Memórias do INCA: 85 anos de histórias na assistência e no ensino em oncologia (1937-2022) / [INCA memories: 85 years of histories in assistance and teaching in oncology (1937-2022)]

A longeva história do INCA encontra-se registrada em diversas publicações, sejam elas institucionais próprias ou como parte de trabalhos de autores ou de organizações externas que versam sobre a trajetória do controle do câncer no Brasil. Entretanto, a maior parte dessa memória está direcionada para as políticas de saúde pública, estratégias e ações de prevenção que marcaram a gênese e o desenvolvimento do INCA nos últimos 85 anos, período em que o Instituto exerceu papel fundamental e pioneiro no controle do câncer em nosso país

Direct-to-Consumer Advertising for Cancer Centers and Institutes: Ethical Dilemmas and Practical Implications.

In the United States, many cancer centers advertise their clinical services directly to the public. Although there are potential public benefits from such advertising, including increased patient awareness of treatment options and improved access to care and clinical trials, there is also potential for harm through misinformation, provision of false hope, inappropriate use of health care resources, and disruption in doctor-patient relationships. Although patient education through advertising is appropriate, misleading patients in the name of gaining market share, boosting profits, or even boosting trial accrual is not. It is critical that rigorous ethical guidelines are adopted and that oversight is introduced to ensure that cancer center marketing supports good patient care and public health interests. Patients with cancer have been identified as an especially vulnerable population because of fears and anxiety related to their diagnosis and the very real need to identify optimal sources of care. Cancer organizations have a fiduciary duty and a moral and legal obligation to provide truthful information to avoid deceptive, inaccurate claims associated with treatment success. In this article, actionable recommendations are provided for both the oncologist and the cancer center's marketing team to promote ethical marketing of services to patients with cancer. This tailored guidance for the oncology community includes explicit communication on (1) ensuring fair and balanced promotion of cancer services, (2) avoiding exaggeration of claims in the context of reputational marketing, (3) providing data and statistics to support direct and implied assertions of treatment success, and (4) defining eligible patient groups in the context of marketing for research. These recommendations for cancer centers are designed to promote ethical quality marketing information to patients with cancer.

The founding of the Tata Memorial Hospital, 1932-1941.

This article presents a brief account of the founding of the Tata Memorial Hospital. It draws upon archival material to show that this was not a mere philanthropic act but a scheme carefully thought-out by the Trustees of the Sir Dorabji Tata Trust. It discusses the major concerns of the Trustees as they deliberated upon establishing the Hospital.

[A decade's review for the foundation, establishment and development of the Department of Minimally Invasive Gastrointestinal Surgery in Peking University Cancer Hospital].

Department of minimally invasive gastrointestinal surgery in Peking University Cancer Hospital (also named as Department of Gastrointestinal Surgery IV) was established on April 7, 2009. Up to now, ten years have passed since its foundation. As the first department built in specialized cancer hospital, which mainly focuses on laparoscopic surgery, its foundation and development has a very important historical and practical significance in the development of surgical oncology in China. Reviewing the rapid growth of the Department of Minimally Invasive Gastrointestinal Surgery over the past decade, on the one hand, it has benefited from the opportunities of the times and the support of leaders in Peking University Cancer Hospital at that time. More importantly, the progress owes to the pioneering Professor Su Xiangqian, who is brave and innovative, with indomitable spirit and advanced management philosophy. With rigorous training, the ability of the team has been steadily enhanced, the competitiveness has been gradually improved, and the development direction which focuses on laparoscopic gastric cancer surgery and laparoscopic colorectal cancer surgery has been established. Now, the Department of Minimally Invasive Gastrointestinal Surgery has become a well-known domestic gastrointestinal tumor center. In the past ten years, under the leadership of Professor Su Xiangqian, the growth of this team is innovative and comprehensive: (1) Introduce the internationally advanced Baldrige medical service management framework, and propose the "management by principle" concept to improve the core competitiveness of the department; (2) Establish an academic brand by laparoscopic standardized surgery training courses for gastrointestinal tumors, promote cooperation and exchange at home and abroad, and participate in international multi-center clinical research projects; (3) Adhere to the "formation of a research-oriented department, conducting clinical and basic research simultaneously" as the development direction; (4) Stick to the core development concept of team building and cultivate professional talents. Looking forward to the future, our team will not forget the beginning of the heart, and move forward! In the next ten years, we will break through ourselves and continue to pursue the higher level!

