We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
Vols saber com serà la teva estada a l’Hospital Universitari Vall d’Hebron? Aquí trobaràs tota la informació.
In general, patients with sarcoma and other musculoskeletal tumours are very vulnerable and receive very long treatment. For this reason, health education is essential, for patients, their families or the main carer, and also on discharge. Hygiene, physical position, medication, pain and emotional support will all be included.
It is important to follow a series of advice related to lifestyle and treatment. The most important advice is:
Oral mucositis is the redness or a burning sensation produced by chemotherapy and radiotherapy. It consists of inflammation of the digestive mucous membrane, frequently in mucous membrane in the oral cavity, and may lead to an ulcer, causing pain and/or difficulty eating as well as affecting the quality of life and the patient’s ability to continue with treatment.
Good prevention and early detection are fundamental to avoid complications. To reduce the symptoms of mucositis it is important to follow the following advice:
If you notice ulcers in your mouth or any other change (redness, burning sensation, white spots, etc.) that cause pain or stop you from eating properly, consult your nurse and/or day hospital.
If you have a fever which develops call the immediate care line or go to A&E.
Acute leukaemia involves abnormal cell growth in the haematopoietic system characterised by significant proliferation and accumulation of immature cells, firstly in the bone marrow and subsequently in the blood, with a great degree of clinical and biological heterogeneity. Acute leukaemias are clonal proliferations (tumour cells that originate from a single initial cell and accumulate various genetic mutations that result in development of the disease) of altered blood stem cells. In normal circumstances, multipotent stem cells give rise to haematopoietic cells, which give rise to blood cells via a process of cell proliferation and differentiation mediated by the cell’s own mechanisms and by the surrounding tissues. Under normal conditions, blood cells migrate to the blood and tissues and are indispensable for the body to function correctly.
In acute leukaemias, the accumulation of different genetic and molecular alterations gives rise to the progressive accumulation of these cells, which substitute normal blood cells in a process known as "hiatus leukemicus", whereby progenitor cells (blasts) do not mature and accumulate in the bone marrow and peripheral blood. The symptomatology may be very mild and non-specific initially, resulting mainly from the lack of blood cells and sometimes from tissue infiltration. These are very serious diseases that require chemotherapy treatment to control them and often a transplant of bone marrow progenitor cells.
In many cases there are at first no major symptoms. Any symptoms there are mainly derive from the lack of blood cells and include tiredness, bleeding, infections and on rare occasions lack of appetite, bone pain, breathing difficulty or neurological symptoms. A physical examination may reveal palpitations, bruises, bleeding from mucus membranes, fever, infiltration of gums or other organs (skin, spleen, liver, etc.).
The average age for acute leukaemia is generally 67 years, but it can affect people of any age. Acute leukaemia is the most common cause of abnormal cell growth in children, with lymphoid leukaemia being the most common. Myeloid leukaemia is more common in the adult population.
A suspected diagnosis is reached in a number of ways, including clinical history, physical examination and a blood test. The diagnosis is confirmed using bone marrow aspiration in which we study neoplastic cells (blasts) under a microscope, as well as conducting multiparametric flow cytometry, cytogenetic analysis and molecular biology tests.
Based on chemotherapy. New drugs are currently being developed, such as immunotherapy or treatment against specific biological alterations (personalised treatment). If not contraindicated, a transplant of haematopoietic progenitor cells may be required once the response has been reached. Therapeutic strategies are adapted on the one hand to the patient’s situation (age, concomitant diseases, etc.) and on the other hand to the biological characteristics of the disease.
Full blood test and bone marrow aspiration.
Unfortunately, there is no way of preventing acute leukaemia from developing. The mechanisms that lead to a person developing this disease are not exactly known. We do know some factors that may be related, such as chemotherapy or radiotherapy in the past or exposure to certain toxins. A predisposition in some congenital diseases has also been observed, as well as cases where there is a family history of the disease.
The most common form is chronic myeloid leukaemia and this sheet refers exclusively to this form of leukaemia. It is a form of abnormal cell growth (neoplasia) that originates in immature multipotent blood cells (stem cells) and gives rise to red blood cells, platelets and white blood cells.
It is characterised by cellular proliferation of white blood cells with cytogenetic alteration that consists of the appearance of an abnormal chromosome known as the Philadelphia chromosome. The Philadelphia chromosome is also seen in other processes, such as acute lymphoblastic leukaemia, and diagnostic differentiation is required to distinguish which process is occurring. Chronic myeloid leukaemia may also involve red blood cell and platelet disorders, and is characterised by its chronicity. This disease serves to illustrate the revolution that has taken place in the last few years with targeted therapies in abnormal blood cell growth.
