The Oncology Unit of Udine, was instituted in the late 1950’s and is one of the oldest in Italy, possibly in Europe. In 2004 the Department of Medical Oncology was born from the merger of two pre-existing units: the "historical" Oncology Unit of the Regional Hospital Santa Maria della Misericordia and the Cancer Clinic which had been recently established by the University of Udine within the Universtity Hospital. Four years later the two hospital structures were unified into one single institution. A few months after the merger, in 2008, the Palliative Care Unit, sited close to the Oncology Ward, was opened. Currently the Department of Oncology is part of the University Hospital of Udine, recently accredited by Joint Commission International as an Academic Teaching Hospital.
The Medical Oncology Department is in an independant building on three levels: on the ground floor there is the Day Hospital Unit, on the second floor the Visiting Rooms for out-patients and on the third floor both the Oncology Ward and the Palliative Care Units are situated.
The Day Hospital is made up of five rooms, with six armchairs which are used for chemotherapy infusion, supportive treatments, blood transfusions and minor procedures such as paracentesis and twelve day-beds. The Oncology Ward is reserved to patients that must undertake chemotherapy or radiotherapy treatments but also supportive care; the Palliative Care Unit is reserved to those patients with advanced disease requiring best supportive care. The Oncology Ward is made of 8 rooms with 20 beds and 2 single occupancy rooms. The Palliative Care Unit has 2 single rooms. In each area there is a separate Nursing Staff: between 20 Nurses and Health Care Assistants work in the Day Hospital and 33 Nurses and Health Care Assistants work on the both the Oncology Ward and the Palliative Care Unit. The Nursing and Medical Team devoted to the Palliative Care Unit are highly skilled in palliative care.
The Medical Staff is composed of 18 Medical Oncology Consultants and 17 Trainee in Medical Oncology. There are also four Psychologists working in our Department, three available for out-patients and one dedicated to in-patients. There is a Welfare Worker, a Physiotherapist, a Dietician and a Spiritual Assistant working in the Oncology Ward and Palliative Care Unit.
Each patient starting chemotherapy are provided with a leaflet explaining the principal treatment side effects and how to manage them, together with useful phone numbers in case of emergencies. As a result of the collaboration with voluntary associations, two more guides are provided to patients, with all the information about services, facilities and assistances available both in hospital and local areas.
There is also in the Department a consultation room dedicated to unplanned medical assessments, most of them related to treatment side effects or disease complications. This is an everyday service covered by a Trainee in Medical Oncology and a Medical Oncology Consultant.
In our department the Medical Oncology Consultants and all Trainees in Medical Oncology are subdivided into groups, each dedicated to the main tumour types: Breast, Gastro-Intestinal (GI), Thoracic and Genitourinary (GU) group. Recently, Head & Neck (H&N) the Central Nervous System (CNS) and Skin & Melanoma groups have been activated. As clinical research is one of the main interest and objectives of our Deparmtent, our Institute is an active recruiting centre for several national and international, sponsored and spontaneous clinical trials with almost 50 trials currently on going. Both clinical and research meetings are regularly planned in our institution: the weekly MDTs for each subspecialities and meetings to discuss specific clinical cases twice a week. There is a weekly management meeting, a monthly research group meeting and a weekly Journal Club. Seminars and conferences are also periodically organized in our institute, also in collaboration with other cancer centres.
Palliative and supportive care
The Palliative Care Unit isprovided with sofa beds available for relatives. Its facilities are designed to assure both a comfortable and private place for patients and caregivers where patient’s relatives are allowed to stay night and day. A Medical Oncology Consultant and a Trainee in Medical Oncology examine the patients during the daily ward round; a Trainee in Medical Oncology is on site and a Consultant is on call during the night. Psychosocial problems are identified and dealt with during regular meetings between the patient and/or his/her family and doctors, nurses and Welfare Worker. The Welfare Worker helps to find the best continuing care at home, once the patient is discharged and is in contact with the community team. Our Psychologist offers psychological support to care givers during all the phases of disease and during the grief. Finally, a great help comes from volunteers, affiliated to cancer charities. A written document (called “Carta dei servizi”) provides all information for supporting patients at home.