National Oncology Center (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 center also have long stay day care ward (12 beds), and a short stay day care ward (16 beds). In addition to these shared ones, there are 6 private rooms, and average 5-8 private rooms (Special Nursing ward and VIP ward), occupied by patients at any given time on average. We have 4 consultants in medical oncology, 3 consultants in radiation oncology, 5 consultants in hematology, 3 consultants in pediatric oncology and 3 consultants in Nuclear medicine. The total number of specialists is 20, and registrars as 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.
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 3 consultants, 3 specialists, and 3 registrars; supported by amicable number of nursing and paramedics staff. The PC members have fellowships from Australia, United Kingdom, Canada and India. They have internal medicine, anaesthesia, pain management, or radiation oncology background. 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 PC team evaluate the patients on daily basis, while in patient. 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 regular multi-disciplinary clinics. The family members are often allowed to attend part of consultation/review with counselling.
The palliative common symptoms encountered are pain, distress, fatigue, drowsiness, confusion, asthenia, anorexia, weight loss, xerostomia, insomnia, irritability, cognitive function, confusion, diarrhoea, hiccough, constipation, mouth ulcers, and pruritus. These are monitored 1-2 times per week, while in patient and once fortnightly as outpatients. Most of patients are qualitative and assessed by objective trained clinician on a scale of 1-5. Some like weight are qualitative. Often VA scale or clinical evaluation is required. 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 6 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 4 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 organized once a week, with radiology and pathology meeting also as weekly. The meeting within a small group discussion can be convened as and when needed.
Last update: July 2021