INTERGRATED ONCOLOGY SERVICES

Intergrated oncology services RSUP H. Adam Malik is one of the services seeded ones expected to take precautions and treatment of the disease cancer is increasingly increased both quantity as well as its particular quality in the northern part of Sumatera. Role as a hospital national oncology referrals already year 2014, since the issuance of the decision minister of health republic Indonesia no. 02.02/MENKES/390/2014.

Activities undertaken in order to prevent and treatment of cancer at RSUP H. Adam Malik that is:

1. Promotive efforts include lectures monthly routine, lay seminar, talk show at television, brochures, banners, newspaper magazines and social media.

2. Preventive effort covers the ban for smoke hospital environment minimize radiation exposure in radiology, radiotherapy, and nuclear installation; avoid using containing foodstuffs preservatives, flavorings, synthetic dyes and flavoring and flavoring in nutrition installations and hospital canteen; lectures/seminar lay about prevention of cancer; and surgery to prevent cancer.

3. Early detection of cancer includes mammography, Usg mammae, Pap Smear, Vaksin for cancer, bronkoskopi, Endoskopi; lecture/seminar on early signs and symptoms of cancer; and brochures and banners about
   early signs and symptoms of cancer.
4. Cancer therapy include surgery, from small to large tumors (from early stage to Advance stage); Chemotherapy, Hormone therapy, Target therapy, in rooms and nurses with special skills; brachyterapy and radiotherapy; nuclear medicine.

Treatment of cancer is a combination from some therapies and integrated. For example, surgery followed by chemotherapy, or it could be radiation followed by chemotherapy. Which type of therapy and combination is selected, depending on the type of cancer suffered by the patient. Integrated Oncology Services has three integrated units for therapy, namely radio therapy / radio oncology, nuclear medicine and chemotherapy.

A. Radio Oncology / Radio Therapy

Oncology Radio Service is located in the building of Central Medical Unit (CMU) 1st floor of RSUP H. Adam Malik already has some advanced equipment that is Linear Accelerator (LINAC), a variant for external radiation activity. This tool can minimize damage to healthy tissue, even the form of irradiation performed can be adjusted form of tumor. The Therapeutic Radio section has also been equipped with Intensity Modulated Radiation Therapy (IMRT) for cancer in the head and neck. To be more precise irradiation and not damage the surrounding tissue, a CT simulator is required as a tumor scanner. This tool is used to determine the patient’s position and the direction of irradiation before the actual external radiation is performed. In addition to external radiation, Integrated Oncology Services Oncology radio therapy unit also serves internal radiation using Brachytherapy tool. This tool uses radioactive material directed to the target cell using an applicator with a shell / catheter radiation source. This method is more effective because it is directed or killed directly to target cancer cells while minimizing damage to healthy tissue around the target radiation. The oncology radio unit is also capable of installing implants containing radioactive substances in target organs of certain types of cancer such as breast cancer, as well as cancer in the neck and throat areas.

B. Nuclear Medicine

For cancer diagnostics and therapies with nuclear medicine technology, Integrated Oncology Service is supported by sophisticated equipment. One of them is a gamma camera. This camera is able to process gamma radiation from the human body to be changed in the form of image data and numbers (graphs) so that it can be known form, the location and whether the organ is functioning well or not. Previously, patients were given radioactive substances either orally or by injection. There are two kinds of gamma cameras used in nuclear medicine namely Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET). The fundamental difference between these two cameras is, the type of radioactive substance used. SPECT tool capable of scanning tumor cells so that at the time of radiofarmaka giving target. Radiofarmaka is a radioactive drug capable of detecting and killing cancer cells directed. Called directional because it does not interfere with other healthy organs. In the nuclear radio section there are hybrid imaging tools that combine SPECT with computed tomography (CT). This technology can help determine the location of tumor cell anatomy. As a result, both diagnostic and therapeutic measures will be more accurate. Nuclear medicine diagnostic and treatment unit at 1st floor of Central Medical Unit (CMU) building of RSUP H. Adam Malik is adjacent to the unit room of Radio oncology / Radio therapy. This is in accordance with the radionuclear therapeutic procedure which states that patients within 3-4 days post radioactive therapy,prohibited directly blend in with the environment. They have to occupy a special room until the radioactive level is considered normal / environmentally friendly, after which the new patient may go home.

C. Chemotherapy

Integrated Oncology Services is performed by specialist physicians and subspecialist physicians in the field of oncology (cancer), is devoted to cancer therapy through chemotherapy that is the administration of drugs through intra veins or blood vessels. The service is done every working day at the inpatient room (Rindu) B 2nd floor of RSUP H. Adam Malik. There are 4 chemotherapy rooms with 24 beds for chemotherapy, which is divided into 10 beds for men, 10 beds for women, as well as two beds for the kids. Two special beds for cancer patients who also suffer from other diseases and must be separated with other patients. Integrated Oncology Services in Northern Sumatera region is still limited, patients with cancer can be handled immediately. Cancer disease if quickly treated, the development of cancer in patients can be minimized and resolved so as to increase the hope of healing and life of the patient.