When all forces and resources in the health service are directed to fighting the epidemic, oncology must remain able to operate efficiently so that cancer patients continue to be treated. Every day, approximately 170 patients undergo radiotherapy at the Amethyst Radiotherapy Center and the Rydygier Hospital in Krakow. Marcin Hetnał, MD, medical director of Amethyst and head of the radiotherapy department, talks about the challenges associated with this.

Patient associations and many oncologists are alarming that the number of oncological patients has decreased, diagnostics are poor, and fewer DiLO (Diagnostics and Oncological Treatment) cards are issued. However, your facility does not see any reduction in traffic.

Marcin Hetnał: In September, over 300 patients completed our therapy. 290 in October. We work very intensively. However, I also have to confirm the facts you mentioned. We recorded a clear decline in the number of patients in April and May, which was an obvious result of the suspension of the functioning of many medical facilities and the fear of patients about the coronavirus. However, oncology patients are aware of their condition, so after the first shock, most of them returned to therapy. Hence our current statistics. However, we look to the future with concern, because the current increases in Covid-19 cases may again affect the effectiveness of oncological treatment. Problems with diagnostics, closed hospital wards, imperfect teleconsultations in clinics, postponed dates of planned procedures, staff shortages, and patient anxiety will soon result in another decline in oncology patients undergoing therapy.

Delaying treatment for cancer can have devastating consequences.

MH: Delaying the start of treatment increases the risk of death by up to several percent. It also increases the length and burden of therapy. In the case of rapidly growing tumors, including: located around the head and neck, lungs and cervix, every day counts. For these reasons, p

Has Covid-19 had any impact on the therapies used? How do you heal today?

MH: Radiotherapy has not changed, but we now approach treatment time differently and prioritize it differently. First of all, we focus on shorter fractionation schemes enabling the delivery of the appropriate dose of radiation in a shorter time. This increases the safety of the patient, who stays in a medical facility for a shorter time and moves less, so the possibility of infection is minimized. For example, in the case of breast cancer, we now usually use 3-week regimens instead of 5 weeks. In some situations, we choose to postpone the invasive procedure (this applies to brachytherapy, when the radiation source is placed in the tumor or its vicinity), changing the order of therapeutic methods used. This may apply, for example, to low-risk prostate cancer patients. All these modifications are consistent with applicable medical procedures and are safe for patients. The coronavirus epidemic forced us to be even more flexible and led to even more individualized treatment. We consider each case separately.

The epidemic caused the spread of teleconsultations in medicine. How effective is this method in oncology?

MH: Already in March, we replaced some traditional follow-up visits with telephone consultations. They are a great convenience for patients who do not have to travel by public transport, contact other people, and can maintain a safe social distance. However, after nearly nine months of experience, we also know that teleconsultations in oncology may constitute only a fraction of our contacts with patients. The first visit and control before starting therapy absolutely require direct contact. During radiotherapy, in many cases of cancer, the doctor also needs to see the patient. However, teleconsultations work well as follow-up visits for patients after radical treatment.

What happens when an oncology patient gets sick with covid-19?

MH: Like any other person, he or she must self-quarantine and be under medical supervision if symptoms occur. From a radiotherapy perspective, this is a difficult moment because in many cases it requires interruption of treatment. This has happened to us several times since the outbreak of the epidemic. After the disease ends, we resume radiotherapy. We are already treating several recoveries in our center. However, there are asymptomatic cases in which it is necessary to continue treatment of the cancer due to its rapid growth. We are ready for this eventuality. These months of fighting the epidemic meant that we learned to live with it. Both our medical staff and patients are accustomed to the sanitary regime. We are aware that any of us can get sick, which is why we use all necessary safeguards and skillfully rotate our staff. So far, these methods have proven effective. We are healing all the time.

By the end of March 2015, the Amethyst Radiotherapy Center in Krakow registered 398 patients as part of the oncology package. Some of them, over 180 people, have already completed treatment, the rest are undergoing tests or therapy. The number of medical facilities that cooperate with Amethyst in terms of access to radiotherapy for patients treated as part of the oncology package is growing.

Patients arriving at the Amethyst Radiotherapy Center are admitted on an ongoing basis, and the date of the first consultation is scheduled within the next 3 days. For Amethyst patients, the introduction of the oncology package has not changed much. As last year, dates for the first visit to the radiotherapy clinic are scheduled as soon as possible, and therapy begins immediately after specialists develop a treatment plan.

