ABOUT

The Augusto P. Sarmiento Cancer Institute adopts a unique multidisciplinary team approach to cancer prevention, early detection, diagnosis, and management. It applies innovative molecular technologies in diagnosis and treatment for truly customized care.

With a full appreciation that no two individuals are alike – regardless of similarities between two patients diagnosed with the same type of cancer – our program applies an individualized approach to the diagnosis and treatment of cancer based on the patient’s profile at the molecular level.

Unique Benefits that the Flagship Program Offers to the Patients:

  • Integrated / multi-disciplinary, team-based approach
  • Innovative, minimally invasive surgeries and procedures
  • Capability to undertake diagnostics and treatment at the molecular level
  • Comprehensive cancer screening and surveillance
  • Customized and accessible cancer treatment/care
  • Continuing patient education and preventive advocacy interventions

ONE COMPLEX, TWO HOSPITAL SYSTEMS

Good news! Because so many of you have been asking if you can already visit your doctors or proceed with your diagnostic tests, we have implemented changes to ensure your safety as part of our New Normal. All our staff are on-hand to guide you on your visit and make sure your health remains our top priority.

SERVICES

PERSONALIZED CANCER CARE SERVICES

Nurse Navigator Services / Cancer Care Coordinating Services

It is a service system that facilitates continuity of your care where all services you need are delivered overtime by service providers who established secure and dependable relationships and where appropriate care is available and flexible enough to meet your needs.

Multidisciplinary Family Meeting

A multidisciplinary team develops a personalized treatment plan according to the profile and preferences of the patient who is the focus of the cancer program. The team is made up of cancer specialists, nurses, and other specialized health care professionals. Family members are also an important part of the team. Another unique service offering of the Augusto P. Sarmiento Cancer Institute is the multidisciplinary meeting. During the multidisciplinary meetings with members of the care team, the patient and his family members are encouraged to ask questions, express reservations and get involved in making important decisions concerning the patient’s care plan.

Nutrition Management Services

Obesity increases the risk of many types of cancer. It also increases the risk of heart disease, stroke, diabetes, and other health outcomes, such as dying at an early age.

While it is not clear exactly how excess body fat, consuming too many calories, and lack of physical activity raise cancer risk, there is no question that they are linked to an increased risk of many types of cancer and that they are a serious and growing health problem.

Being overweight or obese is clearly linked with an increased risk of several types of cancer:

  • Breast (among post menopausal women)
  • Colon and rectum
  • Endometrium (lining of the uterus)
  • Esophagus
  • Kidney
  • Pancreas

Being overweight or obese also likely raises the risk of other cancers:

  • Gallbladder
  • Liver
  • Non-Hodgkin lymphoma
  • Multiple myeloma
  • Cervix
  • Ovary
  • Aggressive forms of prostate cancer

Cancer Treatment down to the Molecular Level

At the Medical City, we only use adult stem cells which can be harvested from the bone marrow (bone marrow aspiration) or the peripheral blood. We can also use stem cells from the umbilical cord blood and materials. The Medical City has an Umbilical Cord Bank. In our laboratory, the cells are then isolated, cultured and expanded, engineered, and processed. The kind of cells that will be eventually used is dependent on the individual patient’s needs and disease processes.

Once the cells are completely prepared, they are either injected intradermally or through the skin (eg. In case of cancer vaccines), infused intravenously (through the veins) or locally injected (eg. Intraspinal injection or injected into joints. This is done in the hospital under careful monitoring. The duration of the treatment will depend again on the individual patient’s disease and response.

Stem cell therapy is not a one-size-fits-all therapy. Each person is different. The response of each person to the therapy is likewise different, even if they have similar diseases.

Pain Management Services

The Medical City Pain Management Clinic is a unique and comprehensive facility that provides extensive diagnostic and therapeutic pain-related services for both in- and out-patients of various ages all in one location. The multidisciplinary approach to pain management is an assurance of excellent and cost-effective management of acute and chronic pain syndromes, including cancer pain.

The Pain Management Clinic offers the following services and features:

  • Dedicated Anesthesiologists/ Pain Management Specialists, and Pain Nurses
  • Peripheral Nerve Blocks
  • Trigger Point Injections
  • Epidural Steroid Injections
  • Facet Joint Injections
  • Intravenous/ Epidural Patient-Controlled Analgesia for inpatients
  • Inpatient Evaluations/Referrals
  • Outpatient Consultations

Palliative Care

Palliative care is a special kind of patient and family centered health care that focuses on effective management of pain and other distressing symptoms that cause strain, anxiety and suffering for the patient, while incorporating psychosocial and spiritual care according to patient/family needs, values, beliefs, and cultures.

