“Doing a bit of history, the hospital day started six years ago in the “San Pablo”, refers Dr. Vicente Villalba, chief physician of this oncology division of the maternal and child general hospital.
Ambulatory care
The concept of “day hospital” alludes to the ambulatory nature -of no more than one day’s duration- of each cycle of chemotherapy provided to cancer patients. It contrasts with another modality that involves hospitalization for two or more days in a hospital.
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Increase
Dr. Villalba remembers that they grew rapidly. Initially having two chairs for chemotherapy application, today they have 32 seats, if we talk about availability in two shifts. A year after Hospital Día began to increase in the number of armchairs “We advanced from 2 to 8, with which we stayed for two years.”
New and better space
A new and better space was also part of the growth of the “San Pablo” day hospital.
“When a large part of the services moved to the new hospital building, we moved into a place that was previously used by the Neonatology service in the old premises. It we recondition and we re-equipped with the specificities of a day hospital”.
Along with a new space for patients and health professionals, a state-of-the-art laminar flow hood was installed for the preparation of oncology drugs, essential for the biosafety of health personnel and patients. This was a generous contribution from the Health Council of the Municipality of Asunción, according to Dr. Villalba.
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SICAM support to projects
“We still have plans to grow and keep moving forward; expanding our portfolio of services”, says the oncologist.
This year, the late shift will be enabled for patient care. And today they are inside a Women’s Cancer System project (SICAM)a North American entity that carries out projects with emerging countries and, within them, is helping Paraguay obtain cancer drugs.
We present to SICAM a project for breast cancer care -continues Dr. Villalba- that not only involves provision of medicines, but also equipment.
part of the way
Advancing despite the needs is part of the story of having started from scratch to go after the dream of a day hospital for patients from Asunción and other parts of the country.
“Looking back and seeing how we are today is a source of pride for all of us. And not only for those of us who work in day hospital, but for all of San Pablo. Let us remember that the citizen of Asunción did not have the possibility of a center that could provide a comprehensive cancer care; the closest he had was the Hospital de Clínicas and then the National Cancer Institute. Sometimes, even for a patient who lives in the interior, it is easier to get to the capital. This is reflected in the number of patients we receive from Asunción and from many towns in the interior. An advance, however, is that today we already have many oncology hospitals operating in the departmental capitals”, the doctor remarks.
Comprehensive care
The application of chemotherapy for cancer patients It is the most visible part of the complex care provided by the “San Pablo” day hospital. Describes Dr. Villalba:
“The care is comprehensive. Cancer treatment today is multidisciplinary, where there are several professionals who are caring for a patient. When that patient arrives at the hospital one day, the correct thing to do is to stage the disease. Based on the staging and extension studies, a treatment is planned and, if it involves using chemotherapy, the patient is told from the beginning the number of cycles, and the periods in which the medication has to be applied. And this control implies, in each consultation or application, a comprehensive control of how the patient is doing clinically – nursing monitoring of weight, vital signs – how are their laboratory controls and the results of their extension studies. And the control goes from the moment the patient arrives; chemo is applied, until he is discharged on the day, with his instructions on what to do, what medication to take at home and when to return”.
The accompaniment is comprehensive, continuous and inter-disciplinary, as defined by the oncologist. “In this care, not only are clinical oncologists, but also nutritionists, dentists, transfusionists, psychologists, and surgeons.”
In the day hospital, all support procedures for a patient are also carried out, which include treatments and transfusions of lobular and platelet concentrates, specifies Dr. Villalba.
human resources
The San Pablo day hospital works with four medical oncologists, eight nurses divided in two shifts, a surgical oncologist, gynecological-oncologist surgeons, general surgeons. “Of course, we need more people,” says the oncologist.
State-of-the-art treatments
The “San Pablo” day hospital “has all the latest generation chemotherapy application treatments, from classical chemo, through monoclonal antibodies, immunotherapy, hormone therapy. It is a very broad spectrum, whose indication depends on the biological type of cancer that the patient has. Today we can make these diagnoses in 100% of patients”, adds Dr. Villalba.
Most common forms of cancer in women
Villaba details that the 90% of cancers in women treated at the hospital on the day of “San Pablo” corresponds to breast cancer. “It is followed by cancer of the cervix, endometrium, ovary, vulva and vagina.”
A call to control for early detection
Villalba ends by expressing “The figures for breast cancer are worrying and the fact that most of our patients come to advanced stages. That is why the campaign of the Pink Octoberto call for a control that allows early detection and timely treatment”.
