Fondazione IRCCS Istituto Nazionale dei Tumori General info Unit Director: Riccardo Valdagni, Radiation Oncology 1 and Prostate Cancer Program Interdisciplinary and Multiprofessional Team Core Team Urologists, Radiation Oncologists, Medical Oncologists, Pathologists, Nurses, Data Managers Non Core Team and Associated Services Imaging specialists, Medical physicists, Radiation technologists, Palliative care service, Clinical psychologists with experience in uro-oncology, Clinical trial coordinator, Physiotherapist, Sexual therapist or urologist trained in andrological urology or certified andrologist or clinical nurse specialist (supervised by sexual therapist, clinical psychologist or urologist trained in andrological urology) specially trained in using interventions that can minimize post-therapeutic sexual complications and promote rehabilitation, Geriatrician, Patient advocates or advocacy group members Interdisciplinary and Multiprofessional Case Management: Team Meetings held on a regular basis, Multidisciplinary clinic for newly referred prostate cancer patients Treatments available: Radical prostatectomy, External Radioterapy, Brachytherapy, Hormonal therapy, Chemotherapy Observational programs available: Active Surveillance, W atchful W aiting The Prostate Cancer Unit at Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, provides comprehensive multidisciplinary care to prostate cancer patients referring to the oncologic center with the longest tradition in Italy. Starting in 2005, our interdisciplinary and multiprofessional team offers a multidisciplinary and holistic approach to prostate cancer patients at all stages. The core team, which includes urologic surgeons, radiation oncologists, medical oncologists, and pathologists, works in synergy with the non core team composed of imaging specialists, experts in palliative and supportive care, dedicated psychologists and experts in rehabilitation. Multidisciplinary management through weekly clinics for newly referred patients, biweekly clinics for patients on active surveillance and weekly tumor boards for complex, non univocal cases, objective proposal of all the therapeutic and observational options, active surveillance, patient centeredness and empowerment in the decision making process, focus on quality of life and life styles (physical exercise, nutrition), and promotion of interdisciplinary education are the main targets of the Prostate Cancer Unit at Fondazione IRCCS Istituto Nazionale dei Tumori. Preclinical, translational and clinical research is a core activity at Fondazione IRCCS Istituto Nazionale dei Tumori, with over 30 protocols and studies running on prostate cancer. Fondazione IRCCS Istituto Nazionale dei Tumori Via Venezian 1 20133 Milan, Italy Phone: Fax: 00390223903015 Web-site: www.istitutotumori.mi.it 1/7
Multiprofessional management Interdisciplinary Multiprofessional Team Core Team Urologists Radiation Oncologists Medical Oncologists Pathologists Nurses Data Managers Non Core Team and Associated Services Imaging specialists Medical physicists Radiation technologists Palliative care service Clinical psychologists with experience in uro-oncology professionals authorized to offer regular psychological support Clinical trial coordinator Physiotherapist Sexual therapist or urologist trained in andrological urology or certified andrologist or clinical nurse specialist (supervised by sexual therapist, clinical psychologist or urologist trained in andrological urology) specially trained in using interventions that can minimize post-therapeutic sexual complications and promote rehabilitation Geriatrician Patient advocates or advocacy group members Clinics At least one clinic per week for newly referred prostate cancer patients Discussion of the newly referred cases in the Interdisciplinary and Multiprofessional Team Meeting W ritten information on the disease and possible therapeutic and observational options handed out to patients W ritten information on sperm preservation handed out to patients Clinic for the follow up of patients who undergo treatment at the Prostate Cancer Units Follow up supervised either by one of the Prostate Cancer Unit members responsible for the initial treatment or by professionals formally collaborating with the Prostate Cancer Unit in a network Dedicated clinic for patients with recurrent/advanced prostate cancer Interdisciplinary and Multiprofessional Case Management Interdisciplinary and Multiprofessional Team Meetings are held on a regular basis Cases in which the diagnosis/staging is uncertain are discussed Cases with a diagnosis of cancer to be considered for radical therapy or observational strategies are discussed Cases following surgery on receipt of the pathologic report are discussed Cases in follow up after radical treatment or in observational settings or who have undergone diagnostic investigations for possible symptoms/signs of recurrent or advanced disease are discussed N. cases discussed last year 450 Physicians and health professionals participating in the meetings Urology Radiation Oncology Medical Oncology Pathology Imaging Psychology and Mental Health Specialties Palliative Care Geriatric Care Physiotherapy Sexual Health Counselling Nurse Clinical Trial Manager Data Manager Social worker Patient Secretary Patient advocacy 2/7