The goal of palliative care is to anticipate, prevent, and reduce suffering and to support the best possible quality of life for patients and their families, regardless of the stage of the disease or the need for other therapies. Palliative care begins at diagnosis and should be delivered concurrently with disease-directed, life-prolonging therapies and should facilitate patient autonomy, access to information, and choice. Palliative care becomes the main focus of care when disease-directed, life-prolonging therapies are no longer effective, appropriate, or desired. Palliative care should be initiated by the primary cancer team and then augmented by collaboration with a multi-disciplinary team of palliative care experts. (National Comprehensive Cancer Network, NCCN, Clinical Practice Guidelines in Oncology).

Pathology

The Medical City Department of Laboratories operates under the discipline of laboratory medicine and provides relevant information for the diagnosis, prevention or treatment of disease, impairment of personal care, and assessment of health.

The Laboratory processes over two million laboratory procedures annually. It has extensive testing capabilities in the following areas: Chemistry, Hematology, Blood Bank and Transfusion Services, Clinical Microscopy, Histology/Cytology, Microbiology, Serology, Immunology/Special Chemistry and Molecular Biology. The Laboratory can also provide a vast majority of routine tests, as well as a variety of special procedures. Ninety-nine percent of all testing is performed in-house. A home phlebotomy service is available for ambulatory and non-ambulatory patients.

Radiation Oncology

The Medical City’s Radiation Oncology Department offers radiation therapy services for the treatment of diseases primarily malignant tumors with the intent of improving the quality of life of patients. The Department also provides quality treatment by utilizing available modern technology and, complemented by its qualified and competent medical and allied medical staff. Through this, patients are assured of getting The Medical City’s brand of quality patient care and safety.

  1. External Beam Radiation Therapy: Using two Linear Accelerators (LINAC)
    1. Varian Truebeam Linear Accelerator (with Image Guided Capability)
    2. Varian Clinac 21EX Linear Accelerator
  2. Types of External Beam Radiation Therapy Procedures:
    1. Conventional Radiation Therapy
    2. Three-Dimensional Conformal Radiation Therapy (3DCRT)
    3. Intensity Modulated Radiation Therapy (IMRT)
    4. Image Guided Radiation Therapy (IGRT)
    5. Stereotactic Radio Surgery (SRS) / Stereotactic Body Radiation Therapy
  3. Computerized Treatment Planning 3D image based planning using CT-Scan and Magnetic Resonance Imaging (MRI)
  4. High Dose Rate Brachytherapy

Cancer Support Group

The Medical City’s Cancer Support Group meets every first Saturday of the month. They hold several activities like the Wellness in Illness Program. This is a semi-structured intervention to help facilitate emotional expression and processing for patients with chronic and debilitating illnesses and their families.

Primary modality:

  • Eat – nutrition for health
  • Pray – spirituality and prayer
  • Live – self-expression through art, music, dance, creative writing

Objectives are:

  • To provide a venue for emotional expression, primarily for patients and their families/caregivers
  • To facilitate coping with symptoms of illnesses and their treatments










PROGRAMS AND SERVICES PER CANCER SITE

Breast

The Breast Center operates the country’s first Stereotactic Mammotome Breast Biopsy System which allows computer-guided, minimally invasive biopsies that preserve breast tissue and can be done quickly and safely. Its superior imaging modalities include Digital Mammogram, Breast Ultrasound, and Breast Magnetic Resonance Imaging (MRI) Biopsy Coil, a device that maps the tumor’s location inside the breast more sharply.

Digital Breast Tomosynthesis, the latest addition to the Breast Center’s most advanced technology, is a newly developed form of three-dimensional (3D) imaging of the breast which offers a clearer and more accurate view compared to digital mammography (2D) alone.

The advantages of digital breast tomosynthesis include improved diagnostic capabilities, clearer images of dense breast tissue, earlier detection of small breast cancers, fewer unnecessary biopsies or additional tests and less emotional and physical stress for patients, among others.

(1) Stereotactic Mammotome Breast Biopsy System (Minimally invasive biopsy);

(2) Digital Breast Tomosynthesis (3D Imaging);

(3) Digital Mammogram, Breast Ultrasound, and Breast MRI Biopsy Coil

(4) Breast Conservation Surgery (BCS) with Intraoperative Radiation Treatment (IORT)

(5) Nipple sparing/ Skin Sparing Mastectomy with Immediate Breast Reconstruction

(6) Sentinel Lymph Node Biopsy

(7) Oncoplastic Procedure

(8) Image-Guided Biopsy Procedure


Colorectal

The Program’s Colorectal Unit is manned by the country’s premier specialists and equipped with state-of the art diagnostic and surgical technologies. Rectal Cancer can be staged accurately using Endorectal and Endoanal Ultrasonography performed by the most experienced colorectal surgeons in the country. The Unit is capable of treating all stages of colorectal cancer, using advanced endoscopic and minimally invasive techniques for early stage disease, as well as appropriate aggressive surgery for advanced metastatic disease.