Patients who come to the Amethyst Center with oncological diagnosis and treatment cards (DiLO) issued in other medical facilities are not always clear about the new procedures in force. An important question is whether radiotherapy must take place in the same medical facility where the consultation took place? Amethyst also accepts patients whose case was consulted in another center. If a patient wants his radiotherapy to take place at Amethysta, a second consultation is held at the facility.

Every year on July 28, World Hepatitis Day is celebrated. On this occasion, the Amethyst Radiotherapy Center together with the Specialist Hospital. Rydygiera organized a meeting for the media and a special information campaign.

In the world, the number of carriers of the hepatitis B virus (HBV) is estimated at 350 million people, and the number of carriers of the hepatitis C virus (HCV) - at 170 million. In Poland it is approximately 385 thousand. and approx. 700 thousand people. HBV is almost 100 times more infectious than HIV, the acquired immunodeficiency virus. Chronic, usually asymptomatic or only mildly symptomatic, untreated hepatitis B and C infections may lead years later not only to liver cirrhosis, but also to the development of hepatocellular carcinoma.

Since hepatitis remains undiagnosed in most chronically ill people for a long time, and there is a lack of knowledge about prevention in society, therefore the Specialist Hospital. Ludwik Rydygiera in Krakow and the Amethyst Radiotherapy Center have prepared a special information campaign. On Tuesday, July 28, a meeting with local media was held at the radiotherapy center on methods of preventing infections and methods of treating liver cancer. It was attended by, among others: Marcin Hetnał, M.D., director of the Amethyst Radiotherapy Center, as well as Henryk Łabza, M.D., head of the Department of General and Oncological Surgery, and Leszek Sykut, M.D. - both representing the Krakow Specialist Hospital. L. Rydygier. Dr. Sykut is also the author of information material for patients and their families. Such leaflets, containing the most important information about hepatitis and infection prevention, are available at the center.

We also encourage you to read extensive material on hepatitis and methods of treating liver cancer - download link below.

Knowledge for health – hepatitis C

Representatives of the Amethyst Radiotherapy Center took part in the 8th Krakow Medical Tourism Congress organized by the city of Krakow in cooperation with the Małopolska Tourist Organization and the Krakow Chamber of Tourism. The congress took place on October 9 and XNUMX at the ICE Kraków Congress Center.

The main panel devoted to the promotion of medical tourism and the possibilities of developing this branch of medicine was attended by representatives of the Ministry of Foreign Affairs, the Polish Tourist Organization, the Polish Investment and Trade Agency, the Polish Association of Private Hospitals and the Krakow authorities. During a panel devoted to the possibilities of developing medical tourism through new technologies, Barbara Werchowiecka-Rusinek presented Amethyst's achievements and our readiness to serve foreign patients.

On the occasion of the congress, at the request of the Krakow City Hall, a market analysis was carried out and an update of the database of medical facilities that are appropriately prepared to accept foreign patients was carried out. For this purpose, a "mystery shopper" survey was used, which included sending an e-mail inquiry, a telephone conversation, and in some cases also a visit to the branch. The Amethyst Radiotherapy Center was among the facilities that received the highest scores, which confirmed the center's readiness to serve foreign patients.

The Amethyst Radiotherapy Center admits approximately 3 patients annually from the Lesser Poland Voivodeship, but also from other regions of Poland. Among them, there are more and more people from Ukraine who, while working in Poland, are covered by health insurance. This means that the Krakow facility has long been conducting activities aimed at efficient service of foreign patients, which also results in the readiness to provide commercial therapies for people from locations other than Poland.

How to deal with cancer? Access to modern therapy and medical care are priceless, but what also counts is the patient's mental strength, the support of his loved ones, and the will to survive. The prevalence of cancer means that we encounter this issue more and more often. How to deal with the diagnosis, how to help yourself and your loved ones - this is the question that guides the activities of the Krakow Unicorn Association.

The 4th Forum for Oncological Patients is ahead of us, which will take place on February 4 this year. at the ICE Kraków Congress Center. The forum will start at 9.00:21 a.m. with a workshop part (12.30 workshops on psychology, dietetics, rehabilitation, medicine), and from 17.00:XNUMX - XNUMX:XNUMX p.m. the main session is scheduled, during which speakers will include: Barbara and Jerzy Stuhr, prof. Krystyna de Walden-Gałuszko, Dr. Mariusz Wirga, Dariusz Duma and Szymon Hołownia.

The day before, on Sunday, February 3, at 14.00-17.00 the organizers invite you to an open day at the UNICORN Psycho-oncology Center (Kraków, ul. Zielony Dół 4). In addition to visiting the center, numerous consultations and workshops are planned.
More information http://www.onkoforumkrakow.pl/