MIL OSI Translation. Region: Russian Federation –
The center plans to admit the first patients on October 25.
Overhaul in the center of outpatient oncological care (building No. 9) of the city clinical oncological hospital (GKOB) No. 1 has been completed. It is located at the address: Zagorodnoye highway, house 18a. Sergei Sobyanin examined the center, and also got acquainted with the progress of the repair of the oncosurgical building No. 7.
“We are continuing the reconstruction and creation of modern cancer centers. Today, such a center is opening on the basis of the first city cancer clinic. It complies with all modern world standards, providing a full range of diagnostics and therapeutic treatment of patients. The center will be involved in the treatment of residents of the Central District, and in some areas it will work in eight administrative districts of Moscow. The number of people who will be able to receive help here will also increase, and, of course, the quality of treatment will be on a completely different level, ”he said.
The Mayor of Moscow added that the new centers are receiving patients, as well as diagnostics, therapeutic and surgical treatment. “These are huge centers that employ hundreds of thousands of people. In general, in Moscow today there are more than 300 thousand people in our cancer registry. Therefore, we also introduce monitoring of the work of these centers in terms of the quality of service, accessibility and, in fact, the opinions of the people themselves about the help they receive in these centers, ”said Sergei Sobyanin.
He emphasized the need to monitor the work of each center so that it is clear how comfortable and effective their activities are for patients, and expressed the hope that the creation of such centers will bring the provision of cancer care in Moscow to a new quality level.
Individual approach and quick help
Overhaul of building No. 9 of GKOB No. 1 on Zagorodnoye Highway (built in 1966) began in April 2020 and ended in October 2021. Before the renovation, this building was occupied by the Moscow City MHI Fund.
As part of the work, the building was almost completely rebuilt: the structures were reinforced, the facade was insulated, the roof was repaired, utilities, floor slabs, internal partitions and floor screeds, door and window blocks were replaced.
For people with limited mobility, a lifting platform, ramps and handrails were installed, and clear logistics were provided inside the building.
Upon completion of the renovation, an outpatient oncological care center (CAPC) for residents of the Central Administrative District of Moscow will be opened in a three-storey building with an area of 5.1 thousand square meters. Also, residents of seven districts suffering from malignant tumors of the head and neck will receive help here.
The opening of the CAPO on Zagorodnoye Highway will allow organizing in one place a full cycle of diagnostics and treatment of specialized patients – from diagnosis, surgical treatment, drug, and later chemotherapy to dispensary observation.
Each patient will be provided with an individual approach from the moment of the first visit – a council of oncologists will operate at the State Clinical Hospital No. 1 on Zagorodnoye Highway.
Sergei Sobyanin noted that today the hospital is the basic one in the treatment of head and neck tumors and provides assistance to residents of eight Moscow districts: “It is very important to ensure the availability of this assistance.”
In a conversation with doctors, the Moscow Mayor asked how comfortable the working conditions were for them. The hospital’s oncologist Natalya Kirdakova said that the institution created comfortable conditions for workers and those undergoing treatment: large offices, there is a relaxation area for patients, a buffet, a dining room and spacious toilets.
“We, of course, require doctors to treat patients with heart. But for this we need to create the necessary conditions for you too, ”added Sergei Sobyanin.
The new CAP is located on the same territory as the hospital, which makes it possible to use the diagnostic facilities of the hospital for outpatients (endoscopy, MRI, CT). If necessary, a multidisciplinary team of doctors (therapist, cardiologist, gynecologist, neurologist and others) will take part in the treatment.
The capacity of the new center for outpatient oncological care allows for more than 140,000 consultations per year, which is 30 percent more than in the old dispensaries where patients in the Central Administrative District received care. As a result, it will be possible to get an appointment with an oncologist as soon as possible, without delays or queues.