An appreciation of the science and philanthropy of Sir Oliver Scott, founder of the Gray Cancer Institute.

This Commentary focuses on the landmark paper about hypoxia in radiotherapy by Gray, Scott et al published in 1953. By then, it was known that hypoxic regions in tumours could make them resistant to radiation treatment and that this was a possible cause of failure. The paper proposed that oxygen breathing could substantially decrease this resistance without incurring significant additional damage to normal tissues, thus reducing the likelihood of recurrence. Although the paper's supporting data were in some respects incomplete, the case it made was convincing and it prompted pilot clinical trials that combined radiotherapy with oxygen breathing, including under elevated pressure. Research into tumour hypoxia and strategies to overcome its adverse effects soon expanded and entered full clinical trials. Meta-analysis of their results showed improved outcomes in accord with the original proposals of Gray, Scott et al. A secondary result of their 1953 work was the founding at Mount Vernon Hospital of what later became Cancer Research UK's Gray Cancer Institute. This project was initiated by Oliver Scott and construction of the new laboratories was funded by a donation that he provided.

Atuação do enfermeiro na reconfiguração do cuidado paliativo em uma unidade de referência nacional (2004) / Nursing performance in the reconfiguration of palliative care in a national reference unit (2004)

No Brasil, o século XX, alcançou políticas públicas voltadas para a oncologia, que influenciaram diretamente na organização e estrutura do Instituto Nacional de Câncer (INCA) e na assistência ao paciente em cuidados paliativos. Esse cenário contribuiu diretamente para o desenvolvimento de iniciativas voltadas à reconfiguração da assistência desses cuidados no Hospital do Câncer IV (HCIV). Esta pesquisa tem como objeto de estudo: reconfiguração do cuidado paliativo do enfermeiro em uma unidade de referência nacional, com vistas a obter a acreditação hospitalar. Os objetivos: descrever as circunstâncias que ensejaram a reconfiguração do cuidado paliativo oncológico do enfermeiro no HCIV; analisar as estratégias empreendidas pelo enfermeiro para reconfigurar o cuidado paliativo oncológico frente ao processo de acreditação hospitalar no HCIV; e discutir os primeiros efeitos simbólicos da reconfiguração do cuidado paliativo oncológico do enfermeiro no HCIV, visando o processo de acreditação hospitalar. Metodologia: trata-se de um estudo histórico-social, de abordagem qualitativa, na perspectiva da História do Tempo Presente, cujo cenário foi o Hospital de Câncer IV (HCIV). As fontes históricas foram: diretas (escritas: relatório, manuais, folderes, entre outros; e depoimentos orais temáticos com sete participantes) e as indiretas (artigos científicos e livros sobre o tema). Os resultados evidenciaram que, para se reconfigurar o cuidado de enfermagem em uma unidade de referência nacional para cuidados paliativos em pacientes oncológicos, iniciou-se, em 2004, um grande investimento institucional, empreendido pela unidade e pelos enfermeiros, tais como a implantação do novo modelo de gestão, centrado em eixos específicos de trabalho, entre eles a acreditação hospitalar. Além disso, foram criados a Divisão de Enfermagem, o regimento interno da unidade, o Núcleo de Assistência de Enfermagem e o ambulatório de curativos tumorais e ostomizados, bem como ocorreu o desenvolvimento do Fórum do 5.o Sinal Vital. Também foram consolidadas a educação continuada e a humanização em âmbito institucional por meio do Projeto de Humanização, vinculado à Política Nacional de Humanização (PNH). Concluiu-se que os enfermeiros, apoiados por uma aliança pactuada com a direção da instituição, contribuíram para que a unidade atendesse aos critérios e objetivos determinados. Destarte, se destacaram, empreenderam eficazes estratégias e alcançaram significativos avanços no cuidado de enfermagem a pacientes oncológicos em estágio avançado, à medida que participavam desse investimento, se transformavam em porta-vozes legítimos de um discurso autorizado no campo da enfermagem oncológica no Brasil.

