The Ankara University Faculty of Medicine is a modern teaching and research hospital. Shown here is the front entrance of the Department of Pediatrics.

In developing countries such as Turkey, pediatric oncology is a relatively new field. Most children afflicted with cancer receive late referrals to cancer centers in urban areas because of the long distances between their homes and proper health care facilities, as well as the cost of treatment.

In the desert of despair and suffering, Ankara University Medical School is an oasis of hope. The teaching hospital has been training Turkish physicians for more than five decades, and is a recognized leader in health care and research. It is a large hospital, with modern facilities, a broad reach within the region and a well-trained medical staff that employs Western protocols in cancer treatment.

Faculty of Medicine

Ankara University Faculty of Medicine, the first medical faculty of the Turkish Republic, has graduated almost 12,000 doctors in 50 years. Its goal is to educate and train the best possible doctors and academicians and to provide a very high quality health service. It is equipped with all the facilities of contemporary medicine.

Children and their familes who visit the pediatric cancer center at Ankara University find a bright and welcoming environment. It is one of 24 pediatric centers in the country, and handles the majority of Turkey’s retinoblastoma patients.

A number of branches functioning within Ankara University’s Faculty of Medicine offer students and researchers valuable opportunities for education and research. A variety of laboratories provide both services and training, as well, in many cases, as research. These include laboratories for microbiology and parasitology, hematology, histopathology, clinical chemistry, immuno-electrophoreses, pulmonary medicine, angiocardiography, nuclear medicine and radiobiology, endoscopy, AIDS research and an animal laboratory. Within the several hospitals associated with the Faculty of Medicine are various specialized units including a 60Cobalt radiation center, an adult and pediatric bone marrow transplant center, a cardiovascular surgery center, an endoscopy unit, a Behcet’s disease center, an acupuncture unit, a migraine relief and treatment center, and psychiatric group therapy and rehabilitation centers. Pediatric hematology-oncology is one of six applied research centers to have been established recently at Ankara University. (The other new centers focus on cardiology, education-rehabilitation, psychiatric crisis, oncology, and gastroenterology. This wealth of specialized programs, all staffed by well trained and experienced health professionals, make Ankara’s Faculty of Medicine one of the leading health institutions in the Middle Eastern region.

Dr Emel Unal, a lecturer in pediatrics at Ankara University Medical School who trained in hematology, was honored recently for her work with young cancer patients. She is a member of INCTR’s Retinoblastoma Strategy Group.

The Faculty includes 328 full professors, 105 associate professors, 16 assistant professors, 425 research and teaching assistants, 13 instructors and 20 specialists. The total bed capacity of the hospitals connected with the Faculty of Medicine is 2,000. 430,000 emergency cases are admitted each year and about 15,000 surgical operations are performed per annum.

Pediatric Oncology

In a country where one-third of the population is under the age of 18, where infant mortality rates hover at 37 per 1000 live births, where 40 percent have no health insurance, and in which national defense spending surpasses that for health care by a factor of 4, the field of pediatric oncology is a challenging one. The two dozen pediatric oncology centers in a country of 68 million are located in Turkey’s major cities, based at urban hospitals. There is as yet no reliable national cancer registry, but based on figures from other countries, it is likely that there are at least 6-7,000 new cancer cases per year in children. Yet despite the odds real progress is being made here, as evidenced by more effective drug protocols and improved cure rates in recent years, at least in part due to earlier diagnosis.

Retinoblastoma

Retinoblastoma, the most common intraocular tumor, may be the easiest to diagnose and treat, if caught in its earliest stages. Yet when diagnosis is delayed, cure becomes more difficult to accomplish, and treatment is more toxic and expensive. Ankara University sees the majority of Turkish patients with retinoblastoma, and the number of patients has increased from 636 patients in the 30 years up to 2001, to 107 patients during the past two years.

A playroom in the pediatric ward allows patients the opportunity to forget their illnesses for a time.

Drs Emel Unal and Nurdan Tacyildiz, pediatric oncology specialists at Ankara University, are both members of INCTR’s retinoblastoma strategy group, through which they are able to work with colleagues from around the world to find solutions to the most pressing problems, including the development of a protocol for advanced retinoblastoma and improving public awareness of the disease among those who routinely see babies who might exhibit the telltale signs. If diagnosed in the early stages, treatment includes chemotherapy followed by laser therapy performed by the Ocular Oncology Service, which, in many cases, permits preservation of the eye. The avoidance or radiation therapy is also important in a disease that is associated with a high incidence of second malignancies, especially when radiation therapy is used. It is hoped that the demonstration that good results can be achieved will convince the government to make additional resources available.