In accordance with the new standard for the provision of oncological care, the CAPC will provide a wide range of therapeutic and diagnostic procedures, including biopsy (examination by the method of tissue and cell sampling), ultrasound and functional diagnostics (ultrasound Doppler ultrasonography, echocardiography, electrocardiography), dermatoscopy (examination of skin lesions using special equipment) and others.
The necessary analyzes and research will be carried out by the ultramodern center of pathological and anatomical diagnostics and molecular genetics, located in building No. 18 of the City Clinical Oncological Hospital No. 1.
In the offices of specialized specialists (urologist oncologist, gynecological oncologist, mammalian oncologist, oncodermatologist, oncoproctologist), equipment is installed for conducting examinations of the highest quality. In particular, at the center it will be possible to perform a breast biopsy under ultrasound control already during the initial appointment.
An operating room for minimally invasive interventions with a wake-up room and a pain treatment room will also be organized in the outpatient oncological care center.
Spaces for comfortable waiting in a cozy and calm atmosphere – with comfortable furniture and designer interiors, soft lighting and air conditioning, Wi-Fi and TV – are provided on all floors of the CACS for patients and accompanying persons.
The outpatient oncological care center of the GKOB No. 1 plans to admit its first patients on October 25, 2021. It will be open daily.
Specialists of oncological departments, which were previously located in the building of the State Clinical Hospital No. 1 on Baumanskaya Street (house 17/1), will be transferred to the new institution.
In 2019, on Zagorodnoye Highway, a major overhaul of building No. 8 of GKOB No. 1 was completed. In a seven-story building with an area of 9.7 thousand square meters, a modern center for oncosurgery with 200 beds, including 20 observational ones, was located.
By the end of 2021, it is planned to complete the overhaul of the neighboring building No. 7. The seven-story building with an area of 14.6 thousand square meters will house the departments of radiation, endoscopic, ultrasound and functional diagnostics, chemotherapy (with day hospital), oncourology, resuscitation and intensive care, an operating unit other. A total of about 200 beds will be organized, including day (short-term) beds, intensive care and awakening beds.
A new standard for cancer care
Moscow is the Russian leader in the application of modern technologies and methods of cancer treatment. In 2019, Sergei Sobyanin approved a new standard for cancer care for the population of Moscow. During 2020, the main provisions of this standard were introduced into the practice of the capital’s healthcare.
On the basis of the largest city hospitals, six multidisciplinary oncological centers (clinic, pathomorphological laboratory, outpatient oncological care centers) have been organized with a full range of clinical capabilities: diagnostics, surgical treatment, drug therapy, dispensary observation and others. Each center has a population of one or two administrative districts of Moscow.
Thus, all stages of the provision of specialized care – examination, treatment and dispensary observation of patients – are carried out in the structure of one medical organization, which makes it possible to reduce the time for making a diagnosis, increase its accuracy and begin treatment faster.
The bed fund for oncological patients is 1776 beds, including 255 radiological beds.
A standard for an outpatient oncological care center (CAPC) has been created and implemented with the ability to perform all diagnostic tests necessary to establish or exclude a diagnosis of cancer.
There are currently four CACOs in operation, including:
– a center based on the city clinical hospital named after S.P. Botkina – for residents of the Western District;
– two centers on the basis of the city clinical oncological hospital No. 1 – for residents of the North-Eastern and Central districts;
– a center on the basis of the city clinical hospital No. 57 named after D.D. Pletnev – for residents of the Eastern District.
In 2022, it is planned to open the CAPO on the basis of the city clinical hospital No. 40 for residents of the Southern and South-Western districts.
In 2020, 286 288 hospitalizations were carried out (in 2019 – 214 742), 9132 courses using radiation therapy methods (in 2019 – 8142), 248 012 courses of chemotherapy treatment (in 2019 – 164 106).
For eight months of 2021, 207,767 hospitalizations, 6385 courses using radiation therapy methods, 180,328 courses of chemotherapy were carried out.
