Hacettepe University Faculty of Medicine
Preventive Oncology Subdivision
Preventive Oncology Subdivision carries out the activities on determining the cancer load in our hospital and country, evaluating cancer risks in individuals, prevention of cancer by controlling the individual expositions around the person that can cause cancer and their cancer causing mechanisms (primary protection), enabling early diagnosis and treatment of cancer with routine clinic and laboratory evaluations and scanning (secondary protection), protection and improvement of psychological health and life quality of cancer patients and their families by enabling them to cope with the stress caused by cancer diagnosis and treatment (tertiary protection), offering training and consultancy services about the life style changes that may be necessary and evaluating the effects of these services.
The subunits offering service within the division are as follows:
• Smoking Cessation Unit
• Cancer Record Support Unit
• Cancer Risk Assessment and Early Diagnosis Planning Unit
• Life Quality Assessment Unit
• Psychosocial Oncology Unit
• Assessing the individual’s cancer risk
• Offering smoking cessation service for individuals
• Preparing special customized scanning program for individual according to the risk level
• Assessing the life qualities of patients
• Providing psychosocial support for patients
• Practicing individual and group trainings on protection from cancer
FOR SOCIETY OR SPECIAL GROUPS
• Execution of hospital cancer recording system
• Contributing on forming a public opinion about protection from cancer
• Determining scanning principles and applying them for the served groups
• Assessing the occupational cancer risks and accordingly training occupational groups
• Making the necessary planning to provide social and psychological support for cancer patients
• Providing consultancy services for questions that may rise from individuals, organizations, or media
• Giving academic lectures about preventive oncology to relevant individuals
• Providing methodological support for cancer studies in relevant fields
At the present time, tobacco is the most lethal substance and smoking is the most significant addiction factor. 1 billion people in the world have still been smoking. Approximately the half of smokers die due to a reason related with smoking, one out of every 5 people get cancer. The life expectancy of a smoker is approximately 10 years shorter than a non-smoker. In 21st century, it is estimated that 1 billion people will die due to reasons related with smoking, and this number is greater than the number of people dead due to any war, disaster or disease in the world, until today. Thus, smoking is the most significant epidemic in the world and it is defined as the first health problem, by World Health Organization.
The most effective method in delimitating tobacco usage is to enable prevention of starting smoking. It may be possible with only training the adolescents and younger adults, however there are several social and psychological barriers ahead of this approach.
A considerable number of smokers have started to desire stop smoking, with the harms of smoking have become well-known. However the dependence level of tobacco is so severe, only the 5% of the people who try to stop smoking without getting any support are able to be non-smokers at the end of the first year. A person who is determined to stop smoking succeeds after approximately eight trials, however a considerable part of them can completely quit smoking unfortunately after a severe health problem is developed. The success rate can be increased considerably with the help of persons and clinics specialized on smoking cessation support.
The contributions consultations and psychological supports to be provided for persons who try to quit smoking should not be underestimated. The success rate of attempts with the support of persons and clinics specialized on smoking cessation is two times higher than the attempts without support. Generally these clinics also provide pharmacological support, therefore they increase the success rate further.
The major purposes are to remind people the significance of smoking cessation and its benefits and corroborating these information with clinic visits and phone calls, to embody their reasons for smoking cessation and to teach and support the methods for coping with the nicotine deprivation symptoms above all. Especially the group meetings are observed to be effective on improving motivation. Behavioral therapy may also be performed on people who failed after repetitive smoking cessation trials.
Smoking Cessation Unit of Hacettepe Oncology Hospital offers a fully equipped clinical service from the moment on that you decide to quit smoking, with specialized physicians, psychosocial support specialists and health care personnel, in order to help you in quitting smoking by providing the truest medical and professional support for you. When you apply to Smoking Cessation Unit with the referral document that you receive from the relevant health institution; blood examinations, breath carbon monoxide tests, complete health evaluations with consultations with other clinics and with monitoring methods are performed when deemed necessary, without charging extra costs. Following the required clinic examinations, the appropriate medical treatment and psychosocial support will be planned by interviewing.