In Brazil, the 20th century was an increase in public policies focused on oncology, which directly influenced the organization and structure of the National Cancer Institute (INCA) and patient care in palliative care. This scenario has directly contributed to the development of initiatives aimed at the reconfiguration of health services in Cancer Hospital IV (HCIV). The research has as object of study the reconfiguration of the palliative care nursing support in a national unit of reference, in order to establish the hospital accreditation program. Objectives: to describe the circumstances that led to the reconfiguration of the palliative care nursing support in HCIV; to analyze the strategies undertaken by nurses to reconfigure oncologic palliative care in the HCIV accreditation program and to discuss the first symbolic effects that the process produced among the participating nurses professionals. Methods: This is a historical-social study with a qualitative approach from the perspective of the History of Present Time, whose scenario was Cancer Hospital IV (HCIV). The historical sources were direct as reports, manuals, folders and thematic oral statements with 7 participants and indirect sources as scientific articles and books. The results showed that in order to reconfigure nursing care in a national referral unit in palliative care for cancer patients, a major institutional investment was initiated in 2004, conducted by the council and nurses to implement a new management model, centred in specific working areas, seeking for a hospital accreditation. In addition, the Nursing Management Services, the unit's internal regiment, the Nursing Station and tumour and ostomy dressing outpatient clinic were created and the 5th Vital Sign Forum was held. Continued education and institutional humanization were also consolidated through the Humanization Project linked to the National Humanization Policy (PNH). It was concluded that the nurses, supported by an alliance with the institution's management, contributed to achieving the determined objectives that the unit pursued. In addition, they have held a prominent position, undertook effective strategies and achieved significant advances in nursing care for advanced cancer patients. As they participated in this investment, they became legitimate spokespersons for an authorized discourse in the field of oncology nursing in Brazil.

Pathfinders in oncology from the beginning of the 19th century to the inauguration of the first cancer hospital in the United States.

The fields of medicine and oncology made substantial progress between 1800 and 1885. The first half of this period was dominated by the spectacular progress in physiology, cytology, histology, histopathology, and diagnostic microscopy. In the second half of the period, advancements in surgical techniques, anesthesia, asepsis, and laboratory medicine, including bacteriology, chemistry, and biochemistry, led to the development of medical specialties, including surgical pathology and surgical oncology. Although wars, revolutions, and socioeconomic upheavals interrupted the daily life of the populace, distinguished artists, scientists, and physicians continued, against all odds, to advance their field of interest. Among the many eminent individuals, there were 7 renowned physicians (4 pathologists and 3 surgeons) who revolutionized medical and oncology thinking in ways that are still felt today. They were polyglots with formidable erudition, beloved teachers, and mentors, and are remembered eponymically for their contributions to oncology to this day. As a passing note, the 3 surgeons also were skillful microscopists. Cancer 2018;124:230-41. © 2017 American Cancer Society.

O pioneirismo da Primeira Clínica de Tumores em 1947 e a tradição de cirurgia nos anos 1940-1960 / The pioneering spirit of the First Clinic of tumors in 1947 and the tradition of surgery in the years 1940-1960

Comentário sobre o tratamento da tuberculose e as intervenções cirúrgicas, sobre o convênio com a Associação Paulista de Combate ao Câncer, em 1946, sobre a inauguração da Primeira Clínica de Tumores, do Instituto Central (Hospital A. C. Camargo). Mostra o pioneirismo na quimioterapia, a cirurgia plástica, a presença da comunidade nipo-brasileira e a utilidade pública e a filantropia. Acrescenta reflexão sobre os vinte anos de convênio com a APCC, os Institutos de Pensões e Aposentadorias e Previdência Social. (AU)

[Historical overview and the current practice of intracavitary treatment of cervical and endometrial cancer in the Oncoradiology Center of Budapest]. / A méhtest- és méhnyakrák intrakavitális kezelésének történeti áttekintése és jelen gyakorlata a Fõvárosi Onkoradiológiai Központban.

