Dr. Hasin Anupama AzhariMedical physics is the application of physical methods and concepts in diagnosis (examination), therapy (treatment) and prevention of human disease and disability which is associated with the practice of medicine. The traditional areas of medical physics have been obviously shown? in radiotherapy, radio- diagnostic, nuclear medicine and in health physics, but with the recent rapid translation of new physical techniques into medical sciences, the work of physicists is getting essential in many clinical areas, e.g. magnetic resonance imaging (MRI), ultrasound, measurement of the body's electric and magnetic fields, positron emission tomography, pulmonary, physiology, cardiology, neurology, ophthalmology and biomedical sensors and implants.
A medical physicist shall have a degree in a discipline of physical science or MBBS with additional M.Sc. degree in medical physics from a recognized university. The responsibilities of a medical physicist usually include clinical service and consultation, research development and teaching. In a survey (2002) done by the American Association of Physicists in Medicine (AAPM) it was observed that the majority portion (76%) of medical physicists works in radiotherapy, 15% in imaging physics, 3% in nuclear medicine, 4% in health physics, 1% in engineering and 1% in administration. The primary responsibility of medical physicist is clinical (78%), academic (8%), research (5%), administrative (3%), in regulatory (4%) and in product development (2%).
Cancer can be treated in three ways: surgery, chemotherapy and radiotherapy. Surgery is the art, practice or work of treating tumor by operative procedures. Chemotherapy is the treatment with drugs that kill cancer cells or make them less active. Radiotherapy is the use of high energy radiation to treat cancer. Out of these three techniques radiotherapy is the cheapest and most curative and palliative ways for various types of cancer. Usually combined therapy is mostly implemented in certain types and stages of cancer.
In clinical radiotherapy practice, medical physics deals with the therapeutic applications of x-ray, gamma ray, neutron, electron, charged-particle beams and radiation from sealed radionuclide sources on the human body. It is also involved with the associated equipment responsible for their production, use, measurement and evaluation. Another important subject in this field is the image quality in the diagnostic area with its entire production methodology and radiation source. Medical physicists are the partners of radiation oncologists or radiologists in cancer treatment or examination respectively.
The main aim of radiotherapy (RT) is to deliver doses of radiation to eradicate a tumor, while nearby tissues or normal structures should be spared as far as possible. Usually, radiotherapy is based on delivering a uniform radiation doses to all target volumes (Tumor). The uniform dose approach describes the best possible tumor control for the case in which all regions of the tumor have exactly the same biological characteristics and sensitivity to radiation. In the radiotherapy technique a team consisting of a radiation oncologist, a medical physicist, a radiotherapy technician and a medical dosimetrist work together for the treatment of cancer. Out of this team, the main jobs of a medical physicist are planning the calculation and treatment of the prescribed patient dose, planning of the high specialized treatment procedure and maintaining the overall quality assurance for patients and the staff.
Comparing all disciplines of medical physics between other countries and Bangladesh, medical physicists are working mainly in radiation oncology physics and diagnostic imaging physics. Medical physicists hold professional appointments in radiotherapy and diagnostic departments in hospitals and medical centers.
The number of cancer patients is growing day by day worldwide as well as in Bangladesh. The complexity in the radiation therapy treatment of this disease requires more qualified medical physicists. So for a better future for the cancer treatment in Bangladesh, we have to put more emphasis on this subject as soon as possible. We hope that the number of medical physicists will increase in the near future as well as the professional level of competence within the coming 5-10 years.
In Bangladesh the number of cancer patients equals 2000 out of 1,000,000 inhabitants per year. That number of cancer cases needs up to 2 teletherapy machines (e.g. a linear accelerator Linac per 1 million people).According to WHO for 160 million Bangladeshi inhabitants we need approx. 320 megavoltage teletherapy machines, 160 radiotherapy facilities are needed to cover an optimal standard in radiotherapy treatment. This means a minimum of 500 qualified medical physicists are required in the future to satisfy the demand of the country. Until now Gono University has been the only university offering B.Sc and M.Sc courses in Medical Physics and in Biomedical Engineering in Bangladesh.
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