Collecting and reporting the data on patients with cancer are required for correctly identifying the greatness and features of cancer which varies geographically, in each country. The widespread computer usage has enabled these systems to be developed easily and worldwide standard recording systems to be established. In our country, difficulties exist in operating recording systems rather than installing them, and even in hospital-based activities, the cancer records are lower than expected. These difficulties result from the differences of data collecting orders between the different sections within the hospital and the procedure of filling form is not included within the procedures when each patient comes. Reaching the collected data in different sections by cancer record staff who are trained especially for this purpose, controlling the data with computer network and completing the deficiencies, transferring the collected data to the cancer record system in certain intervals will considerably eliminate these problems.
Cancer Record Systems, are the systems developed for the data of cancer patients to be collected, saved, analyzed, interpreted and notified systematically. It is unquestionable that a regular cancer record system will have a big contribution to any kind of researches on cancer cases. Especially in prospective researches, when the losses in unacceptable ranges in patient follow up phase in developing countries are taken into account, even the contributions on following up shows that the cancer record systems are significant requirements. Furthermore, in our time that the health care policies gain importance, the reliable databases have made great contribution on planning health care services. The activities which the computer usage is put into service in hospital administration to the best advantage, exist in the literature. Cancer record systems are separated into two: hospital-based and population-based. Hospital-based cancer record systems are constituted at hospitals and includes only the information related with the cancer patients that are examined in that hospital. Their purpose is to contribute to the hospital services by enabling easy access the data such as treatments applied for patients with cancer and the results of treatments. Population-based cancer record systems collect the data related with all patients with cancer among an identified population. Population-based cancer record systems offer service especially on epidemiology and public health, through enabling the presentation of incidence and mortality rates.
Population-Based Cancer Record Systems
This kind of systems should distinguish the natives and non-natives of a certain region. They should also contain sufficient data on each case, to prevent multiple records to exist on the same case. All health care sections and health care personnel to have collaboration is a significant element for a well-functioning cancer record system. Obtaining reliable and prevailing information will be possible only with such a collaboration. Since the population-based cancer record systems concern about each new cancer case and it use it to define the population under risk, censuses that present age and gender information for the region correctly are necessary.
The dataflow to population-based cancer record systems arise from the following sources:
• Data obtained from treatment services; cancer centers, large hospitals, private clinics, nursing homes, practitioners.
• Data obtained from diagnosis centers; especially pathology laboratories, hematology, biochemistry and immunology laboratories.
• Death certificates and death record systems.
Information is obtained from these sources with two methods. Active Collection: In this record system, collection is performed by relevant personnel to visit data sources regularly and to collect the required data on related forms. Passive Notification: It is performed by healthcare services personnel to fill the forms that are developed and delivered by record system or to send the copies of patient epicrises to the record center. The data collected with both methods are used in record systems. Medical Record Sections at hospitals are also among the important record sources.
A different "cancer record number" is given by record system for each case. If a patient has more than one primary tumor, different record numbers for each tumor should be registered. Name-surname, gender, age and address are the important basic information. Address is particularly important for the purpose of determining the conditions of living place and following up. Age is a valuable determinant for defining the cancer incidence. The date that the cancer exists, should be considered as the date that the patient's first apply to hospital due to cancer or the date that the consultation is requested, thus the data should be able to be controlled when needed.
If this information cannot be obtained only following dates can be used as the date of existence: diagnosis date, date of first pathology report, death date if the cancer is firstly realized with death certificate or autopsy. Asking the prevailing diagnosis method enables evaluating the reliability of incidence rates. At least whether the diagnosis is made microscopically should be recorded. It is necessary to define the localization and the morphology of the tumor in accordance with the ICD-O (International Classification of Diseases - Oncology) classification. The location of the primary tumor in tumor localization should be stated. This data is the most significant information that is recorded and it constitutes the base of cancer record system data classification. The morphology code used in ICD-O classification defined the histological type and behavior of the tumor.