The aims of our study were to describe the history and development of intracavitary brachytherapy in the treatment of gynecological tumors, to introduce our current practice for intracavitary brachytherapy treatments based on CT planning. Gynecological intracavitary brachytherapy has been applied in our department since the early 1930s. After a long development it has been completely renewed by 2014. In our center definitive and/or preoperative gynecological HDR-AL brachytherapy treatments were given to 25 patients (13 corpus uterine cancer patients and 12 cervical cancer patients) during the period of 01. 01. 2014-31. 01. 2015. In each case, target volumes were planned by CT images, DVH (dose volume histogram) analysis was performed in order to calculate the radiation tolerance dose of rectum and urinary bladder. Evaluation was performed by the EclipseTM 11.0.47. brachytherapy treatment planning system. During the definitive treatments of the 13 uterine cancer patients the D2cc value related to rectum tolerance was 66.3 GyEQD2 (46-91 Gy). The average D2cc value of urinary bladder tolerance was 76.5 GyEQD2 (30-112 Gy). CI was 0.72 (0.6-0.95). Average value of COIN was 0.57 (0.35-0.78). Compared to the prescribed dose D100 and D90 values were given in ratios. Compared to the volume which receives 100% of reference dose V150 and V200 values were also given in ratios. D100 and D90 were calculated to be 0.66 (0.47-0.97) and 0.91 (0.8-1.25). V150 and V200 volumes were 0.11 (0.04-0.18) and 0.06 (0.02-0.1). During the definitive treatments of 12 cervical cancer patients the D2cc value related to rectum tolerance calculated by DVH was 75.2 GyEQD2 (60-82 Gy). The average D2cc value of urinary bladder tolerance was 85 GyEQD2 based on DVH. CI was 0.66 (0.42-0.76). Average value of COIN was 0.52 (0.32-0.78). Mean value of DHI was 0.46 (0.27-0.54). D100 and D90 were calculated to be 0.72 (0.57-0.89) and 0.91 (0.84-1.11). V150 and V200 volumes were 0.057 (0.02-0.13) and 0.02 (0.002-0.06). During treatments no severe side effects were found. During gynecological intracavitary HDR therapies the calculated dose of the target volume can be given safely using the EclipseTM 11.0.47. brachytherapy planning system and CT-based planning. CT-based treatment planning provides optimal safety for organs at risk, acceptable doses for rectum and urinary bladder while the target volume receives the proper prescribed dose.

Visión histórica del Hospital Provincial Docente de Oncología María Curie de Camagüey / Historical vision of the Provincial Teaching Oncology Hospital

Se realizó esta investigación con el objetivo de describir la evolución histórica del Hospital Provincial Docente de Oncología María Curie de Camagüey. Surgió con la constitución de la Liga Contra el Cáncer en Camagüey en 1941 hasta su desaparición en 1960, que logró el propósito inicial de construir un dispensario anticanceroso. Debido a la mala atención médica brindada por los gobiernos republicanos se destacó el gesto desinteresado del pueblo camagüeyano con su aporte económico para la construcción de este dispensario. Con el triunfo revolucionario se logró transformar en hospital, que junto al desarrollo de la Oncología en la provincia, es actualmente un centro de alto nivel científico para la atención al pueblo. La información fue obtenida de personalidades que participaron en su creación, fotos y periódicos de la época, además de documentos existentes en el Archivo Histórico de Camagüey(AU)

An investigation was carried out with the objective of describing the historical evolution of the Provincial Teaching Oncology Hospital María Curie of Camagüey. It was originated with the constitution of the League against Cancer in Camagüey in 1941 until its disappearance in 1960, achieving the initial purpose of building up an anti-cancerous dispensary. Due to the bad medical attention given by the republican governments, it stood out the generous gesture of the people of Camagüey with its economic contribution for the construction of this dispensary. With the triumph of the revolution it was turned into a hospital, which together with the development of the oncology in the province is currently a high scientific level center for the attention of the people. The information was obtained from personalities that took part in its creation, photos and papers of the period, along with documents of the Historical Archive of Camagüey(AU)

[Aristides Maltez Hospital and the control of cervical cancer in Brazil]. / O Hospital Aristides Maltez e o controle do câncer do colo do utero no Brasil.