These are not very specific: Usually marked by tiredness, anaemia, loss of appetite.
This disease has a low incidence (1-1.5/100,000 pop./yr) and low mortality (more than 90% survival in the last 5 years). It mostly affects middle-aged people (40-50 years), although it can occur at any age.
A physical examination often reveals spleen growth. Blood tests show a very significant increase in white blood cells and bone marrow aspiration should be conducted to confirm. Genetic and molecular biology tests are also conducted.
The treatment most used is tyrosine-kinase inhibitors. It is an oral, chronic and relatively well tolerated treatment, including Imatinib: it is the first drug that was described, and the most commonly used. Side effects include submalar skin pigmentation (aesthetic problems), nausea and vomiting, which are often mild.
As there is some resistance to this drug, new drugs need to be developed to stop the other proliferation pathways of the affected cells.
Physical examination, blood test, bone marrow aspiration.
Chemotherapy consists of combining different types of medications that destroy cancer cells in different ways. It acts on these cells that are rapidly reproducing, cancer cells and healthy cells, too.
Chemotherapy is administered in different ways and for various reasons:
The human body is made up of different cells that each have a certain function. Cancer begins when a group of cells reproduces very quickly and uncontrollably. This affects the cells’ function and, therefore, stops the body functioning normally.
Chemotherapy acts on these cells, which may or may not be cancerous, that are rapidly reproducing. This causes side effects, which will depend on the medication, dose, duration and each individual person.
Chemotherapy can be intravenous or oral, meaning it can be administered by the vein or by the mouth. The first option is the most common.
To administer this treatment, sometimes a catheter is left in place that is then connected to a disc below the skin. The medication is administered through this device. This catheter is called a port-a-cath, although there are more types of catheters. The way the vein is accessed depends on the characteristics of the person and the duration of the treatment.
Chemotherapy is applied at intervals and the duration depends on the type of programme, control and treatment.
Chemotherapy can produce the following side effects:
The Radiation Oncology Department stands out for its paediatric oncology and radiosurgery care, as well as for its participation in numerous oncological clinical trials. For this reason, we receive residents from all over Spain who do rotations specifically in our units, and visits by specialists from around the world who wish to learn the most advanced techniques. We have extensive experience in continuous professional development for residents, many of whom have gone on to take up positions of responsibility in international hospitals.
Radiotherapy Oncology training itinerary
The Radiation Oncology Teaching Unit is provided by the Radiation Oncology Department, with the involvement of Haematology, Internal Medicine, Medical Oncology, Radiology, Radiophysics, A&E, and Palliative Care. In Radiation Oncology we attend to patients at the hospital and in the Vall d’Hebron healthcare area of influence, but we are also active in other parts of the country as we are a leading centre for several complex diseases.
We offer a training programme in radiation oncology that includes learning in research. This means taking part in multidisciplinary committees that analyse different pathologies and generate hypotheses for future research projects. Residents integrate into a line of research when they join the programme, assisted by a consultant.
We are part of the Vall d’Hebron Research Institute (VHIR) and the Vall d'Hebron Institute of Oncology (VHIO). We actively participate in different national and international research groups, such as the European Organisation for Research and Treatment of Cancer (EORTC), the International Society of Paediatric Oncology (SIOP), and the Radiation Oncology Clinical Research Group (GICOR).
The complexity of the diagnoses and treatments performed by the Medical Oncology Department requires working in multidisciplinary teams of specialists, with the aim of providing an integrated approach from diagnosis to the end of treatment. For this same reason, we work in expert cancer-specific committees and assess each case as a team to determine the appropriate treatment for each person. If you train with us, you will be working with highly qualified professionals and the latest generation technology. Training is backed up by our own training programmes and through collaboration with centres of recognised quality and prestige.
Medical Oncology training itinerary
The core of this teaching unit is provided by the Medical Oncology Department, with participation from Haematology, Internal Medicine, Radiation Oncology, Radiology, Pathological Anatomy, Infectious Diseases and Palliative Care, the Intensive Care Unit and the A&E Department. The Unit can accommodate three residents per year. Residents’ training in Medical Oncology takes five years in total. The two first years are spent on core training, with the following three years dedicated specifically to specialisation.
Residents in medical oncology are expected to have in-depth knowledge of preventative, diagnostic and therapeutic choices for cancer. For this reason it is important that they continuously update their knowledge of cancer biology. To this end, they must take part in research projects that promote excellence in research. They will also have the opportunity to become familiar with the main lines of research in the Department and to take part in some of them. Over the course of training, residents learn to have a critical and open approach to the high volume of clinical studies and advances in the specialisation, whilst always keeping ethical considerations at the forefront of their work.
Why do your residency at Vall d’Hebron?
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