National Oncology Centre (NOC) Royal Hospital was established in 2004, to cater for the ever increasing and pressing needs of cancer patients. It provides diagnostic and therapeutic services for patients all over Sultanate of Oman, being the prime facility. It has divisions of Medical oncology, Radiation oncology, Pediatric oncology, and hemato-oncology.
The NOC has about 52 beds for adult and 26 beds for pediatric oncology patients. The centre also has a long-stay day-care ward (12 beds), and a short-stay day care ward (16 beds). In addition, there are six private rooms and around 5-8 private rooms on the Special Nursing ward and VIP ward. The staff comprises: four consultants in medical oncology three consultants in radiation oncology, five consultants in hematology, three consultants in pediatric oncology and three consultants in nuclear medicine. The total number of specialists is 20, and registrars is 24.
The outpatient clinics have consultation rooms, Phlebotomy, laboratory investigations, ultrasound, echocardiography, X-rays, resuscitation, FNA, diagnostic/therapeutic aspirations, and short infusion facility. The facility is equipped with online electronic patient medical record system (Al-Shifa). The clinic provides consultation, laboratory collections, outpatient pharmacy dispensing, pain management, palliative care and counseling services.
Areas of specialisation
The National Oncology Center has divisions of medical oncology, radiation oncology, pediatric oncology, and hemato-oncology and provides the following services:
- Oncologic diagnosis
- Systemic Chemotherapy, Targeted therapy, Hormonal therapy
- IMRT, 3DCRT, External beam radiotherapy, IGRT, SRS, SRT
- Cancer Pain management and palliative care
- Patient and family Counseling
- Follow up services
- Diagnostic and therapeutic services in pediatric oncology, oncology, nuclear medicine, and hemato-oncology
- Liaison and advice to satellite centres, local hospitals, regional hospitals
Palliative and supportive care
The PC team comprise of three consultants, three specialists, and three registrars; supported by nursing and paramedics staff. The PC members have fellowships from Australia, United Kingdom, Canada and India with backgrounds in internal medicine, anaesthesia, pain management, or radiation oncology. The members of PC team go through regular local and international courses, workshops, symposia and conferences to keep them abreast with current trends and developments.
The team evaluate the inpatients on a daily basis. The PC and oncology physician joint review is every 2-3 days. These reviews may be bed-side when needed as a joint round, or a joint discussion/meeting in the counselling rooms, as well as weekly multi-disciplinary clinics. The family members are often allowed to attend part of consultation/review with counselling.
Common symptoms encountered are pain, distress, as well as fatigue, nausea, depression, anxiety, drowsiness, appetite, shortness of breath and other problems the patient reports, such as constipation, mouth ulcers, and pruritus. These are monitored using the modified Edmonton Symptom Assessment Scale (VA scale). The refractory symptoms are discussed in interdisciplinary team meetings. There are at present no guidelines clearly chalked out. We extrapolate from other guidelines on PC.
There are six beds allocated for palliative care. In case of need, extra beds or rooms in other wards can be used if available. There is no fixed number but it remains less than four at any given time. One must understand that with greater ratio in advanced disease, the proportion of patients on PC is high. The multidisciplinary meetings are organised once a week, with radiology and pathology meeting also as weekly.