In each multidisciplinary oncological center (GKB No. 57 named after D.D. Pletnev, MKSC named after A.S. Loginov, MGOB No. 62, GKB named after S.P. Botkin, GKB No. 40, GKOB No. 1) a supermodern pathomorphological laboratory has been created. In 2019-2020, the Moscow Government carried out a large-scale re-equipment. In total, more than 300 units of medical equipment were purchased.
As a result of the re-equipment of the laboratories, it became possible to organize work according to the most modern standards:
– conduct research for the individual selection of targeted and immune therapy for patients;
– to reduce the time for conducting pathomorphological studies;
– to automate the process of processing the diagnostic material as much as possible;
– go to the digital environment – digitize images with the possibility of archiving them, consult on complex and controversial cases with experts from cancer centers, provide consultations to other regions, and exchange experience with colleagues from Europe and the United States.
Due to the increase in the productivity of the equipment, the number of studies being carried out for the selection of targeted and immune therapy for cancer patients is growing. So, in 2020, the number of histological studies increased by 12 percent (up to 1.23 million), molecular genetic studies – by 93 percent (up to 14.45 thousand), immunohistochemical studies – by 15 percent (up to 140.14 thousand).
For eight months of 2021, 852,377 histological studies were carried out, including 13,017 molecular genetic studies and 122,801 immunohistochemical studies. Due to the re-equipment of laboratories, the number of studies for the selection of targeted and immune therapy for cancer patients has grown significantly. This allows you to select the most effective treatment tactics using the most modern medicines.
In August 2021, a project was launched for the early detection and prevention of colorectal and stomach cancer. On the basis of the S.P. Botkin and the V.M. Buyanov created modern endoscopy centers equipped with the highest quality expert-class equipment.
The total capacity of the two centers is up to a thousand studies per day. Endoscopic examinations are performed for patients from risk groups (dispensary groups with precancerous diseases, genetic and family risks, age) in comfortable conditions under mild sedation.
Since the beginning of the project, 93 malignant neoplasms of the gastrointestinal tract have been identified.
Moscow became the first region in Russia to switch to new federal clinical guidelines for the treatment of the most common types of cancer ahead of schedule – three years earlier than the established date. From April 1, 2019, patients are prescribed the most effective targeted and immune drugs.
Modern medicines allow:
– to achieve control over the tumor, which increases the chances of saving the patient even with those cancers that were previously considered fatal;
– selectively affect certain types of malignant tumors, thereby avoiding many side effects;
– to influence certain mechanisms of malignant cells through the immune system, increasing resistance to cancer and protecting a person from various diseases and infections;
– to make the treatment process more comfortable for the patient, because the drugs can be used in a day hospital.
Since the beginning of 2021, 31,760 patients have received drugs for drug therapy for six types of cancer (breast and prostate, kidney, rectum, lung, melanoma) (34,745 patients in 2020).
In total, 39 421 patients were provided with drug therapy for oncological diseases during this period (in 2020 – 43 188 patients).
Monetary compensation for the purchase of medicines was received by 303 patients with cancer (in 2020 – 675 patients).
“From January 1 of next year, Moscow is introducing additional high standards for the treatment of oncological diseases in four more nosologies, and this covers 90 percent of all oncological diseases in Moscow,” added Sergei Sobyanin.
Patients with cancer of the bladder, ovary, stomach, head and neck will be able to receive drug therapy.
In addition, Moscow is ready to borrow the best foreign methods of cancer treatment. “We have launched a program of observational studies of modern technologies and world-class treatment in order to determine which of them are acceptable and effective for Moscow healthcare. I hope that my colleagues, together with the scientific community, are doing this work effectively, ”he said.
Moscow City Cancer Register
In August 2020, the integration of the Moscow City Cancer Register and the Unified Medical Information and Analytical System of the City of Moscow (UMIAS) began. This made it possible to combine data on cancer patients previously contained in different information systems.