How much the disease spreads before treatment, treatment methods and various follow up criteria are among the items that are optional to be recorded in the database. A detailed code list about the source that the data is obtained should be in each cancer record system.
Population-based cancer record systems should publish the obtained indications and results in cancer incidence reports, certain private reports and scientific journals as articles and should convey the collected information to users. These reports should contain the features of cancer record system, record methods, definitions of included population and residential area, statistical methods and indications. The data should be presented with tables and graphic methods.
The epidemiological researches in each line are able to obtain support of the data of cancer record systems, in terms of their definitions.
Hospital-based Cancer Record Systems
Hospital-cased cancer record systems and Medical Record Sections are the basic elements of hospital-based data systems, which are commonly benefited in establishing and evaluating the needed cancer services at hospitals. One of the most important sources of well-operating population-based cancer record systems are also hospital-based data systems. The Medical Record Sections among them, are the sections that should be present at each hospital are established in all developed countries to be used for preserving all hospital records, for reapplying and for analyzing. In developing countries, these sections are quite restricted and generally they are stores in where bulks of printed records are kept. The necessity of the centers in where the hospitals records are kept in preplanned, reliable and coded manner, are also felt in our country. Furthermore, these sections create significant resources for other privatized systems, such as hospital-based cancer records systems.
Hospital-based cancer record systems offer services for the hospital administration, cancer program of the hospital and the cancer patients. It is also one of the sources of population-based cancer record systems.
Hospital-based cancer record systems give information on the localization of cancer types, incidence age, phase distribution, treatment methods, responses to treatments, paces of life by creating reports on the cancers observed within the year. These data are used in determination of prospective treatment, material and personnel requirements. It has also considerable contributions to cancer researches in clinic and patient follow ups.
In addition, hospital-based cancer record systems set a good model for population-based systems in determining, summarizing, coding and analyzing activities of cases. Establishing standard systems will enable the cancer information to be compared by hospitals in different regions.
The patient records of below mentioned departments are aimed in Hacettepe University Cancer Record System.
• Adult Hematology
• General Surgery
• Chest Diseases
• Chest Surgery
• Gynecology and Obstetrics
• Cardiovascular Surgery
• Medical Oncology
• Nuclear Medicine
• Orthopedics and Traumatology
• Pediatric Surgery
• Pediatric Hematology
• Pediatric Oncology
• Pediatric Pathology
• Plastic and Reconstructive Surgery
• Radiation Oncology
Within the Risk Assessment unit, the Cancer Risk Assessment Questionnaire which is prepared by our division is applied to individuals and their knowledge, approach and behavior levels are determined with the answers on personal, familial and life style characteristics and significant scanning programs that may pose cancer risks. Following the assessment, required treatments and tests are carried out, behavioral change is suggested when deemed necessary, the customized ideal scanning planning is made and offered for the patient.
According to the primary protection perception in Preventive Oncology concept, a considerable distance can be covered in protection from cancer by performing the required assessments and arranging the life style of the individual before the cancer occurs. The individual is subjected to a complete physical examination, all tests and monitoring methods are performed, moreover environmental and occupational risk factors are assessed along with personal habits. A customized protection plan is prepared in accordance with the results.
In Early Diagnosis unit, the early diagnosis programs are constituted and individuals are subjected to long-term follow op processes by means of regular scanning programs against potential cancers as a result of long-term exposures. Thus, the treatment can be started in earliest period against the cancer that may develop.
It should not be forgotten that you should not be afraid of cancer, but of being late.
Determination of how the patient feels himself and to what extent his health allows him to carry out his daily activities at a satisfactory level is listed among the most important criteria of assessing a patient, in addition to objective medical assessments. This determination, called as the assessment of the individual’s life quality is performed by our division in a way that helps the physicians to follow up the disease in routine application using the Life Quality Scales developed abroad specifically for each type of cancer and adapted to our country with appropriate studies.
