Institute of Nuclear Medicine, Oncology and Radiotherapy (INOR) is the 13th Nuclear Medicine & Oncology (NM&O) Hospital of the chain of NM&O centers of Pakistan Atomic Energy Commission in Pakistan. It was formally inaugurated on 17th May, 2004. INOR, since its inception INOR is doing its best to provide quality nuclear medicine and oncology services for the people of its catchment area.INOR is a well-known Nuclear Medicine and oncology center and passed it stage of infancy and blooming on surface of dignity and fame.It is located within the premises of Ayub Medical College and Teaching Hospital. Patients from Hazara Division, almost whole of Northern Areas (Gilgit Baltistan), Kashmir, Swabi, Shanglaetc and Punjab (Attock, Hassan Abdal) are coming to INOR for diagnostic and therapeutic purpose. A significant number of patients are also coming from Afghanistan. INOR is the big source of relief for cancer patients and is not only providing the curative treatment facilities for early stage cancer patients but also encourages late stage cancer patients to avail palliative treatment care; Beautiful valley of Abbottabad and whole Hazara is topographically comprising hills and mountains . Traveling of cancer patients from these hilly areas is laborious task for patient’s relatives and reaching to INOR is a blessing for such patients. Otherwise patients have to travel a long distance to some other hospital in KPK like Peshawar or Islamabad or other places for treatment further adding to their physical, mental fatigue and financial miseries.After serving atIRNUM Peshawar for 26 years as consultant Oncologist I joined INOR in 2014 as Director INOR. I tried my best and left no stone unturned for progress and uplift of INOR. Patient’s turnover increased to double the previous number with other achievements including start of multidisciplinary tumor board, online seminars/webinars, and symposia. Needless to mention that start of Tumor board with Gynecologists of Auyb Teaching Hospital has given a tremendous service to the local community especially in field of oncology. Students from various disciplines are encouraged for their learning at INOR. Students from Radiology, Oncology and Medical Physics are regularly coming for their projects and mandatory rotation.
Institute Of Nuclear Medicine Oncology & Radiotherapy (INOR) Abbottabadis a state of art tertiary care hospital which provides specialized diagnostic and therapeutic facilities for various benign (non-cancerous) and malignant (cancerous) diseases. It is the 13th cancer hospital of the chain of Pakistan Atomic Energy Commission Cancer Institute’s and second largest functional institute in the Province. INOR is committed to provide best diagnostic services in field of nuclear medicine imaging. Treatment of cancer patients with chemotherapy and radiotherapy is done according to the international standards. New trends in radiation therapy are being adopted and the center will be providing facility of IMRT (Intensity Modulated Radiotherapy) to eradicate the tumor exclusively while saving the normal tissue. Indoor facility for cancer patients is provided round the clock and INOR has ward of 56 beds for this purpose. A separate Chemotherapy Bay is present with proper Chemotherapy chairs as daycare.
Objectives of INOR
- To expand the capacity of quality oncological services to help the cancer patients of this region in alleviating their sufferings
- To provide state of the art diagnostic and radio-therapeutic services
- To deal with the increasing number of cancer patients effectively
- To create cancer awareness in general public as a primary step towards the prevention of disease
- To provide better teaching, training and research facilities to local doctors and staff.
Quality policy of INOR:
INOR is a specialized medical center to provide diagnostic and treatment facilities in the field of nuclear medicine and oncology and is committed to provide cost effective, efficient, ethical, safe and uniform health care services to the patients through the application of affective quality management system and continual improvement in the processes and facilities.
Nuclear Medicine is the branch of medicine that utilizes various radionuclides for diagnostic and therapeutic purposes. Nuclear Medicine department is one of the maindeoartments of INORand is facilitated with latestmodern equipment including single-head and double-head gamma cameras for imaging and capable of doing SPECT, Hot lab along with Fume hood, and I-131 administration equipment, andradiation protection devices etc.
Nuclear Medicine Department has three sections i.e. exclusive, Nuclear Medicine section, Radiology and Diagnostic laboratory.
