News nr. 29 | September/October 2012
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Some Notes on the Oncological Pulmonology Unit of the Pulmonology University Clinic of FMUL/HSM

Renato Sotto-Mayor
Head of the Pulmonology Department
Guest Assistant Lecturer at FMUL
Coordinator of the Oncological Pulmonology Unit of the Pulmonology Department I/ HSM 


Since the mid-1960s that the Pulmonary Diseases Clinic of FML/HSM, at the time directed by Professor Thomé Villar, started to pay special attention to problems related to lung cancer and other pulmonology malignancies, whose patients were beginning to account for a significant percentage of consultations and hospitalizations and were usually diagnosed at an advanced stage of the disease, when diagnosis, staging and treatment methods were still very limited.

The Pulmonology Courses for Postgraduate Students began in 1967 and, among other relevant topics, started to address themes in the area of Lung Oncology, taught by both national and international lecturers. Example of this was the conference given by Dr José Maçanita in the 3rd Pulmonology Course for Postgraduate Students on the «Medical Treatment of Lung Cancer », which was attended by Professor Lucien Israel, from Paris, who subsequently invited him to collaborate on therapy protocols and to come to his Department in Lariboisiére Hospital, which he did.

This paved the way to the creation of a clinical group interested in Lung Oncology, which came into being in the 1970s. However, due to the temporary stay of the doctors involved (especially Pulmonology interns), it only became permanent in the beginning of the 1980s (Director of Department: Professor M. Freitas e Costa) when myself and later Dr Encarnação Teixeira became involved on a long-lasting basis.

At the time we initiated a weekly meeting on therapeutic decisions – possibly the first Therapeutic Decision Multidisciplinary Consultation of HSM – at first formed by Dr Maria Emília Silvestre (Radiotherapy), Dr Paula Campos (Imaging) and myself, and later extended to other members of the Cardiothoracic Surgery Department and to other clinicians of the unit and of the Pulmonology Department.

Apart from the regular Oncological Pulmonology consultations, the anti-neoplastic therapies began to be conducted at the Day Hospital based on well-defined protocols and supported by nurses trained for that effect. More recently, a Clinical Psychologist and a Social Worker have also joined the team.

The support that all Directors have always given to the Pulmonology Oncology Unit must be underlined (current Director: Professor A. Bugalho de Almeida), as well as the important contribution of Dr Encarnação Teixeira, which has guaranteed the quality of the assistance provided and of the clinical research – clinical trials, most of which by international promoters.

In short, the Oncological Pulmonology Unit conducts assistance, pedagogical, scientific, and research activities, being a national reference in its line of work.

The main activities of the Unit in terms of providing assistance include consultations, prescribing cytoreductive chemotherapy or targeted agents therapy, offering personalised therapy to ambulatory patients and constant support to hospitalized patients. The work is backed by multidisciplinary decision meetings attended by physicians from the fields of imaging, thoracic surgery, radiotherapy, other unit members and, less regularly, by doctors in the field of interventional bronchology and pathological anatomy.

It has been responsible for the diagnostic guidance, the follow-up and the therapy of practically all patients with bronchopulmonary, pleural and mediastinal primitive neoplasms who come to HSM, and for the teaching of Oncological Pulmonology to dozens of interns doing their Pulmonology or the Oncology Internship in several Portuguese hospitals.

The Unit doctors are also involved in clinical research in multiple strands of work, most of which are included in international protocols.

As part of their functions in the Unit, or, in a broader sense, in the Pulmonology University Clinic, doctors have denoted their scientific commitment through their participation in national and international initiatives, chairing or moderating medical meetings, making presentations and submitting posters, giving talks and participating in conferences, organising postgraduate courses and publishing papers in several journals (most of them in indexed publications) and specialist books and articles at the invitation of the editors. Examples include «Pneumologia na Prática Clínica», published by the Pulmonology Clinic of FMUL, «Tratado de Pneumologia», published by the Portuguese Pulmonology Society, «Atlas de Pneumologia», idem, «Pneumologia Clínica», published by the Pulmonology Clinic of FMUL /HSM, or their own publications, such as the monographs «Cancro do Pulmão», which had two editions, and the books «Pneumologia Oncológica» and «Pneumologia Oncológica – Temas de Actualização», publications which, for several years, were the basis of the study of Lung Oncology by Portuguese pulmonology interns.

The Unit’s work has received several scientific awards.

The Head of the Unit is a member of the Cancer Coordinating Committee of CHLN, was part of the working group that wrote Recomendações Nacionais para o Diagnóstico e Tratamento do Cancro do Pulmão (2009, edition of the High Commissioner for Health) and has long been Guest Assistant Lecturer at FMUL, giving practical and theoretical classes (the latter on lung cancer). He has also supervised several master degree theses in the medical degree, most of which on topics related to oncological pulmonology. He has also taught master courses at FMUL, FCML and FMUP. 

Photo courtesy of Office of Communication and Public Relations CHLN-HSM

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Prof. Doutor J. Fernandes e Fernandes
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