Data on the current stage of treatment or dispensary observation of the patient, information on the dynamics of the disease, performed laboratory and instrumental diagnostic methods, consultations of specialists are displayed in the patient’s oncological passport in UMIAS and is available to oncologists of outpatient oncological care centers.
Personal assistant: service to guard the health of Muscovites
Also in August 2020, the Moscow Government launched a pilot project “Personal Assistant” for citizens with cancer.
The functions of assistants were taken over by employees of the centers of public services “My Documents”. Specialists help patients with oncological diseases make an appointment with the necessary specialists, take tests and conduct research, remind them of an upcoming visit to a doctor, enter information into the city cancer registry, and solve emerging problems.
Information about the possibility of personal support is provided in polyclinics when referring to an oncologist. Upon consent, patients are given a card with the phone number of the future personal assistant.
Currently, the “Personal Assistant” project covers patients with suspected or confirmed oncological diseases in all administrative districts of Moscow.
68 specialists are involved in the project, who have already provided assistance to about 30 thousand Muscovites.
High-tech medical care
Most types of specialized oncological care are included in the basic compulsory medical insurance program. In addition to the basic program, patients in need receive free 3D and 4D radiation therapy in 14 city, federal and private medical clinics.
Proton therapy is carried out at the S. Berezin Medical Institute. Since the beginning of 2021, 43 patients have been treated there (in 2020 – 44 patients).
In just eight months of 2021, 6385 cases of treatment were completed within the framework of high-tech medical care (3D and 4D radiation therapy).
City Cancer Council
Leading oncologists take part in the work of the city council on the profile of “oncology”. The chairman of the council is Igor Khatkov, the chief freelance specialist oncologist in Moscow.
The city council allows doctors to quickly find non-standard methods of treatment for the most difficult patients, as well as accumulate the experience of the best specialists in the city for the selection of therapy for patients with a complex clinical picture. The council is attended by the main specialists of not only city, but also federal centers, and, if necessary, doctors of related specialties are involved.
The tasks of the city council include making decisions on the prescription of drugs to patients in cases where a non-standard clinical approach or prescription of drugs that are not provided for by clinical guidelines or are not included in the list of drugs for additional provision is required.
During the work of the city oncoconsilium, 49 meetings were held, 246 clinical cases were examined (229 unique patients).
The oldest oncological hospital in Moscow
City Clinical Oncological Hospital No. 1 is one of the oldest specialized Moscow clinics. It dates back to 1946. Specialists have accumulated unique experience in the treatment of malignant neoplasms of various localizations.
On the main territory of the hospital on Zagorodnoye Highway (building 18a) there is an oncosurgical building, a center for pathological and anatomical diagnostics and molecular genetics, and an outpatient oncological care center for residents of the Central Administrative District. The institution also includes the CAO for residents of the North-East Administrative District, located at 26 Durov Street.
GKOB No. 1 provides assistance in the main areas of oncological profile, such as oncourology, gynecological oncology, tumors of the head and neck, skin, breast, esophagus, stomach, liver, pancreas, small and large intestine, lungs and mediastinum (organs located in the pleural area).
The first oncological hospital in Moscow is one of the few clinics in the capital, where operations are performed on patients with one of the most severe forms of cancer – head and neck tumors, followed by reconstruction of the facial skeleton, which is necessary to preserve the patient’s quality of life.
The hospital performs about seven thousand operations to remove cancerous tumors every year. Surgical operations are performed both in the traditional way and using minimally invasive methods of laparoscopy.
The hospital employs 1,052 people, including 291 doctors (17 doctors and 34 candidates of medical sciences), 332 nursing staff, 12 nursing staff and 417 other staff members.
About 69 thousand people are registered at the dispensary. In 2020, medical care was provided for 154.1 thousand calls, of which 115.6 thousand were with malignant neoplasms, as well as 13.1 thousand hospitalizations.
EDITOR’S NOTE: This article is a translation. Apologies should the grammar and or sentence structure not be perfect.