The Unit has specific multidisciplinary programs for advanced, Stage IV disease, including metastasectomy for either liver or lung metastasis, and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for abdominal carcinomatosis. Permeating through-out the unit is an over-all commitment to excellence and quality. It utilizes the official Enhanced Recovery After Surgery (ERAS) program developed in Europe to ensure quick recovery and minimal complications, particularly for elderly patients. ERAS is a multidisciplinary program aimed at improving patient outcomes and recovery after surgery. It focuses on the involvement of the patients being active participants in their own recovery and ensures that they receive only evidence-based care at the right time.

State of the art staging modalities:

(1) Endorectal UTZ;

(2) Triphasic UTZ;

(3) MRI

State of the art surgery:

(1) Mesorectal excision;

(2) Sphincter preservation - to avoid permanent;

(3) Pelvic nerve preservation;

(4) Minimally invasive surgery;

(5) Cytoreductive surgery (CRS);

(6) Hyperthermic Intraperitoneal Chemotherapy (HIPEC);

(7) Enhanced Recovery After Sugery (ERAS)


Gyne / Cervix Uteri

Cervical cancer is cancer in the cervix, the lower, narrow part of the uterus (womb). Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cases of cervical cancer.

When exposed to HPV, a woman's immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years before it eventually converts some cells on the surface of the cervix into cancer cells. Half of cervical cancer cases occur in women between ages 35 and 55.

The Medical City’s ECO Clinic Offers:

(1) Cervical Cancer Screening: Pap Test and HPV DNA Test;

(2) Diagnosis: Colposcopy, examination of the cervix;

(3) Limited, Non-invasive Cancer Treament: Loop Electrosurgical Excision Procedure (LEEP), Cryosurgery, Hysterectomy;

(4) Invasive Cancer Treatment: Radical Hysterectomy, External Beam Radiation, Brachytherapy, and Chemotherapy


Head and Neck

The Head and Neck Cancer Unit is composed of the strongest multidisciplinary Head and Neck Cancer team, treating the most number of private patients. Services offered by the unit include Rigid nasal endoscopy, Laryngeal endoscopy, Flexible nasopharyngolaryngoscopy, Biopsies, Ultrasound guided fine needle aspiration biopsy, Multidisciplinary team meetings and Audiometry.

Biopsies can also be divided into nasopharyngeal biopsy, oral cavity biopsy and core needle biopsy. Other service offerings include a nasal and prosthesis laboratory and microvascular reconstruction.

Main services:

(1) Diagnosis: Blood tests for Thyroid hormones, Thyroid ultrasound and fine needle aspiration biopsy;

(2) Treatment: Thyroidectomy, Radioactive Idone Therapy, Thyroid Hormone Replacement Therapy;

(3) For recurrence: Regular follow up, Neck Ultrasound or CT scan, Measurement of thyroid hormone and thyroglobulin.


Liver

TMC's Center for Liver Disease Management and Transplantation (CLDMT) is a specialized clinic with an existing program for liver cancer. It is composed of a highly trained, multidisciplinary team of experts involved in the care of patients with malignant liver disease. Treatment options for all stages (early, intermediate, advanced) of liver cancer are available at the CLDMT.

These include surgery (liver resection, liver transplantation), local ablation (radiofrequency ablation [RFA], microwave ablation, percutaneous ethanol injection [PEI]), locoregional therapy (Transarterial Chemoembolization [TACE], Drug-eluting Bead Chemoembolization [DEB-TACE], Selective Internal Radiation Therapy [SIRT] with Yttrium90 beads), systemic therapy (chemotherapy, molecular targeted therapy, biologic agents) and palliative care. The CLDMT is likewise actively involved in viral hepatitis and liver cancer research, both locally and internationally.

Treatment: Surgery, Local Ablation, Locoregional Therapy, Drug-eluting Bead Chemoembolization, Selective Internal Radiation Therapy, Systemic therapy, and palliative care


Lung

Lung Cancer is a malignant tumor of the lungs. The abnormal cells of the tumor multiply without order or control, and destroy the healthy lung tissue around them.