- Nuclear Medicinesection:
Nuclear Medicine section utilizes radionuclides especially Technetium (Tc-99m) andRadioiodine (I -131) for various diagnostic studies including cardiac scan, bone scan, thyroid scan,renalscan,lung perfusion scan, Radioiodine Whole body scan etc. These radionuclidesare tagged with different pharmaceutical moieties in hot lab. Nuclear Medicine section provides services to a large number of new and follow up cases with Benign and malignant thyroid diseases as well as cases for bone pain palliation therapy in benign and metastatic bone diseases. Radionuclide therapy is a logical approach for patients with refractory, multisite metastatic bone pain and treatment is well tolerated and delivers sustained symptom relief.
Indoor treatment facility for high dose Radioiodine I-131 ablation therapy in differentiated thyroid cancers including follicular and papillary thyroid cancers has been recently started for the first time which will lessen the financial burden on such patients previously used to visit Islamabad or Peshawar .Indeed it is the only facility available in whole province of KPK for this purpose, an isolated room with proper shielding and comfortable environment is prepared in ward and few patients have been treated successfully so far.
Nuclear Medicine Services available at INOR:
- Cardiac scintigraphy
- Skeletal scintigraphy
- Liver scintigraphy
- Hepatobiliary scan
- Lung perfusion scan
- Renal scan
- Parathyroid scan
- Salivary gland study
- Gastric emptying time, GER study
- GI bleed study
- RBC labeled study
- Thyroid scan (pertechnetate& I-131)
- I-131 Whole body scan
- I-131 therapy for Hyperthyroidism
- I-131 therapy for Differentiated Thyroid cancers
- I-131 MIBG therapy for Neuroendocrine tumors
- P-32 therapy for Polycythemia and Metastatic Bone pain palliation
Nuclear Medicine Section is facilitated with single and dual head Gamma camera and ETT Machine. Furthermore to expand the capacity of quality services to help patients and alleviating their sufferings, the extension of INOR is in progressand soon INOR will be facilitated with a Dual Head SPECT gamma camera and Dual Head SPECT-CT.They will not only reduce the acquisition times but have superior resolution and image quality.
INOR has a well-developedRadiology section.Treatment facilities available in Radiology Department are:
- Gray scale and Color & Power Doppler Ultrasound
- Ultrasound guided aspiration and Biopsy facilities
- Diagnostic and therapeutic aspiration procedures like Breast lumps FNAC, Thyroid FNAC, pleural and ascetic taps and abscess aspiration
- Mammography for screening and diagnostic purposes
- DEXA Scan for bone mineral density for new and follow up cases of osteoporosis
- Conventional Radiography and Contrast Studies
- Moreover INOR has a well developed Breast Care Clinic which utilizes clinical breast examination, sonomammographyand mammography and biopsy facilities and is playing a vital role in breast cancer awareness and its earliest possible detection followed by referral for prompt treatment.
Laboratory at INOR is outfitted with Immulite 1000, ELISA, Chemistry Analyzer, Hematology Analyzer and RIA equipment.
Treatment facilities available in Radiology Department are:
- Complete blood picture, ESR & Urine R/E
- Biochemistry including RFT, LFT, Alkaline phosphatase, Serum Calcium, LDH, Glucose etc.
- Hepatitis B and C screening
- Hormonal Analysis including Thyroid function tests, Prolactin, estrogen, progesterone etc.
- Tumor Markers including B-HCG, AFP, PSA, Ca 125 etc
Objective of INOR Oncology is to decrease the morbidity, agony and mortality due to cancer through outstanding programs that integrate compassionate patient care, research and prevention. The department presents a unique opportunity of bringing together diverse groups from surgical, medical and radiation disciplines to focus on cancer care and to develop education and research in this area, leading to a Centre of Excellence which will be a beacon-light for whole country.Our clinics cover nearly each cancer type and have a strong focus in new therapeutic approaches. Around 1200-1300 new patients register in INOR oncology per year. More than 9000 patients consult the department for follow up.
Day care Chemotherapy
The Oncology Day Care Unit is a specially designed facility for patients suffering from various malignant disorders. The Day Care Unit offers outpatient cancer chemotherapy for all types of malignant diseases. The day care unit is well equipped and specified chemotherapy chairs are present for comfortable delivery of chemotherapy. More than 6000 chemotherapies are done annually for variety of malignant diseases.
