Tbilisi Cancer Center-past, present, future

Tbilisi Cancer Center (TCC), which is located in Tbilisi, Georgia, provides diagnosis and every type of treatment of oncologic patients from whole country.  TCC activities include the establishment of Population-based on-line Cancer Registry and the creation of Tbilisi/Health Cancer Information Network (HCIN), in order to study the cancer epidemic situation in Georgia. It is center, which is focused on preventive treatment of cancer diseases (especially in woman population) in the region. TCC   cooperate with the foreign organizations like ECCA - European Cervical Cancer Association (http://www.ecca.info/ka/the-ecca/ecca-members.html), WACC - Woman Against Cervical Cancer (http://www.wacc-network.org/network/Georgia.php), IARC-International Agency for Research on Cancer.
The Tbilisi Cancer Center (TCC) was opened in 2005, in Tbilisi, Georgia. Its foundation was encouraged by the existed cancer epidemical situation and difficulties in the field of oncology in the country. The TCC was the first medical institution which started realization of cancer prevention programs in Georgia. The main objective of the TCC is to prevent cancer diseases, lighten their burden in the population of Tbilisi, decrease cancer incidence and death and promote a healthy life style. The Center implements cancer screening-diagnostic, early detection and prevention programs, under the guidance of the Tbilisi Municipality and the UN Population Fund (UNFPA). The TCC accomplished the following  tasks: 1.Creation of the informational database and Epidemiological analysis - Formation of the Tbilisi Population-based Cancer Registry; 2. Arrangement of informational-educational activities for the population of Tbilisi, as well as trainings for doctors of the primary health care network of the city; 3. Cancer control and implementation of cancer screening-diagnostic programs; 4. Follow-up of patients and management of special medical treatment of detected diseases. In the frames of National Screening Program (NSP) TCC provides free medical consultations, instrumental examinations, laboratory tests and out-patient and in-patient surgical treatment of patients. The center successfully realized its aims in 2004-2011. Over 30 000 patients have been examined at the clinic. About 6000 cases of pre-cancer diseases and approximately 800 cases of cancer have been early detected and as a result this number of patients has avoided the progress of the disease through complex medical care.  Over 5 000 operations have been conducted at the surgical department of the clinic.

  1. The Breast and Cervical Cancer Screening Programs are effectively carried out at the TCC. The beneficiary of these programs is a vulnerable part (80%) of the population of Tbilisi. Cervical cancer prevention was one of the main themes at the Tbilisi Conference/Summit on Health Advocacy and Cancer Control, held by the TCC in October 2006 in Tbilisi. Along with Georgian colleagues, prominent specialists in cancer control from the American Cancer Society, the Emory University and the Armenian National Centre of Oncology have participated in the event. The UNFPA evaluated the TCC cancer prevention activities as the most successful  program among the similar projects implemented in the East Europe and the Caucasus region.

Since 2011 NSP includes Breast Cancer Screening, Cervical Cancer Screening, Bowel Cancer Screening, Prostate Cancer Risk management services. All this services are available in our center.

  1. The main goal of the TCC with support of Ministry of Labor, Health and Social Affairs of Georgia and Healthcare and Social Issues Committee of Parliament of Georgia also with nongovernmental organizations is to widen the sphere of its activities and is ready to cooperate with foreign organizations, operating in cancer prevention and control.

The Center implements various innovation projects to prevent, diagnose and treat cancer diseases via new, high standard methods. Nowadays TCC is the only center in the Caucasian Region offering Intrabeam therapy, and now LIAC IORT (https://www.youtube.com/watch?v=FGvifeFzErA)  and ROMA test, as well as Flow cytometry.

  1. IOR therapy is a type of brachytherapy for breast, skin, neuro, abdomen, gynecology, proctology cancer. After removing the tumor with surgery, doctor uses a small probe to treat the area with radiation.  IORT takes less time and is more convenient than external beam radiation. External radiation can take five days a week for six weeks. With IORT, patient might have just one treatment after doctor removes the tumor.  IORT therapy causes fewer side effects than external beam radiation. Doctor can send high-energy beams directly to the tumor area without going through healthy tissue. 

  2. ROMA test- Risk of Ovarian malignancy Algorithm –on base of checking CA125 an HE4 markers simply calculates the risk of development of ovarian cancer (OC) via special program. So, gives us opportunity to plan preventive measures to avoid development of OC or detect existence of this disease at early/curable stages.

  3. Flow cytometry -a laser- or impedance-based, biophysical technology employed in cell counting, cell sorting, biomarker detection and protein engineering, by suspending cells in a stream of fluid and passing them by an electronic detection apparatus. It allows simultaneous multiparametric analysis of the physical and chemical characteristics of up to thousands of particles per second. Flow cytometry is routinely used in the diagnosis of health disorders, especially blood cancers, but has many other applications in basic research, clinical practice (rheumatology, endocrinology, ophthalmology, chemotherapy, transplantation, infection diseases)  and clinical trials. Right now it is very important for us to implement immune status study for Georgian population to establish standards/norms for our country.

Future plans

  1. Department of psycho oncology - earlier diagnosis and improvements in treatment mean that more patients are surviving cancer. The impact of psychological morbidity when living with and beyond a cancer diagnosis is now well-recognized and has consequences, not only in terms of quality of life but also in overall healthcare outcomes and costs. Despite this, the provision of emotional and psychological support across the Country is often limited and certainly inconsistent. Diagnosis of cancer is a significant life event that can be a catalyst for mental ill health– how people cope depends on their psychological resources, support from family members, health professionals. If we are really interested in well being of cancer patients, improving oncology programs, make them more clinically and cost –effective, we should develop national guidelines, protocols, departments for psychological oncology in Georgia.

  1. Patient education, onco -dietology, rehabilitation department –without informing patients and their family members, working with them individually or in the focus groups , giving them clear recommendations about life style, nutrition, self-care, physical exercises and etc. -it is impossible to achieve the best results in the treatment of cancer and improve life quality.

  2. Social projects- art therapy, onco- café - will provide meetings of patients with each other, with health educators, nurses, psychologists and voluntary supporters, plan and conduct various activities -from parties to exhibitions and concerts, will give them opportunity to learn more about healthy nutrition, behavior, to use their talent to create art samples, find new interests and support not only own mood, but help others too.

Academic direction- staff development, education, research projects, establishment of collaborations with experienced research institutions