Reporting Medical Council of Lviv Oblast-level Cancer Facility

On February 24, 2016 the visitors at the Lviv Cancer Treatment and Diagnostics Centre were given information on the analysis of the incidence, treatment and mortality from malignant tumors and the effectiveness of medical and surgical works, and with operation of the gynecological services in Lviv oblast. 

 

As of 01.01.2016, 62,493 cancer patients have been registered in the Lviv oblast, with 62% (38,751 patients) of those who have been put on record for over 5 years, including primary in 2015 - 7 974 persons. The women to men ratio is 1: 1. The increase in the incidence of cancer in the Lviv oblast for the past 20 years is 43%. 

 

In terms of the rates of incidence, the largest segment involves skin cancer (in the first and second stages, in 92% of the cases), breast cancer (78% - stage I-II), with lung cancer on the third place (29% of neglected stage). Stomach cancer occupies the 5th place in the structure of morbidity, but is the most troublesome because it has the highest level of negligence - 36%. Cervical cancer ranks 13th place in the structure of incidence with 85% of detected cases in stage I-II. 

 

Of the greatest concern at present in Lviv oblast and in the city of Lviv is a high incidence of gastric cancer and its negligence. The possible effective methods of early detection and effective treatment are dissemination of information via setting up Health Care Schools with regard to the possibilities of early examination, prevention of a disease and ways to overcome it among the medical community and patients. 

 

Late diagnosis, and therefore negligence of diseases is of the biggest concern with experts; thus general negligence in the oblast is 17% (the highest level in Zhovkva, Turka, Sokal districts and in the city of Boryslav; the lowest is in Busk, Zolochiv districts, in the Lviv Municipal Hospital № 5, and in the city of Chervonohrad). The growth in the number of neglected visual localizations of cancer is not a positive indicator: in 2015, 34.6% were registered in the share of initially recorded cases. The most neglected cases of all locations refer to throat cancer (54.9%), oral cavity (47%), stomach (36.3%), esophagus (28.7%), pancreas (23.2%), lungs ( 21.1%). 

 

 

 

71% underwent treatment, including 60% of those who received treatment at the Lviv Cancer Treatment and Diagnostics Centre. The lowest percentage of primary cancer patients treatment accounts for Kamyanka-Buska (64%), Zhydachiv (62.8%), Brody (62.7%), and Staryi Sambir (57%) districts, the highest percentage of treatment refers to the city of Stryi, specifically 77 2%. 

 

25.9% are covered with combined treatment; 39.7% in Skole district, 39.3% in the city of Chervonohrad, while in Kamyanka-Buska district it accounts for 20.3%, and 21.8 % in Turka district.

 

The mortality rate within the period of up to one year tends to decrease - 27.7% compared to the previous years (28.3%, 28.9%) and is the best in comparision with the national rate (31.4%).

 

The general surgical activity of the Cancer Treatment and Diagnostics Centre in 2015 accounts for 74.9%, the number of operations per the operating unit is 6 377. The highest surgical activity refers to breast cancer - 97.8%, head and neck - 96.8%, soft tissue pathology - 94.7%.

 

In 2015, 430 mastectomies were conducted; the number of reconstructive surgeries increased; subcutaneous mastectomies with implants increased from 9 in 2014 to 17 in 2015. The most common reconstructive surgeries is patient surgery after mastectomy and after radical surgery in the area of the head and neck.

 

Every year the tendency to increase in the number of minimally invasive surgery is preserved, specifically laparoscopic methods; thus 472 minimally invasive surgeries were performed in 2015, for example in 2012 - 303. A positive fact is that the proportion of postoperative complications accounts for only 1.6%, and postoperative mortality - for 0.3%. The physicians at the Cancer Treatment and Diagnostics Centre are highly skilled and qualified professionals who develop their skills and master new minimally invasive techniques and adopt effective European practices of treatment.

 

The operation of hospital beds at Cancer Treatment and Diagnostics Centre is recognized as effective, since the number of bed-days increased while the average bed-day has decreased. Compared with the previous year, the number of operations increased, including those refering to malignant tumors. The intensity of bed use in Lviv Cancer Treatment and Diagnostics Centre is on the 3rd place in Ukraine (after Kyiv and Kirovohrad inpatient units), and is higher than the rate at the National Cancer Institute.

 

The directions to improve cancer patient medical care have been defined, including:

 

1. Improving diagnosis - reducing the cost of treatment. Modernization of diagnostic facilities by means of the project "Preventive oncology and the implementation of effective anti-tumour technologies";

 

2. Enhancing the effectiveness of medical care:

 

- Wider introduction of minimally invasive and organ-saving interventions to reduce the level of disability and reduce of bed-day stay in the inpatient unit;

 

- Improvement of combined treatment (waiting for the proceeds by the state program and from the funds for co-financing of the regional program).

 

Head non-state oncologist of the Health Care Department, Mr. I.Kovalchuk, reported on the prospects of raising funds for the Cancer Treatment and Diagnostics Centre modernization and for the reconstruction of old buildings, including the successful implementation of the joint World Bank's and the MOH Ukraine "Serving People, Improving Health" Project in Lviv oblast, which aims to improve the health status of the residents in the oblast in combating malignant tumors. Since the treatment of malignant tumors is mainly focused on the tertiary level in Lviv Cancer Treatment and Diagnostics Center, therefore special responsibility falls on Cancer Treatment and Diagnostics Centre.

 

The Head of the Health Care Department of LOSA, Mr. B.Chechotka, expressed thanks to hospital staff and district oncologists in the city of Lviv and in oblast for their diligent hard work, enhancement in work intensity, for sensibility to patients; at the same time he stressed the need for careful communication with patients, careful performance of their medical commitments. Indeed, due to difficult financial state, problematic situations with provision under the state programs, clear information and frank but sensible attitude helps to find a sustainable solution for the majority of cancer patients.

 

Presentation materials of the Medical Council:

 

1. Analysis of incidence, special treatment, and mortality from malignant neoplasms in Lviv oblast in 2015.

 

2. Treatment at Cancer Treatment and Diagnostics Centre in 2015.

 

3. The state of oncology care provision for the population in the city of Lviv in 2015.

 

4. Surgical operation at Cancer Treatment and Diagnostics Centre in 2015.

 

5. Analysis of gynecological oncology service operation in 2015.