INOR Radiation Oncology is one of the most comprehensive radiation oncology departments of the region. Using state-of-the-art radiation technology, oncologists, medical physicist and staff collaborate to design custom treatment plans for each and every patient. By doing so, most patients feel better, faster and normal, healthy tissues are usually spared or minimally impacted from the effects of radiation. For this purpose INOR is fully equipped with one of the sophisticated LINAC with MLC (Multi leaf collimator), Cobalt 60 unit, Simulator and 3D Treatment Planning System for precise radiation delivery to the affected part of the body. The department is gaining technical expertise and advance equipment to step up for the IMRT (Intensity Modulated Radiotherapy)
Indoor Wards of INOR
Indoor facility is provided round the clock and a ward of fifty six beds ward is available at INOR. Ward is fully equipped with all the facilities. Fully trained nursing staff is available round the clock. Doctors are also there to cater patients should an emergent situation arises.
Cancer Patients Support
Patient’s chance of long term survival cannot afford the treatment. Furthermore most of our patients present with advance stage disease mainly because of lack of awareness about the disease, not only in the general population but also in the medical community.
Government of Pakistan is providing help to these patients who cannot afford the high cost of treatment through Zakat and Baitul Mal.It is pertinent to mention about Begum Nusrat Bhutto oncological services which was initiative of KPK govt. This program helped a lot the poor cancer patients of KPK to a large extent. However this assistance has been exhausted and has not replenished Zakat and Baitul-mal financial help is insufficient and cannot cope with the patient’s load especially for Afghan refugees. This issue was of great concern and laid down the foundation of INOR PATIENTS WELFARE SOCIETY (IPWS).
INOR patients’ welfare Society (IPWS) was established with the aim of helping poor cancer patients, creating cancer awareness in masses, health professionals and medical technicians. These personnel are targeted in special to suspect and diagnose cancer at an early stage. Director INOR and General Secretary IPWS made various visits at different forums of Health professionals, including hospitals, Haripur, COMSAT universities, Women Medical College, Frontier Medical College, Govt; Degree College for Girls, doctors of various PPHI disciplines at Abbottabad, Mansehra and Haripur. All these efforts are to create awareness regarding the facilities available at INOR for screening, diagnosis and treatment of various cancers. For Donations for cancer patients- INOR DONATION ACCOUNT NO: 4006760407&IPWS ACCOUNT NO: 4837-4 (National Bank of Pakistan)
INOR Teaching Program
With all the facilities and expertise available at INOR, the institute participates actively in different teaching and training activities and research related activities. INOR is accredited from CPSP for FCPS training in Radiotherapy. FCPS trainees of different disciplines are benefitted from INOR by getting their complete/partial clinical attachment. Students of MS Medical Physics, Radiation Oncology and Nuclear Medicine from PIEAS carry out their clinical attachments and research projects at INOR. Moreover students of Pharmacy, biochemistry etc from Comsats, GC college ATD, Hazara University, also perform their research projects at the Institute.
Moreover Continuous Medical Education is constantly being promoted at INOR especially over the last couple of years. For this purpose various Seminars, symposiums and conferences are being held at INOR which are attended by medical doctors, paramedics, medical students and general public as well.
Lectures related to Nuclear Medicine and Oncology is also frequently being delivered by consultants of INOR to the medical students of different medical colleges like Ayub Medical College, Frontier Medical College, and Women Medical College etc. Weekly academic lectures/presentations are regularly held on every Saturday to enhance the knowledge and skills of doctors, scientists as well as non-technical officers.
Technologist and nurses from recently functional PAEC Nuclear Medicine and oncology centers in KPK like BINOR, SINOR etc. were trained at INOR before starting their career at their respective institutes. Moreover, various cancer awareness programs are being constantly arranged by INOR like breast cancer awareness programs, World cancer day etc.
Research and Development:
INOR is actively involved in research and development studies to evolve better understanding and strategies for the prevention, screening, diagnosis and treatment of benign and malignant diseases.
For this purpose a series of research studies on animals have been conducted in collaboration with different colleges and universities of Abbottabad, Mansehra as well as Faisalabad. Various radionuclides are used for this purpose. Different research articles are regularly published in renowned Journals like Journal of Ayub Medical College (JAMC), Pakistan Journal of Nuclear Medicine (PJNM), JCPSP etc.