The Aristides Maltez Hospital in Salvador (Bahia) was inaugurated in 1952. The hospital was a philanthropic institution of the Bahian League Against Cancer. The Aristides Maltez Hospital specialised in cancer treatment, especially cervical cancer, and became a reference centre for the control of cancer in northeastern Brazil. This article follows the creation and consolidation of the hospital as a treatment, research, and training centre, evaluating its role in discussions and action networks on cervical cancer in the mid-20th century. The institution has been a space of transition in the use of diagnostic tools and the organisation of campaigns to control cancer in municipalities of the hinterland.

Análise do processo de criação e desenvolvimento da Rede de Institutos Nacionais de Câncer–RINC, da UNASUL/ Saúde / Análise do processo de criação e Desenvolvimento da Rede Institutes of Câncer-RINC Nacionais gives UNASUL / Saúde

O presente trabalho é um estudo de caso exploratório que investigou como se deu o processo de criação e institucionalização da Rede de Institutos Nacionais de Câncer (RINC), no âmbito da UNASUL/Saúde. Nas últimas três décadas determinadas doenças infecciosas e parasitárias, que eram até pouco tempo as principais causas de morte, vêm paulatinamente reduzindo sua incidência e compartilhando espaço com as doenças infecciosas emergentes, re-emergentes e as doenças crônicas não transmissíveis (DCNTs), consideradas hoje um dos principais problemas de saúde no mundo, tendo entre elas as neoplásicas que já são a maior causa de mortes. Com o intuito de lidar com esse crescente desafio, a RINC foi criada como uma plataforma de interação entre países da América Latina e Caribe. Seu objetivo principal é promover a troca de informações e experiências relacionadas à prevenção, tratamento e controle do câncer, agindo de forma proativa sobre a doença e no seu impacto na saúde das pessoas, como também nos próprios países. A Rede integra a cooperação internacional do Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA), instituição pública brasileira, de referência em ensino, pesquisa, prevenção, controle e assistência em câncer. O objetivo geral do presente trabalho é analisar a trajetória de criação e início de funcionamento da RINC, com ênfase no papel e relevância da participação do INCA nesse processo. A hipótese que o estudo buscou explorar é que a criação da RINC foi motivada pela necessidade de dinamizar a articulação regional para o controle mais efetivo do câncer. Ao mesmo tempo, se inseria na estratégia mais ampla da UNASUL de estabelecer redes temáticas de instituições públicas em nível regional, que atuassem sobre temas de saúde e cujo intercâmbio pudesse trazer benefícios para as respectivas populações dos seus países membros...

The present work is an exploratory case study that investigated how was the process of creation and institutionalization of the National Cancer Institutes Network (RINC) within the UNASUR / Health. In the last three decades certain infectious and parasitic diseases, which were the leading causes of death until recently, have gradually reducing its incidence and sharing space with emerging infectious diseases, re-emerging and chronic non-communicable diseases (NCDs), considered today one of the main health problems in the world, and among them the neoplastic that are already the leading cause of death. In order to address this growing challenge, RINC was created as a platform for interaction between Latin America and the Caribbean. Its main objective is to promote the exchange of information and experiences related to prevention, treatment and control of cancer, acting proactively about the disease and its impact on people's health, but also within countries. The Network is part of the international cooperation of the National Cancer Institute José Alencar Gomes da Silva (INCA), Brazilian public institution, reference in teaching, research, prevention, control and care in cancer. The general objective of this study is to analyze the trajectory of creation and early operation of RINC, emphasizing the role and importance of the participation of INCA in this process. The hypothesis that the study sought to explore is that the creation of RINC was motivated by the need to boost the regional articulation for the most effective cancer control. At the same time, formed part of the broader strategy of UNASUR to establish thematic networks of public institutions at the regional level, which acted on health topics and whose exchange could bring benefits to their populations of its member countries...