Augusto P. Sarmiento Cancer Institute offers the following services:

(1) Lung Cancer Screening: low-dose computed tomography (CT) scan;

(2) Smoking Cessation and Relapse Assistance and Prevention Program (SCRAP)

(3) Comprehensive range of options for diagnosis using state of the art equipment: Bronchoscopy, Transthoracic Biopsy, Surgical Biopsy;

(4) Treatments: Surgery, Radiation Therapy, Chemotherapy, Molecular Targeted Therapy, Immunotherapy

(5) Multidisciplinary approach and coordinated care for patients diagnosed with lung cancer to patients and family


Neuro

Tumors affecting the brain and the spinal cord are being detected at an increasing rate due to early recognition of the signs and symptoms and rapid diagnosis with CT-Scan or MRI. Most of these tumors are benign and could be managed with cure as an intention. Patients with malignant lesions have been shown to have improved survival rate with multimodality treatment. The success of treatment of such conditions depends largely on timely and appropriate intervention.

Services:

For Brain Tumor – Routine Craniotomy and Excision; “Keyhole” Minimally Invasive Approaches; Skull Base Surgery; “Awake” Surgery with Cortical Mapping; Transphenoidal Excision of Stellar Tumors; Steriotactic Biopsy; Endoscopically Assisted Surgery; Intraoperative Cranial Nerve Monitoring; Tumor Embolization

For Spine Tumor – Routine Excision; Complex Thoracic and Abdominal Approaches; Instrumentation and Stabilzation Procedures

Other Services:

Prompt Diagnosis; Chemotherapy; Radiotherapy; Comprehensive evaluation and management of Pituitary Tumors; Accurate Histopathologic Diagnosis and Multidisciplinary Family Meeting.


Pancreatic

The Augusto P. Sarmiento Cancer Institute Pancreatic Cancer Unit of The Medical City delivers a highly competent, multidisciplinary approach to the management and care of patients with pancreatic cancer.

Early detection by screening at-risk individuals, early diagnosis using CT-scan pancreas protocol endoscopic ultrasound without biopsy, definitive treatment, neo-and adjuvant treatment, surveillance, rehabilitation, and nutritional support are some of major services offered.

Management of pancreatic cancer is almost always multidisciplinary. Surgery is the best way to cure. Chemotherapy and radiotherapy are adjuvant treatment options. Among cases where surgical option is not the primary mode, procedures done by interventional radiologists and gastroenterologists such as stenting, decompression and other non-surgical procedures may be done.


Prostate

The prostate is a gland the produces the fluid for semen, which helps transport sperm during ejaculation. It is about the size of a walnut. A malignant tumor growing in the prostate is prostate cancer. It can spread to surrounding lymph nodes, to other organs, and even the bones.

TMC's Fight Against Prostate Cancer

  1. Competent and experienced Medical Staff
  2. Latest treatment technologies
    • Da Vinci Robotic Surgery
    • True Beam Radiation therapy
  3. Complete Diagnostic strategies
    • MRI
    • CT scan
    • whole body bone scan
    • prostate biopsy
    Coming soon
    • Fusion biopsy
    • PET scan
  4. APSCI patient-centered services

Skin

Thousands of Filipinos are diagnosed with Skin Cancer every year. Anyone can have skin cancer- Caucasians, Mestizas, Chinese-Filipinos and darker skinned Filipinos are susceptible. People with fairer skin have an increased chance of having skin cancer because they are less protected from the UV rays of the sun. Those at increased risk for skin cancer include golfers, beach goers, outdoor sports enthusiasts, pilots, field engineers, farmers, and vendors, to name a few.

Types of Cancer:

  • BASAL CELL CARCINOMA (BCC)
  • SQUAMOUS CELL CARCINOMA
  • MALIGNANT MELANOMA

The Medical City’s Skin Cancer Treatments

  • MOHS Micrographic Surgery - is a type of skin cancer treatment which combines surgical removal of the tumor with the immediate microscopic examination of the tumor and underlying diseased tissue.

(2) Scraping and burning, freezing, routine excision surgery and topical immunomodulators


PATIENT STORIES

A Story of Cancer Survival

(Breast Cancer)

It is something everyone with a history of cancer in the family dreads most. Agnes Ycasiano, a 68-year-old clinical psychologist came face-to-face with the prospect of her own mortality in February 2017 (1-1/2 yrs. ago), when breast surgeon Dr. Aldine Basa of The Medical City told her and her husband: “It’s malignant.”

Dr. Basa explained that the 1.4 cm mass she got in Agnes’ left breast after a biopsy showed Stage 1 breast cancer. This was later labelled as Stage 2-A, because it had spread to a lymph node.

Agnes, who is trained to manage emotions including her own, took things calmly. Her faith in God also sustained her.

Agnes figured that since God gave her cancer, He can also heal her. Submission to His Holy will kept her from falling apart.

“Friends joked that it seemed to them that it was my husband Dennis who had cancer. At the outset, it was very hard for him to accept that he could lose his beloved wife too early,” she laughs.

