Cancer centre near Mater Dei Hospital

The news that the government intends to build a cancer centre, within the precincts of Mater Dei Hospital came as a surprise, but is nonetheless welcome.

The investigation and treatment of a patient suspected of cancer is a complex and costly health care service, constituting an essential function of an acute, teaching, general hospital such as Mater Dei.

Of course, the centre should have been part of the original plans, thus saving considerable sums in extra public funds, but that is now history, and the challenges of the future are enough to cope with.

There are two main reasons why a cancer centre should be located within an acute general hospital, rather than as a stand-alone unit.

Firstly, the investigation and assessment of a patient with suspected cancer calls for services and facilities such as those found in pathology laboratories of various kinds (haematology, biochemistry, etc.) and of different, modern imaging units that form part of a large department of radiology. The many sections that go to form these two major hospital departments can only be found together in a large, modern general hospital.

Secondly, the treatment of most cases of cancer involves the use of many modalities of therapy, such as surgery, chemotherapy and radiotherapy. It may be termed multimodal and, one should add, interdisciplinary.

Again, it is a case of finding all the sophisticated equipment and medical expertise gathered together contributing to the synergy of improved function, greater convenience and lower costs. And all this can only happen in a major, modern general hospital.

In fact, in many large 'western' hospitals such as the postgraduate Hammersmith Hospital, the treatment of a case of cancer is embarked upon after an open multi-disciplinary conference attended by a fair number of doctors from different specialities and chaired by a senior doctor. It is there that consensus is reached on the most promising plan of treatment and this is recommended for adoption.

Throughout the often long journey that the cancer patient has to travel, he may have to consult and be advised by various medical experts only found within a large general hospital.

Finally, a word on palliative care of patients with advanced cancer. One can safely say that up-to-date ideas on looking after patients with advanced or terminal cancer were formally introduced to Malta at a three-day seminar held at the Holiday Inn in October 1988 by the Hospice Movement Malta.

A team of five experts from the UK was invited to take part in the seminar. Papers were read and discussed on such themes as the philosophy that underlies palliative care, principles of pain control, the use of controlled-release morphine sulphate tablets in the prolonged relief of severe pain in cancer, the spiritual needs of the patient with advanced cancer, bereavement and so on.

My experience at St Joseph's Hospice, in London's East End, run by Catholic Irish nuns, led me to hope that the local Church would show interest in setting up a small in-patient unit for persons with terminal cancer as a joint venture with the Malta Hospice Movement. Our overtures, however, were not taken up; one is now glad the government has expressed its willingness to take on the burden.