If you're coming from out of town, this is what your days in Gurugram will look like.
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What a Treatment Day Looks Like
Twenty-eight days is a long commitment to make without knowing what you are agreeing to. This page walks through the whole thing: the planning that happens before the first session, what an hour on the machine actually involves, and how the four weeks are structured.
Before anything starts: the scan and the plan
Treatment cannot begin until the machine has been programmed for your body specifically. That programming comes from an MRI scan, and it is the reason the first day or two is spent on measurement rather than treatment.
The scan is not only for diagnosis. It measures the proton density of the tumour, a physical property of the tissue, and those measurements become the numbers the planning computer works from. For lesions in the brain the imaging is more detailed, including contrast, diffusion, perfusion and spectroscopy sequences. For tumours elsewhere in the body a routine sequence with contrast and diffusion is sufficient.
The radiologist supplies those images to the treatment team. In the planning software, the region or regions to be targeted are identified and outlined. The largest and smallest diameter of each lesion is measured, and a margin of one to two millimetres is added beyond the visible edge, to include the rapidly growing cells that tend to sit just outside it.
If you have more than one site, each one is planned separately, and the plan can then target several of them in the same session rather than treating them one after another.
If you have recent scans, bring them, along with the reports. Anything that saves repeating an investigation saves you a day.
The marking session
Before the first treatment you will have a marking session. It is painless and it is the step that makes every subsequent day repeatable.
Under very low intensity CT guidance, the radiologist marks the target area on the surface of your body. Those marks are then transferred onto a clear plastic template, which is positioned using prominent anatomical landmarks so that it sits the same way every time.
A low-power laser guide, the kind of red pointing light used across radiology, is focused onto the template to show exactly where each of the machine's axes should be aimed. The positions are marked, the template is lifted off, and the laser is switched off. What remains is a set of reference marks on your skin that tell the team precisely how to position you on every one of the twenty-eight days.
Look after the marks
The marks matter, so treat them gently. Shower rather than scrub, avoid oils or heavy moisturiser over them, and tell the team straight away if any of them fade or wash off rather than trying to redraw them yourself. Remarking takes a few minutes; treating from a wrong mark does not bear thinking about.
A treatment day, start to finish
Allow around two hours at the centre. The treatment itself is one hour; the rest is arrival, checks and positioning.
The shape of a treatment day
Times are approximate and will vary a little from day to day.
You go home afterwards. Treatment is delivered as an outpatient, and admission is arranged only where there is a clinical reason for it.
What you will and will not feel
This is the question people ask most, and the answer is reassuringly dull.
Nothing enters your body. There is no injection, no cannula, no anaesthetic and no sedation. You stay fully awake and fully clothed apart from anything that needs to be moved aside for access. You lie on your back on the treatment bed, the bed moves into position inside the gantry, and the hour passes.
Most people feel nothing at all during the session. Some notice a faint tingling at the treatment site. There is no heat, because the device is designed to work without heating tissue, and no sensation of the field itself.
The main demand the treatment makes of you is stillness. You need to be able to lie flat and reasonably still for the full hour, because the targeting depends on your position not changing. Most people read, listen to music or a podcast, or simply doze.
During the hour
What happens
- You lie on your back, awake
- The bed moves you into the gantry
- A protective sheet keeps you clear of the antennas
- Staff are present and can see and hear you throughout
- You can read, listen to something, or rest
What does not happen
- No injection or drip
- No anaesthetic or sedation
- No heat
- No noise of the kind an MRI makes
- No recovery time afterwards
Please leave metal behind
Metal objects reflect the field and can distort it in ways that affect the treatment, so watches, jewellery, hairpins, belts, coins and anything else metallic come off before each session, and are kept away from the machine rather than in a pocket. If you have metal inside your body, from previous surgery or an implant, this needs to be discussed at assessment and not on the day. The eligibility page covers this in full.
The four weeks as a whole
A standard course is one hour a day for twenty-eight consecutive days. Consecutive is the operative word: the schedule runs straight through, including weekends.
You are seen every single day by a doctor and a nurse, who examine you and record anything you report, however minor. That daily review is part of the protocol rather than a courtesy, and it is worth using. If something feels different, say so on the day.
After the course finishes you are reviewed periodically for a year. The first review is usually about a month after the last session, which is the point at which repeat imaging is normally arranged to see what has changed.
The twenty-eight days
Each square is one session. There are no scheduled rest days.
Missing days matters. If travel, illness or anything else threatens to interrupt the run, tell the team early so the schedule can be managed rather than broken.
If you are travelling from abroad
Most of our international patients find that the logistics, rather than the treatment, are the part that needs planning.
The centre is in Gurugram, about twenty-five minutes from Delhi international airport. Because the course runs daily for four weeks, the practical question is where you will stay and who will be with you, not how you will recover.
- We arrange airport reception on arrival, a local SIM card, and daily transport to and from the centre
- We help you find accommodation nearby, and will arrange it, though we do not provide it ourselves
- Plan for around five weeks in total, to allow for assessment, planning and the full twenty-eight days
- Bring a companion if you can. Four weeks is a long time alone in an unfamiliar city, and most people find it easier with someone
Treatment is delivered on an outpatient basis, so you will not be in hospital. Admission is arranged only where there is a specific clinical need for it.