In the individual interviews in Psychosocial Oncology Unit, the consultation services are offered on following issues:
• The adaptations of patients and families to the life changes exits along with the disease,
• Lightening the emotional load,
• Increasing the adaptation to treatment process,
• Preserving the quality of life as far as possible,
• Increasing the problem solving skills,
• Making the support systems to be noticed and bring them into action,
• Increasing conflict resolution and coping powers
The problem areas of patients in their daily lives are determined by "Daily Life Quality" assessment.
Patients are referred to Psychiatry Outpatient Clinic, when needed.
Individuals and working personnel who attend the Smoking Cessation Program may also receive support from the unit, in addition to the patients and their families. Smoking Cessation Program Support Groups have still been proceeding.
Clinic researches on cancer, are the most significant sources of information for preventing cancer or for minimizing the cancer related health problems, as in all other medical branches. These researches are practiced occasionally on the basis of preventing cancer in healthy individuals and from time to time for healing the cancer patients or for making the disease a common problem that can be lived together. Several researches are able to bring the newly developed cancer treatments for free of charge and the cancer patients in Turkey together, at the same time with the world.
With this, the misconception in society is that the patients are used as cavies in these researches. However, any clinic research cannot be carried out without getting approval of Ethical Committee, consisted of specialized individuals who control whether the researches have qualifications to provide more benefits. By means of the studies carried out with hundreds of people, only the treatment methods which are certainly more efficient than the previously used treatments can come into clinical use.
The essentially dangerous thing which is accepted in society is the uncontrolled usage of several methods whose efficiencies have not been shown with scientific studies, even the statistics have not been kept on whether they are dangerous or not. That kind of practices are sometimes carried out by individuals who claim that they are selling health in places such as spice and plant stores, putting on a white coat although they do not have any medical training, having the only skill to sell the product with the self-confidence; and sometimes by individuals being healthcare personnel, however recommending additional plants, spices or synthetic products with a magical presentation to patients under on-going treatments, although they are not competent on those fields and commercialize the unprofitable products by appropriating the medical treatments of patients and who desire to gain fame and money briefly. For that reason, these events are interferences that are far from any health standard or supervision, based on trial and error in defiance of human life.
Since cancer is a disease which creates social and personal fear more than it deserves, especially cancer patients feel that they need these outdated interferences and they become subjects to them. Cancer medications are products that are established with knowledge and put into use after their benefits are proved by the researches of well-educated scientists. After scanning millions of molecules, spending billions of liras and researching for years, every year only a few medications are deemed to be used in human treatment and can be put into service for human. Preferring the usage of products recommended by uncompleted people, instead of medications that are developed under hard research conditions, with an unnecessary fear or hopelessness feelings, will be a great mistake for patients and individuals trying to protect themselves from cancer.
The unit within the division was established with the aim of supporting this kind of researches to be carried out with high-quality in our country. You can contact our subdivision to obtain information on conducted researches by dialing +90 (312) 305 43 30.
The first examination and control appointments can be received by applying the subdivision on floor 0 (zero) of Hacettepe Oncology Hospital Clinics Entrance in person or by dialing 444 4 444. The same procedures are applied for Smoking Cessation Clinic appointments. Meetings and examinations of Smoking Cessation Clinic are carried out on Tuesdays and Fridays every week at 09:00, in Training Room of Subdivision. Subdivision proceeds between 08:30 and 17:30. It is sufficient for the patients with official security to apply with referral documents.
The subdivision located on floor 0 of Hacettepe Oncology Hospital Clinics Entrance can be reached through the Clinics entrance, Outpatient Clinics entrance, or the -2 entrance.
Telephone and Fax Numbers:
+90 (312) 305 4330 (Head of Department's Office)
+90 (312) 305 4331 (Outpatient Clinic)
+90 (312) 306 6226 (Fax)