Author: BCI

On World Cancer Day we talk to Assoc. Chilingirova, head of the complex oncology center in ‘Heart and Brain’ Pleven – the only Bulgarian member of the European organization of cancer institutes

– Assoc. Prof. Chilingirova, what do the latest World Health Organization data on cancer show?

– Every year, almost 20 million people hear the severe diagnosis and about 9.7 million die from the disease. However, it is important to know that around 40% of cancers can be prevented by avoiding risk factors and implementing prevention strategies that have been proven to work. The spread and severity of these diseases can also be reduced by early detection of new cases and timely therapeutic management. Many cancers have a high chance of cure if diagnosed early and treated adequately.

In 2020, 2.7 million people were diagnosed with cancer in the European Union and 1.3 million people died from the disease. It is expected that cancer mortality in Europe will rise by more than 24% by 2035.

But beyond the statistics, every patient is first and foremost a person, with his or her own destiny. The oncologist’s mission is to be with their patients throughout the process – together they choose the best treatment strategy and achieve the best possible quality of life.

– What is the situation in Bulgaria?

– To a large extent, Bulgaria follows the global trends in morbidity and mortality, lung cancer is the most frequently diagnosed malignancy in men and breast cancer in women. Unfortunately, however, most cancers are diagnosed at an advanced stage. The lack of long-term national policies on screening and prevention remains a problem, as does the inability to diagnose most cancers early. The appearance of symptoms is generally indicative of advanced disease, so it is important to see a doctor and have annual screening.

– Just a few days ago, an international scientific conference related to innovations in oncology concluded. Please tell us more.

– It focused on a multidisciplinary approach and communication. I was impressed by the lively discussions and the rooms full of medical professionals because I believe that this is where solutions and great ideas are born. Colleagues from Bulgaria and abroad took part, from different specialties, but united around the cause of fighting cancer. And the key to success is a team approach. Central in the discussions took the new possibilities of medicine and pharmacy in the fight against the disease, the possibilities of artificial intelligence as an additional tool to help the diagnosis of treatment.

We commented on new therapeutic options in the treatment of lung cancer. We focused on the key role of genetics in modern diagnosis and treatment, discussed new therapeutic options in the treatment of melanoma, and addressed the important role of screening and prevention with a focus on cervical cancer. We showed innovations in surgical approaches -robot-assisted surgery, presented our own data and analyses from clinical practice. In short, we dove into the infinity of modern diagnostic and treatment options, with an eye to the future of medicine.

– What are the takeaways and what are your goals for fighting cancer from here?

– Science is moving forward, and with it the fight against cancer. If I can summarise, I would say that our successes in the war against this disease are based on tireless teamwork and innovation at every stage from diagnosis through treatment and patient follow-up.

It makes sense that in this era of precision medicine and innovation in oncology, we should focus on advanced prevention and screening options to make a positive change to the dismal statistics. Early detection necessitates the introduction of digital technologies and platforms, telemedicine into actual clinical practice. And the goal is to offer adequate screening to target populations (patients at increased risk of disease), e.g. for breast, cervical, lung, colorectal cancer, etc. Such programmes are already underway in a number of other countries at national level.

Another crucial prerequisite for an excellent therapeutic response and good long-term outcomes is the availability of comprehensive cancer centres, where every step from diagnosis through treatment and follow-up happens in one place, without the patient and their relatives having to wander between separate institutions at such a difficult time.

‘Heart and Brain’ is an example of this. For nearly five years now, the comprehensive cancer centre has been applying a modern, multidisciplinary and high-tech world-class approach – in one place. Not surprisingly, we are the only full member and the first Bulgarian member of the largest network of oncology centres and institutions in Europe (OECI).

– What more needs to be done in terms of prevention?

– Prevention and screening are the key to fighting cancer – given the main risk factors for cancer, we could largely prevent or avoid them. For example, smoking is clearly associated with lung cancer, i.e. reducing and stopping it would reduce the risk of developing this cancer. Regular check-ups and vaccination would reduce the incidence of cervical cancer. Vaccines against the human papilloma virus, some of whose subtypes cause cervical cancer, are available in this country and can be administered. Above all, responsibility for health is a matter of personal choice.

Part of the process is raising public awareness, social engagement and providing relevant, accessible and accurate medical information.

Malina Vitkova is a senior midwife at the maternity ward of ‘Mama and I’. She has been a senior nurse at the maternity ward for 26 years. For her, every new birth is a blessing, every baby’s first cry is a satisfaction and the tears in the mother’s eyes are a reward. Today – 21 January – Midwifery Day we talk to her about her choice and dedication to the profession – midwife.

– When and why did you choose to be a midwife?

– From a very young age I always wanted to study medicine. The decision to dedicate myself to midwifery came spontaneously after the birth of my first daughter. At the most important and difficult time for me, I saw in my midwife support, protection and peace of mind. She was my inspiration and I realized that this was my calling.

– How does it feel to be part of the birth of a new life every day?