But they did not know the whole story. Agnes describes her husband Dennis as “my rock.” She opened up to him about her fears, and so did he. Of course, he did not want to see her go. But in order to help her allay her fears and decide on her treatment, Dennis told her he was going to accept their fate – “that it will be hard but I will be alright.”

Her husband’s love inspired Agnes to fight.

She researched on conventional and natural cancer treatments. She agreed to go under the knife which enabled the removal of the mass on her left breast and 23 nearby lymph nodes, only one of which was malignant. Agnes told Dr. Basa that her preference was breast preservation, but she could do a mastectomy if she deemed it was fit.

Again, Agnes’ faith came to the rescue. As she was being wheeled into the surgery room, she imagined the Blessed Virgin Mary standing on her left, and Jesus Christ on her right, with the heavenly choirs of angels surrounding her Agnes had a lumpectomy and 33 radiation sessions. After that, she put her foot down when it came to chemotherapy and Dr. Basa did not object to this. The doctor also agreed to preserve Agnes’ left breast.

“Then it seemed chemotherapy was not necessary because it was not that bad (she had stage 2-A breast cancer) and all my other organ ultrasounds showed negative results for possible spread,” explains Agnes.

“I told myself I will still be able to fight this with my medicines, and disciplined nutrition and exercise.”

Dr. Basa’s decision to follow her will touched Agnes. By respecting her decision, Dr. Basa made Agnes feel that she was a true partner in the decision-making process.

Today, Agnes has yet to find any reason to worry again. Ultrasound tests for the past year showed no spread and negative results. And she is praying it will remain the same in August, when she comes back to The Medical City for the third round of her follow-up monitoring tests, which are done every-six-months.

Cancer has made the already disciplined Agnes even more health- conscious. She fights the temptation to go back to bed and wakes up at 6:00 a.m. for her morning walks with her husband around the Quezon City subdivision where they live. When work permits, the happy couple walks for more than an hour, and this usually happens around three to five times a week.

To complement the Arimidex and Caltrate medicines and other vitamins prescribed to her, Agnes is now more alert about what she eats. She knows sugar feeds cancer cells so sweets are banned on her plate, and she hopes to influence the use of sugar at her home table. She and her husband stick to brown and/or black rice, because she believes the white variety leads to a rise in sugar levels, which has been linked to cancer Agnes has also stopped indulging in her love for white bread because of its high sugar content. She makes herself a tall glass of vegetable shake made up of guyabano, carrots and other cancer-fighting fruits every morning. Agnes takes half of the shake in the morning and the other half at night.

Friends remark that she has not looked this good. Thanks to Agnes, they look at cancer in a more positive way.

“I’m not scared of dying. If it happens, my husband and I have talked about it. I’ll do whatever that has to be done short of chemo to fight cancer. I’ve led a good life. I’ve served and continue to serve people through my profession. I have no regrets,” smiles Agnes.

Thanks to her faith, family, doctors and self-discipline, Agnes remains the oldest in her family to survive cancer.

In proving that she can, Agnes is showing that others can as well.

OTHER STORIES

Early Detection Saves Architect's Life
(Colorectal Cancer)

God Sent Me Angels in Disguise
(Palliative Care)

Giving Voice to Tongue Cancer
(Head and Neck Cancer)

Biography

Augusto P. Sarmiento, MD

Surgeon Par Excellence

Dr. Augusto P. Sarmiento was born on August 21, 1924 in Calapan, Mindoro.

While he had always envisioned himself as becoming a surgeon after graduating from Mapa High School in March 1941, he was (hell) bent in becoming a Philippine Air Force pilot. He had it all planned out. As a requirement for applying to become a flying cadet, he would have had to finish 60 university credit units (equivalent to a 2-year Pre-med course) at the College of Liberal Arts at the University of the Philippines in Padre Faura.

This, however, was thwarted by the outbreak of World War II on Dec. 7, 1941 and because of this Dr. Sarmiento decided to pursue his pre-med course at the U.P. Junior College, Manila from 1942-1943 and obtaining his Associate in Arts degree. He then proceeded to obtain his medical degree from the same university’s College of Medicine graduating on April 13, 1948.

After passing the medical examination board examinations in August 1948 he started working as a Junior Parasitologist from September 1948 to March 1949 under the Schistomiasis Control Program of the Department of Health under Dr. Trinidad Pesigan. He then became a first year resident at the UP-

PGH, Department of Obstetrics. Dr. Sarmiento used his Obstetrics residency training as his gateway to get into the Department of Surgery where he started his surgical residency in early 1950.