features Interdisciplinary and multiprofessional curative and supportive care for patients across their prostate cancer pathways, from newly diagnosed through to advanced disease Evidence-based written guidelines for the diagnosis and management of prostate cancer all stages W ritten protocols for treatment and observation strategies Discussion and sharing of protocols and protocol amendments within the Interdisciplinary and Multiprofessional Team Database for registering clinical information Interdisciplinary and multiprofessional continuous education on all aspects of prostate cancer care for junior staff and students Clinical trials and research W ritten and electronic information sheets for patients Services Urology Prostatectomies performed each year Two or more urologists trained in prostate disease diagnosis and treatment Diagnosis of prostate communicated to the patient in a face to face meeting Patients referred to sexual health counseling, when Diagnosis of prostate communicated to the patient in a face to face meeting 50 Patients referred to rehabilitation programmes, when For urinary incontinence Intensive pelvic floor training Male sling Urethral prosthesis For erectile dysfunction Penile injection therapy PDE-5 inhibitors Penile prosthetic surgery Radiation Therapy Prostatectomies performed each year Two or more specialized radiation oncologists trained in prostate cancer radiotherapy or brachytherapy Two or more radiation technologists primarily dedicated to uro-oncology N. units Simulator Computerized planning system Quality assurance programme Patients referred to rehabilitation programmes, when Patients referred to sexual health counseling, when Patients referred to psychological counseling, when 150 4 Radiotherapy techniques available for prostate cancer External RT 3-D Conformal RT IMRT IGRT Hypofractionated RT Stereotactic RT Brachytherapy High Dose Rate (HDR) Brachytherapy Low Dose Rate (LDR) Brachytherapy 3/7
Medical Oncology Chemotherapy performed each year Two or more medical oncologists or specialists in internal medicine, haematology and oncology trained in the treatment of prostate cancer 51 Pathology One or more pathologists in charge of uropathology, responsible for prostate diseas Quality assurance programme Available equipment Processors Microtomes Staining machines Immunostainers Imaging One or more imaging specialist fully trained and with continuing experience in genito-urinary disease Quality assurance programme Available services Conventional radiology Ultrasound (with the possibility of performing biopsies) Ultrasound (without the possibility of performing biopsies) MRI Multiparametric MRI CT Choline PET-CT Fluorodeoxyglucose PET CT Bone scan Bone density scan 4/7
Contacts Clinical Director Riccardo Valdagni, Radiotherapy Radiation Oncology 1 and Prostate Cancer Program, Director riccardo.valdagni@istitutotumori.mi.it Urology Roberto Salvioni Chair, Urologic Surgery roberto.salvioni@istitutotumori.mi.it 00390223902359 Radiation Therapy Riccardo Valdagni Director, Radiation Oncology 1 riccardo.valdagni@istitutotumori.mi.it 00390223903034 Carlo Fallai Director, Radiation Oncology 2 carlo.fallai@istutotumori.mi.it 00390223902480 Medical Oncology Giuseppe Procopio Chair, Medical Oncology - Genito-Urinary Tumors giuseppe.procopio@istitutotumori.mi.it Pathology Maurizio Colecchia Chair, GU Pathology maurizio.colecchia@istitutotumori.mi.it Imaging Alfonso Marchianò Director, Radiology and Radiotherapy alfonso.marchiano@istitutotumori.mi.it Medical Physics Emanuele Pignoli Chair, Medical Physics emanuele.pignoli@istitutotumori.mi.it Palliative Care Augusto Caraceni Chair, Palliative Care Service auggusto.caraceni@istitutotumori.mi.it 003923903033 Supportive Care Carla Ripamonti Chair, Supportive Care carla.ripamonti@istitutotumori.mi.it Psychology Claudia Borreani Chair, Psychology claudia.borreani@istitutotumori.mi.it 5/7
Physiotherapy Augusto Caraceni Chair, Palliative Care augusto.caraceni@istitutotumori.mi.it Sexual Health Counselling Emanuele Montanari Director, Urology, Ospedale San Paolo, Milan tiziana.magnani@istitutotumori.mi.it 00390223903021 Geriatric Care Silvio Monfardini Chair, Geriatric Care tiziana.magnani@istitutotumori.mi.it 00390223903021 6/7
W here we are Fondazione IRCCS Istituto Nazionale dei Tumori Via Venezian 1 20133 Milan, Italy Phone: Fax: 00390223903015 Web-site: www.istitutotumori.mi.it 7/7