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When we cross the access to the health center, all do it with more or less vulnerability and uncertainty, a cancer diagnosis affects everyone, distinguishes no condition or choose in which economic or social scenario to emerge. With the advancement of medicine in terms of specific treatments obtained with more specific diagnoses with advanced equipment, a cancer that previously had a six-month survival can now be extended for years.
Early diagnosis significantly improves the possibility of a good prognosis, improvement of the patient's quality of life or early remission, however, the National Cancer Institute (INCAN) is a Public sector referral center that receives patients from all social classes diagnosed with cancer arrive: the poor, the extremely poor, the middle class who works and has resources that in the process end up with nothing and the patient who has material assets but without liquidity he resorts to receiving the required treatment.
"When a person discovers that she has cancer, she has an expiration date, she does not know how long she will live and her world is changing and that is why we must consider the cancer patient as a whole.your socio-economic environment up to your illness itself and treat it integrally and offer you the best, we are bound to that. Here we see that those who do not have resources that strive to come to be cared for and we provide all the care available and see how after healing everyone is inserted into their reality because cancer revolutionizes the micro environment, change your life "Breast cancer is one of the most common types of the disease in women treated at the INCAN, the treatment includes nine cycles every 15 days," said the Dr. Julio Rolón, director of INCAN, which equals four The other types require a minimum of six months of treatment and others can last up to two or three years because the patient does not return or improve. There are patients who, as soon as they leave the surgery, no longer need chemotherapy or radiotherapy; others go through the three processes with decompensation, complications and long hospitalizations.
The minimum expenditure of a treatment that includes surgery, radiotherapy, chemotherapy, drugs, supplies and hospitalizations is 150 million G., depending on the time and the series of situations that may arise during treatment, the figure can reach 2 billion per patient.
"This wide range depends on the stage in which it is diagnosed, the type of cancer, the complications, the evolution of the patient and of course what we want to insist on the promotion and the prevention, diagnose as soon as possible, do not be afraid to consult because this can be decisive ", Rolón insists
The vulnerability in which a cancer patient is immersed is such that the patients who manage to overcome it and go out poor or extremely poor social conditions or are left with a less favorable financial situation, return to the risk of suffering from other socioeconomic diseases makes him a vulnerable person not only for cancer but for another disease.
" There are people who are very humble and who receive a medicine that costs between 20 and 30 million guaranis and who, from here, will stay the whole time that lasts it is, at the back of a parent's house a two-by-two room shared by six people, that is to say that cancer should not only be treated with drugs, a surgery, radiation or chemotherapy, but it must be comprehensive and the responsibility of the state is to ensure its the patient can improve their condition of life. Not only does effective treatment guarantee success, but the patient's social status must also be changed, "says the doctor.
Not meeting the needs of cancer patients cured, for Rolón, it's saving him but, leaving him in a state of poverty, he is killed more slowly than with the disease. "For us, cancer is an opportunity to work together, to assess the reality of the patient, to go beyond surgery, chemotherapy and radiotherapy, it is about A context of completeness, determinants of health, your food, your environment, your home, if you have water, latrines, it is important to know your reality for a better future of those people who have been cured of cancer.
The most common
In women, The most common cancer is the cervix and breast cancer and in men's lungs and prostate, while the two share the majority of the colon. There are also more cases of skin cancer, lymphoma, pancreas, liver, esophagus, stomach and kidney.
"Skin cancer has been seen more and the good thing is that we are seeing more early. This means that prevention and promotion campaigns have an effect and that this allows the patient to evolve and that we want to get there as quickly as possible to improve the prognosis of the disease because it must be understood that it There are cancers cured and others not. and others who can be prevented from others who need to be diagnosed at an early stage, "warns Rolón.
Preventable diseases are those of the lung associated with smoking, the cervix of the uterus related to HPV, liver to hepatitis B. and skin that is determined by exposure to the sun and chemicals.There are those who can be cured with early diagnosis such as breast, the prostate, lung, esophagus, pancreas and stomach.One of the most aggressive and fast-growing cancers is that of the pancreas, in any prognosis depends on when the treatment was started.
Losing the fear and consulting in time
Today to say "I will not live long if I have cancer" is very linked to the moment when the diagnosis arrives for the patient and knowing each other physically and emotionally, differentiating the exchange rate and losing the fear of seeking a diagnosis before suspicion, can make the difference. "If I physically notice different things that I need to consult, if I see that my mole changes color, shape or secretion, it may be a skin cancer; If you feel a nodule on the chest when you bath, the woman must consult because it may be a breast cancer or if you have bleeding between the rules, it may be a cancer of the breast. Cervical uterus If an adult who had a normal defecatory rhythm became constipated after the age of 45, it may be a result of colon cancer or d? another person over 50 who needs strength to urinate People need to understand the importance of losing their fear of early consultation, there are many who, out of fear, do not consult in time, earlier, better and for all diseases.Cancer can be cured according to the stage, you can improve the quality of life of what remains of v Our life or prolong life, so we insist on promotion, prevention and early diagnosis, "insisted Rolón.
[19459006TreatmentTreatmentsandlimits
The types of treatment and their specifications provided by INCAN are: general surgery, chemotherapy and radiotherapy. Patients who have already been diagnosed with cancer may need a general surgery that is responsible for the operation of those who already have an indication and who has stumbled upon the availability of beds, which makes the waiting list long.
"We try to optimize resources and make use of the capacity of the same and the ability of professionals so that patients are not interned beyond need." Rolón
L & # 39; Clinical Oncology is the service that supports patients who do not need surgery or who have already undergone surgery but who require chemotherapy.There are two modalities, they stay between two and eight hours at the hospital and those who stay between two and seven days.On the day, INCAN carries out up to 70 chemotherapies, with the capacity to admit 24 patients.
Another sensitive service is radiotherapy, which also does not meet the actual demand with unique operating equipment in addition to the outsourced service.For this treatment, there is a waiting list of 230 patients at three months then that the institute performs between 50 and 70 radiotherapy c every day and 50 patients derive from it. "In Paraguay there should be one machine for 500,000 people, it should be 14," says the professional.
In three years, there was a 45% increase in demand in 2014 with 67,000 attentions closed in 2017 with 110,000 requests. 35% of patients come from the center and the rest of the country and from 15 to 20% from Asunción. "We have not collapsed but we are at the limit and that is why we need to incorporate more human resources because in one or two years we will no longer be able to meet the demand for the growth of the list. # 39; wait. " ]
Improved status of INCAN as a health center could ensure broader specialty care in terms of capacity and supply of drugs in a timely manner, which will save time for the clinic. Purchase of supplies because the time of the procedure does not coincide with the need of the patient.
"We want to organize and restructure all things related to cancer in Paraguay and that INCAN is a regulatory body, a normative controller from which medical services and programs will be published in relation to cancer. The medical services would include the National Hospital of Oncology, INCAN today and the most common cancers, uterine, breast to which would be added the programs of the prostate, the colon and the lungs. It will also be possible to strengthen the training of human resources and create an administrative structure for the funds intended for the purchase of drugs and supplies to support treatment.
Today, 95% of drugs necessary for treatment are counted and it is not 100% due to lack of budget availability.The drugs already on the list have a because they require financial support and, with the proposed changes, it is expected that over the next five years other funds such as Fonacide and Fonares may be used.
A projection to improve the attention is to incorporate a more linear accelerator to reduce the waiting list and in 20 days plus a brachytherapy device will be in operation that will allow a much more specific diagnosis for the treatment of tumors.
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