“My general surgery training in UP-PGH Medical Center from 1950-1954 under the watchful eyes of Dr. Januario Estrada (Head of the Department of Surgery) was a God-given opportunity,” he said. Dr. Estrada, at that time, was deemed the dean of Filipino surgeons. In addition to his very active private surgical practice he also had authored numerous scientific papers that illumined the practice of surgery and medicine as a whole. Upon completion of his surgical residence training in 1954, like many other graduates of various medical specialties, he flew to the USA to pursue more advanced surgical training. After a brief six-months’ stint at the Presbyterian Hospital (July-December 1954), he applied as resident in surgery at Memorial Center for Cancer in New York City, considered the Valhalla of Cancer Surgery. Because of his PGH resume and after a very exhilarating personal interview with the Chairman of Residency Training, he was accepted into the surgical program from January 1, 1955 and progressively until completion in early 1958. For almost four years, Dr. Sarmiento rotated through the anatomically- oriented specialty services such as Head and Neck, Breast, Gastrointestinal and Mixed Tumors, Thoracic, Genito-Urinary, and Bone and Soft Tissues. Admittedly, these programs vastly expanded the young doctor’s armamentarium to deal with all kinds of neoplastic diseases and even strengthened his skills as a general and oncologic surgeon.

Thereafter, until August 1958, he worked as Associate in private practice of Dr. Hayes Martin, widely regarded as the Father of Head and Neck Surgery. Dr. Sarmiento was offered partnerships in private practice by Dr. Martin and also by Dr. George T. Pack, another world-famous abdominal cancer surgeon, but he chose to return to Manila in October 1958. He then started private practice in general and cancer surgery at the ABM Sison Medical Group Clinic in Padre Faura St. Ermita for outpatient consultations and at Our Lady of Lourdes Hospital for his surgical and inpatient practices in November 1958.

He simultaneously also held the position of Assistant Professorship in Surgery at the UP-PGH and at UERMMMC teaching students as well as surgical residents. It was clearly evident that he encountered a very significant number of cancer cases among his many patients.

“I found myself busy helping the afflicted and feeling humbled yet pleased that I had received excellent surgical coaching/teaching both at UP-PGH and in NYC,” he shared.

It was also during this time that the approach to cure was based on the concept that cancer expands by contiguous extension (i.e. the Halsted concept), and “radical excision was the answer,” he said.

Radical mastectomy also known as the Halsted procedure was first performed by William S. Halsted, an accomplished young surgeon at Johns Hopkins, in 1882. With surgery as a breast cancer patient’s only option, a woman treated by this method not only had her entire breast removed, but also the surrounding tissues such as the axillary, lymph nodes and the pectoral muscles. According to Halsted’s belief, breast cancer grew in a slow, orderly way, spreading from the breast to the lymph nodes and finally to other parts of the body. He also believed that the more extensive the surgery, the less likely the cancer would return.

The Jerry Urban modification included the ipsilateral chest wall resection to include the mammary chain of nodes and the chest wall defect covered with the patient’s own fascia lata or from bank fascia.

Aside from Halsted radical mastectomy for breast cancer, other extensive surgeries during that time were pelvic exenteration for uterine and cervical cancers, and “commando” (combined operation for mouth, mandible and neck dissection) surgery for oral malignancies. Significantly, patients with these particular cancer types were unarguably referred to surgical oncologists like Dr. Sarmiento, radiotherapists like Dr. Lapuz, and medical oncologists like Dr. Tangco. But the outcomes, Dr. Sarmiento said, were usually depressing.

Surgery for cancer treatment

In the last 20 years of the past century, a multidisciplinary approach was adopted in the management of malignant neoplasms, or new abnormal growth of tissue. The approach was complemented by “sophisticated imaging, newer cytotoxic and antiangiogenesis drugs, antibody or vaccine immunotherapy, molecular-based laboratory assessments, and minimally invasive surgical interventions for cancer.” Surgery, however, “remains to be the most frequently used therapy for cancer though outcomes are better and more often curative when non-surgical interventions are employed in combination with surgery.”

Presently, surgical, medical and radiation oncologists work closely together with nuclear medicine physicians and pathologists. “Preoperative radiotherapy and chemotherapy are sometimes used to reduce tumor size and increase the efficacy of surgical resection or cytoreduction surgery.”

Dr. Sarmiento likewise explained that cancer in the breast, prostate, head and neck, and soft tissue sarcomas can be managed today by conservative surgery because of the multimodal approach. This, he said, improves both the duration and quality of life of the patient.

Advances in cancer biology, pathology and imaging sciences have led to more limited conservative surgery with combined therapies. These therapies are designed to address the spread of small cancer cells to other organs not picked up by screening or diagnostic tests, even at the earliest stages of the disease.

“The surgeon must be technically adroit, well-versed in cancer biology and have a thorough knowledge and understanding of the range of therapies that other oncologic disciplines can offer patients in order to enhance outcomes,” he said.

