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Prof. Dudov, what is the level of Medical Oncology in Bulgaria compared to the EU and the US? Can we claim a patient gets here what they would receive in Germany, for example?
Medical Oncology in Bulgaria meets highest European and world standards in knowledge and therapeutic options. Nevertheless, diagnostic capabilities as well as some treatments are closely related to the need of the latest generation of equipment. In this sense, pure Medical Oncology (chemotherapy) of solid tumors is at a very high level. So far difficulties were present mainly in obtaining optimal diagnosis and concomitant or subsequent radiation or nuclear treatment.
In Germany, quick and effective diagnosis of malignant tumors is done for a short time and at one place. Then the patient’s is promptly reviewed by an Oncology Committee and their treatment starts – chemotherapy, radiotherapy or a combination of both. This is a huge advantage since timely treatment ensures better results. To start it, however, it requires a perfect timely diagnosis in all its aspects. This is true – from the plain X-ray through the CT, SPECT/CT, other scintigraphy exams, PET/CT, etc.
What do we lack in logistics (organization) and therapeutic guidance in Bulgaria in order to reach the highest level?
Therapeutic guidelines in Medical Oncology or also called Pharmaco-Therapeutic Guidelines (FTR), are an extraordinary success in Bulgarian medicine. The decision to have such mandatory documents standardizes care for cancer patients in the country also in the treatment in various fields.
Launching the work at City Clinic Oncology Center is coming soon. Why did you decide to head it and what more is there? What shall a patient find there – what cannot be found elsewhere?
Joining the team at City Clinic Cancer Center was a great challenge. I love being engaged in complex treatment of cancer patients. Outstanding specialists in the fields of Surgery, ENT, Radiotherapy, Diagnostic Imaging, etc. are my peers at this unique hospital of the future. Tumor location and histological properties, genetic tests, PET/CT, specific isotopes – all these provide vital information in building the diagnostic and treatment algorithm in the tailored care for each patient.
Radiation therapy offers unique methods of patient care – linear accelerators having not only the best hardware but also unique software needed in the treatment of various locations, including stereotaxic radiosurgery – in the past Bulgarians used to travel to Western Europe or Turkey for it. Now even foreign patients can benefit from this device: quick and efficient radiation surgeries within minutes of primary brain tumors and/or metastases in various body locations; radiation surgeries of primary and metastatic tumors in the lungs, pancreas, liver, lymph nodes, retroperitoneum and many other places difficult to access. All of this is entirely new for Bulgaria and it significantly increases the chances of curing and providing a longer duration of life.
The brachytherapy equipment is unique, too – application of local radiotherapy in locations of cervical cancer, prostate cancer and tumors of the head and neck. This will not only result in prolonging lives of a huge group of patients, but it shall also avoid surgical interventions since removing part or the whole tongue, salivary glands, parts of cheek, ear, etc. is not only painful but brings a large-scale social and physical trauma to the patient.
Moreover, combination of radiation with chemotherapy shall be one of the top perspectives at City Clinic Cancer Center, introducing the organ-saving approach.
Medical Oncology (Chemotherapy) at the Cancer Center shall encourage classical anti-cancer drug treatment hand in hand with a targeted biological therapy. Leading specialists at the Genetic Lab shall provide medications under schedule – what and how much of what is needed when.
Have you provided for a complex treatment of malignancies? Does the National Health Insurance Fund reimburse these procedures?
City Clinic Cancer Center University Hospital provides comprehensive cancer treatment, including under the signed agreement with the National Health Insurance Fund. I have already mentioned some of the main methods of the latest generation of treatment.
How do you plan to beat your competitors? Prices, equipment, specialists, easier access?
We offer it all, but as I have always pointed out: teamwork is the main part of it all. Besides, offering high-quality services and latest generation of equipment at a local site is attractive enough to make people reconsider going to Turkey of Germany for their treatment. Moreover, we are going to offer a Counseling Center where they may obtain informed choices on their impartial informed consent.