure that pediatric cancer patients and their siblings engage in fun, educational play therapy and recreational activities during their hospital stay or inpatient clinic visits. While away from home they may enjoy all of what the playroom has to offer including: computers, play stations, T.V and DVD stations, puzzles, toys and a library with many engaging book and stories. Every day a special activity takes place, including: drawing and painting, storytelling, music lessons, drama, hand crafts, exercises, birthday parties and much more.
RET cameraThis highly sophisticated camera enables ophthalmologists to take pictures of tumors inside the eye. The machine has a special lens with a light source, connected through fiber optic cords to a sensor and a computer. Images taken are used to document the progress and effects of therapy. Patient images are retained and may be used for future comparisons. The images are frequently sent via the internet to specialists all over the world for consultation. This machine is available in Jordan only at KHCC.
Telemedicine/TelesynergyThis technology is used at KHCC to deliver the highest level of care. Telesynergy is available in few centers in the world and is used to conduct real-time consultations between medical specialists in two or more different countries. Practically speaking, telemedicine offers physicians in need of expert assistance an opportunity to consult other physicians with more skills, experience and/or resources. Doctors may submit inquiries, along with patient X-rays, other imaging studies, actual pictures and/or microscopic images via an internet connection or special phone lines. The partnering physician(s) usually provides advice to the consulting physician that may potentially pose significant changes to the treatment plan, hopefully resulting in better outcomes for patients.