Most outstanding oncology distinction

Dr. Sarmiento earned the Most Outstanding Oncology distinction from the Philippine Society of Oncology, and the Legend of the Knife of the Philippine College of Surgeons on September 10, 2012.

Affiliated with different medical groups, he is a Diplomate and Fellow of the Philippine College of Surgeons, President of the Philippine College of Surgeons in 1975, a Fellow of the American College of Surgeons, and a Diplomate and Fellow of the Philippine College of Pharmaceutical Medicine.

The TMC connection

In 1965, Dr. Sarmiento and four other bright and young doctors practicing as the ABM Sison Medical Group, named after the group’s mentor, Dr. Agerico B. M. Sison, decided to put up their own hospital to be able to accommodate their growing number of patients and enhance their practice through modern hospital facilities. They found a place along what is now the bustling San Miguel Avenue in Mandaluyong City, then an isolated, overgrown patch of land with cogonal grass.

In October 1967, the ABM Sison Hospital began operations. But only two years after it opened its doors, the hospital was on the brink of bankruptcy. Being a 93-bed hospital, it was just not economically viable because of its location in a virtually unpopulated area.

The solution that was formulated was groundbreaking for the times. Leaders from the medical and business professions would combine to create a revolutionary model of governance rather than conflict.

Under the leadership of the late Augusto M. Barcelon, an acknowledged leader in the banking industry in the country, as Chairman of the Board and Dr. Sarmiento, as President and Medical Director, operations were streamlined, costs were rationalized and internal morale was boosted. Soon, the hospital managed to raise enough funds to expand capacity to 293 beds, 200 of which were small but comfortable and adequate private rooms; the edifice was called the Roxas wing named after the board member who espoused the project. This move led to the rapid success that marked the hospital’s transformation.

In 1975, the hospital was renamed The Medical City, yet it remained focused on delivering excellent patient service through professional medical leadership and innovative management practice. Since then The Medical City has continued to grow steadily.

In 1996, Dr. Sarmiento resigned as President and Medical Director after 27 years (1969-1996) of service. He has been the Chairman of the Board of Directors of Professional Services Inc. (PSI) - The Medical City since 2004 following Mr. Barcelon’s passing. He is also the Chairman of Proser Health Services Inc.; Medical Arts Tower; PSI Healthcare Development Services Corp.; Guam Healthcare Development, Inc.; The Medical City Clark, Inc.; and Philippine Foundation for Health and Development Inc.

Next generation of surgeons

As a surgeon himself, Dr. Sarmiento has played a vital role in continuously educating and molding surgeons in TMC.

When asked what are the most important qualities a surgeon should have, he readily said: “A hallmark of a surgeon who may be considered a great one is the doctor who has gone through many years of excellent training especially at reputable medical institutions and who has dedicated himself to the specialty pursued and always in a focused manner. For having received great coaching, he himself should be a great coach. He must continue training and practicing to be able to keep up and stay on top of all new advances. He must have faith in who he is and what he does and is fully capable of. Communicating directly and connecting well with his patients and with great bedside manners lessen the burdens of a sick patient.”

Longevity

As a nonagenarian, Dr. Sarmiento is still very much active and with a very sharp mind, much to the envy of his contemporaries. He attributes his longevity to good genes, not having any vices, doing and following everything that he advises his patients, and “forever trying to maintain a great shape.”

“Indeed, I feel that I still can take some 60-80 -year olds ‘for a run.’ I know that, at almost 94, I exemplify good health, owing to the fact that I still feel strong and capable at what I do best and love most,” he said.

“I do try to keep busy as much as possible by staying involved with The Medical City because I like keeping my mind working whenever possible. And lastly, I try to stay fit by indulging in the only sport I still can enjoy – golf – which additionally allows me to socialize and have lunches or dinners with close friends,” he added.






OUR TEAM

The Medical City's Augusto P. Sarmiento Cancer Institute is staffed by an excellent team of cancer care professionals:

Breast Surgeons

Dr. Erwin Alcazaren

Dr. Norman Bustos

Dr. Emiterio Banatin

Dr. Ricky Solamo

Dr. Aldine Basa

Dr. Pierette Kaw

Dr. Mary Geraldine Remucal

Dr. Kaiserin Santos-Lipana

Dr. Rommel Menguito

 

Breast Radiologists

Dr. Kimberly Ang-Baluyut

Dr. Heidi Herminia Santos

Dr. Janeth Malabuyoc

Dr. Reza Maria Koa-Sales

Dr. Michelle Ramos-Atienza

Dr. Anna Victoria Figueroa

Dr. Ma. Christina Difontorium

 


Head and Neck

Dr. Daniel Alonzo

Dr. Samantha Castaneda

 


