The commonest type of kidney cancer is known as Renal Cell Carcinoma (RCC). Surgical removal of either the tumor alone or the entire affected kidney is the current standard of care. However, some patients may have medical conditions that make their surgical risk too high. Interventional radiology techniques like RFA and Cryosurgery are an alternative but there is a size limitation.
The traditional notion that RCC is a radioresistant tumor, meaning radiation therapy is less effective against it, is not entirely correct. High dose, high precision radiation has been successful in ablating RCC that has spread to the brain. Treating RCC in the kidney is emerging as an option only recently, because, unlike the brain, the kidney moves with respiration and is close to radiosensitive organs like the gut. The advances in image guidance, motion management and highly conformal dose delivery with Stereotactic Body Radiation Therapy (SBRT) have made non-invasive ablation of kidney tumors a reality. Prospective studies have shown high cancer control rates, and reassuringly, the effects on kidney function seem to be subclinical in subjects with good baseline kidney function.
This talk seeks to give an overview about RCC, and share when kidney SBRT is a viable option, how it is done, and what the results have shown so far.
Our Speaker
Dr. Jonathan Teh
Radiation Oncologist
Dr. Jonathan Teh Yi Hui is a Senior Radiation Oncologist at Asian Alliance Radiation & Oncology (AARO), a private Singapore Radiation and Oncology group focusing on the use of advanced technologies to treat cancer.
Dr. Teh graduated from the National University of Singapore (NUS) in 2002 where his record of academic excellence earned him multiple Dean’s List and Book Prize awards. He commenced training in Radiation Oncology at the National Cancer Centre Singapore (NCCS) in 2006.
In 2009, Dr. Teh received the Health Manpower Development Programme Award for Advanced Training in Clinical Oncology in the UK where he worked as an Honorary Clinical Fellow in the Oncology department of the University College Hospital London until 2011. He also obtained his Fellowship in Clinical Oncology from the Royal College of Radiologists that same year. During this time, he received holistic training on radiotherapy and chemotherapy delivery to cancer patients for cure and palliation. In addition, he provided patient care and participated in clinical trials at the London Sarcoma Service.
From 2011 to 2017, Dr. Teh worked at NCCS as a Consultant Radiation Oncologist. He was a member of the National Cancer Centre Singapore Blood Transfusion Committee from 2012 to July 2017 and was also awarded the Singhealth Doctor’s Long Service Award in recognition of his 10 years of commitment to quality patient care. Between 2013 to 2017, he was the principal investigator of Southeast Asia’s first non-invasive stereotactic ablative body radiotherapy treatment trial for low-intermediate risk prostate cancer.
With nearly 20 years of clinical experience, Dr. Teh specializes in treating Genitourinary (Prostate, Kidney, Bladder), Head & Neck (Nasopharynx, Oral, Throat) Gastrointestinal (Upper GI, Hepatobiliary, Colorectal), Sarcoma and Paediatric Cancers. Dual-trained in Chemotherapy and Radiotherapy, Dr. Teh is well-versed modern radiation technology including 3D conformal external beam radiotherapy, Intensity Modulated Radiation Therapy, Image Guided Radiation Therapy, Volumetric Arc Therapy, Accelerated Partial Breast Irradiation, and Deep Inspiration Breath Hold Radiotherapy. His specialty lies in stereotactic radiosurgery and stereotactic body radiation therapy for both primary and metastatic tumors.
Dr. Teh’s commitment to providing personalised cancer treatment is evident from how he personally accompanies patients overseas to Proton Therapy treatment at regional centres. He takes time to understand each patient’s condition and personal needs, providing close morale and medical support at all times. As an examiner for the Graduate Diploma in Radiation Oncology examinations in 2013, he was also involved in teaching medical students, residents, student radiation therapists, and nurses.
A member of international societies such as the American Society for Radiation Oncology, European Society for Radiotherapy and Oncology and the International Stereotactic Radiosurgery Society, Dr. Teh is renowned for his published work in the International Journal of Gynaecological Cancer, which has been presented at conferences in North America, Europe and Asia. He also reviews publications on radiotherapy and oncology in the British Journal of Radiology. His expertise has led him to be invited to major industry forums including the Singapore Sarcoma Consortium Sarcoma Symposium and Advances in Prostate Cancer Conference.
Dr. Teh's specialty interests are colorectal cancer, gastrointestinal cancers, head and neck cancers, pediatric cancers, prostate cancer, sarcoma, stereotactic bodyradiation therapy (SBRT), and steretactic radiosurgery (SRS).
