Digestive Tract Cancers Treatment Program

• Initial evaluation and preparation.
• Pre-application medical checkup.
• Cyclophosphamide 200 mg
• Nimotuzumab (CIMAher EGF) 24 pairs of vials for 6 weeks treatment.
• The induction phase lasts six weeks corresponding to the application of 24 pairs of vials (4 vials x 6
• vaccine applications), Cyclophosphamide and saline solutions.
• The first dose will be given in Cuban health centers. Follow-up doses can be continued the in Cuba or in the home country.

• Combined laparoscopic abdominoperineal resection for low rectal tumors of the anal canal and anal sphincter preservation: abdominoperineal resection involves the removal of the anus, rectum and sigmoid colon in order to treat cancer low in the rectum or in the anus close to the sphincter muscle (the muscle surrounding the anus that controls bowel movement). A colostomy is then performed whereby a section of the colon is connected to the surface of the abdomen through an opening called the stoma so that waste and gas can pass out of the body. A laparoscopy, a surgical procedure in which a small incision is made in the abdomen to allow a laparoscope (an optic instrument) to be inserted, is performed in order to give the surgeon better exposure.
• Abdominoperineal resections in lower rectal tumors and anal channel with anal sphincter preservation:  this procedure is similar to the one described above with the difference of the preservation of the sphincter muscle in order to avoid a colostomy. Cancer free end of the sigmoid colon is attached to the anal sphincter for the continuation of normal bowel function. This procedure is dependent on the size of the tumour, its location, how far away it is from the anus and how well the sphincter is functioning.
• Abdominoperineal resection in low rectal tumors and anal channel: the standard operation for the removal of the anus, rectum and sigmoid colon in order to treat cancer low in the rectum or in the anus close to the sphincter muscle. It is done by making an incision in both the abdomen and the perineal area (the area between the anus and vulva in women and the between the anus and scrotum in men). A permanent colostomy is then performed in order for waste and gas to be released out of the body.
• Partial colectomy: is the surgical removal of the cancerous part of the colon or rectum as well as small parts of the nearby healthy tissue.  The remaining healthy parts of the colon and rectum are joined together.
• Anterior Proctosigmoidectomy: this is usually performed due to rectal cancer and involves the removal of a part or all of the rectum with part of the sigmoid colon. The anus is not affected and hence waste and gas movement remains unimpaired.
• Conservative Resection of middle and lower rectal cancer: This is the least aggressive surgery for rectal cancer and the most tissue-conserving.

THE FOLLOWING TREATMENT IS OFFERED

Hepatectomy: The removal of tumours from the liver. This is done by the removal of only the part in which the tumour is in, a larger portion of the liver or an entire lobe leaving behind an enough portion of liver tissue in order for the liver to continue in its functions and so that it regenerates. This surgery is dependent on whether cancer has spread to nearby lymph nodes and whether the liver is in good working order as well as on the size, number, and location of cancer.

Pancreatic Cancer Treatment Programs

The pancreas is located deep in the abdomen and is part both the digestive system and the endocrine system. 90% of the pancreas is responsible for the production of enzymes that aid in digesting fat, cholesterol, and proteins the remaining 10% is responsible for the production of hormones, such as insulin and glucagon, that regulate glucose metabolism. Pancreatic cancer is often hard to detect due to its deep location within the body and because it gives off little symptoms until the cancer is well developed. There are two types of pancreatic cancers the first and most common is cancer of the exocrine pancreas (the part of the pancreas that makes the enzymes); the second is cancer of the endocrine pancreas (the part of the pancreas that makes the hormones).

THE FOLLOWING TREATMENT PROGRAMS ARE OFFERED

• Pancreatoduodenectomy: also known as the Whipple procedure and is the most commonly performed surgery for pancreatic cancer. This procedure is the removal of tumours found in the head of the pancreas (the widest part and where most tumours are found). Due to the fact that the pancreas is intermingled with other organs, the duodenum (the first part of the small intestine), bile duct and at times part of the stomach are also removed and then are reconnected to the digestive and biliary system.
• Distal pancreatoduodenectomy: the body and tail of the pancreas (the narrowest part) are surgically removed when tumours are located in one of these two areas. This procedure also includes the removal of the spleen.
• Total pancreatoduodenectomy: performed if the cancer is in an advanced stage and has spread to many parts or the whole of the pancreas. It entails the removal of the entire pancreas, part of the small intestine, a portion of the stomach, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes. Please note that this procedure is inoperable with obstructive jaundice (a blockage of the flow of bile from the liver to the duodenum also known as mechanical jaundice).

PLEASE NOTE THE FOLLOWING IMPORTANT INFORMATION:

• The above program does not include medications for certain conditions such as
  depression, blood coagulation, etc.
• Medicaments, fluids, blood and derivatives to be used, as well as additional procedure(s)
  performed not included in the exact treatment would be invoiced separately on upon the conclusion of said treatment / procedure(s)

• Electronic patient bed
• Equipment for disabled patient
• Oxygen hookup
• Three AP meals taking into account the patient’s preferences and / or special diets prescribed by physician
• Fully equipped private bathroom
• Infirmary and nursing care
• Colour TV with national and international channels
• Local and international phone services (extra cost will apply)
• Safe box
• Internet service on every floor
• Laundry services

• Assistance in visa issuance and extension (If needs be)
• Each patient/ companion will be assigned a multi-lingual field member with the mandate of attending to all of our patients’ translation and personal needs;
• 20 hours internet service;
• Local airport pickup and drop off; and
• Hospital pickup and drop off (if needed)

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