– Being a part of the birth of a new life is a privilege for me and the feeling is unique. Every baby born in my arms is a blessing. The moment I hear the cry of a new life, the exhaustion and stress disappear. I forget about problems, difficulties, worries. And the tears of joy in the mother’s eyes are the greatest reward. Each birth is different in its own way, so the work of the midwife is not patterned. It takes knowledge, skill, patience and love, every time! A midwife’s job is not just about giving birth. Caring for the mother is also very important, both during and after pregnancy. Today, pregnant and birthing women use many more and different sources of information than women did decades ago. They ask a lot of questions and expect us to have the right answers. Today the midwife must be a psychologist and a friend as well as a professional. She does not have “office hours”. She has to be constantly by the woman’s side, to gain her trust and respond to her needs. Also the routine of the profession must not dominate the purely human warmth and respect, for the people who have chosen our hospital for this so important and expected event.

– How do the teams at ‘Mama and I’ deal with the challenges and needs of today’s expectant parents?

– Expectant parents choose the maternity ward of ‘Mama and I’ with great expectations and hope. They are enchanted by the excellent facilities, the dedicated team of doctors and midwives and the opportunities we provide for young families – for example, both parents being together with their newborn from day one. Expectant mothers spend the hours leading up to meeting their newborn in a comfortable environment, as close to home as possible, with the support of their relative and discreet supervision from the team.

The maternity sector has rooms for natural or operative birth. There is also a choice of a private delivery room for normal birth, where the presence of an attendant during labour is also permitted.

In the postpartum sector of ‘Mama and I’ the stay after birth is organized – everything necessary for the mother and the newborn is provided. The teams of doctors and midwives work as one, the knowledge and skills provide security and adequate response, and can sometimes be life-saving.

To meet the needs of pregnant women, we have also formed a school for expectant parents, which is gaining in popularity. In it, we discuss with expectant parents various topics related to childbirth and child rearing in a relaxed and friendly environment. Along with the school, we also hold individual meetings with them on a daily basis so that they are relaxed and as prepared as possible in caring for their child after discharge from the ward. And we are with them at discharge – all babies leave here with a gift – an album capturing their first moments – first photo, first foot and hand print, first impressions.

– You have been elected by the Board of the Alliance of Bulgarian Obstetricians as the President of the structure in Pleven region. The city will host the Academy of Midwives in the autumn of 2025. What goals have you set yourself?

– What we have to develop in midwifery care is the so-called “home patronage” – the care of the mother and child in a home setting. This is a difficult time for the woman, when she feels confused and insecure and needs our care and advice.

– What is 21 January for you and what is your wish for the holiday?

– For me, and for all my colleagues, it is a very special day and I feel extremely proud. The midwifery profession is a destiny and a calling! I wish all my colleagues good health! May they work with love, heart and soul!

The German professor has patented his own method of hip arthroplasty

The first of its kind academy of orthopaedics is being established in the high-tech hospitals ‘Heart and Brain‘ in Pleven and Burgas – this was announced a few days ago by prof. In the last few days the head of the clinic of orthopaedics, Prof. Asparuh Asparuhov, was announced. The initiative is the result of the excellent cooperation of the specialists from ‘Heart and Brain‘ with world-renowned experts in the field of orthopaedic surgery such as prof. Heinz Röttinger , a pioneer in the field of minimally invasive hip and knee arthroplasty, and Dr. Steffen Haug, an international consultant in minimally invasive spinal surgery and degenerative spine pathology. They are joined by Prof. Dr. Nick Spindler from Germany, a leading specialist in plastic surgery for severe trauma cases, and Prof. Prof. Oliver Marin-Peña from Spain, Vice President of the European Hip Society.

The first major scientific forum organised by the academy will be in April on the topic of “Knee joint navigation prosthesis”. The event will bring together orthopaedists from all over the country in Pleven, with scientific sessions and surgeries broadcast in real time. By the end of the year, two more symposia are planned, related to revision of complications after hip prosthesis and shoulder prosthesis with the so-called Reverse Prosthesis.

“Our main goal is to train young doctors, not only from our hospitals but from all over the country. We start with minimally invasive surgery, arthroplasty and endoscopic surgery to get to revision arthroplasty with complications after infections,” said Prof. Asparuhov. “We have achieved a lot – we have built an outstanding team of professionals, we have high-tech equipment and we apply the most advanced world standards in the field of endoprosthetics and revision orthopaedic practice. It’s time to build on this – to implement more new world techniques,” adds Dr. Yordan Valeshkov.

“Our desire is to pass on our experience and knowledge to motivated young orthopedists in Pleven and Burgas. It is a pleasure for me to consult them during the surgeries and I am proud to be able to train the new Bulgarian medical generation”, says Prof. Roettinger and gives Dr. Georgi Dimitrov a friendly hug.

“Every month I am in Pleven to train young doctors specifically in the diagnosis and treatment of the degenerative spine and I meet with exceptional interest. This attitude inspires me. We are preparing a course for Bulgarian specialists in minimally invasive and plastic hand surgery at our clinic in Germany,” said Dr Haug.