Thoracic

Dr. May N. Agno - Pulmonology

Dr. Emily Aventura – Pulmonology

Dr. Allan A. Bacayana - Pulmonology

Dr. Renato S. Cheng - Pulmonology

Dr. Leah Rosario Y. Dycoco - Pulmonology

Dr. Liza L. Garcia - Pulmonology

Dr. Arnold G. Germar - Pulmonology

Dr. Antonio Renato B. Herradura - Pulmonology

Dr. Maria Cecilia I. Jocson - Pulmonology

Dr. Romeo O. Laba, Jr.- Pulmonology

Dr. Lydia K. Lua- Pulmonology

Dr. Hermogenes P. Masangkay, Jr. - Pulmonology

Dr. Francis Luke N. Piedad - Pulmonology

Dr. Evelyn M. Pingul-Agno- Pulmonology

Dr. Josephine B. Ramos - Pulmonology

Dr. Hans Jeremy R. Ramos - Pulmonology

Dr. Ronald Antonio Reodica - Pulmonology

Dr. Evelyn Victoria E. Reside - Pulmonology

Dr. Hilario M. Tamondong, Jr. - Pulmonology

Dr. Esther Fredelyn M. Tomas - Pulmonology

Dr. Calixto A. Zaldivar, Jr. - Pulmonology

Dr. Christine L. Chavez - Interventional Pulmonology

Dr. Julius Caesar J. Dalupang - Interventional Pulmonology

Dr. Manuel Hector U. Silos - Interventional Pulmonology

Dr. Dennis M. De Asis - TCVS/Thoracic Surgery

Dr. Mariam Grace A. Delima - TCVS/Thoracic Surgery

Dr. David F. Geollegue, Jr. - TCVS/Thoracic Surgery

Dr. Anthony V. Manlulu - TCVS/Thoracic Surgery

Dr. Francisco Javier D. Millar - TCVS/Thoracic Surgery

Dr. Racel Ireneo Luis C. Querol- TCVS/Thoracic Surgery

Dr. Cesar A. Millar- TCVS/Thoracic Surgery

Dr. Ed Bautista - TCVS

Dr. Jaime Esquivel - TCVS

Dr. Felix Lukban - TCVS

Dr. Adrian Manapat – TCVS

Dr. Karlos Aleta - TCVS

 


Colorectal (Colon and Rectal)

Dr. Manuel Francisco Roxas - Colorectal Surgeon

Dr. Robert Chang - Colorectal Surgeon

Dr. Marie Dione Sacdalan - Colorectal Surgeon

Dr. Catherine Co - Colorectal Surgeon

Dr. Carlo Angelo Cajucom - Colorectal Surgeon

Dr. Marc Paul Lopez - Colorectal Surgeon

Dr. Joseph Roy Fuentes - Colorectal Surgeon

 


Liver

Dr. Vanessa De Villa - General Surgery/Organ Transplantation

Dr. Janus Ong - Gastroenterology/Transplant Hepatology

Dr. Eternity Labio – Gastroenterology/Transplant Hepatology

Dr. Therese Macatula - Gastroenterology/Interventional Hepatology

Dr. Karen Sophia Mercado – Pediatric Gastroenterology/Hepatology

 


Gynecologic Oncology

Dr. Edna C. Banta - Gynecologic Oncology

Dr. Ronald Augustine O. Campos - Gynecologic Oncology/MIS/Robotic Surgery

Dr. Maria Julieta V. Germar - Gynecologic Oncology

Dr. Mary Christine F. Palma- Gynecologic Oncology

 

Medical Oncology

Dr. Janet B. Bautista

Dr. Marina A. Chua-Tan

Dr. Fatima O. De Guzman-Fuerte

Dr. Alan Paul I. Olavere

Dr. John P. Querol

Dr. Emmanuel Eugenio V. Regala

Dr. Dennis L. Sacdalan

Dr. Ma. Belen E. Tamayo

Dr. Beatrice J. Tiangco

Dr. Josephine C. Tolentino

 

Pediatric Oncology

Dr. Joseph Vincent Eric A. Alba - Pediatric Hematology/Oncology

Dr. Maria Luz U. Del Rosario - Pediatric Hematology/Oncology

Dr. Maria Theresa A. Pernia - Pediatric Hematology/Oncology

 

Musculoskeletal Oncology/Orthopedic Surgery

Dr. Cesar Dimayuga

Dr. Rafael Claudio

Dr. Albert Jerome Quintos

Dr. Richard Rotor

Dr. Amelito Sia

 


Palliative Care/Home Care

Dr. Maria Fidelis Manalo

Dr. Agnes Bausa-Claudio


Contact Us

The Medical City's Augusto P. Sarmiento Cancer Institute (APSCI) is located on the 8th floor, Nursing Tower B.

Trunkline: 8988-1000/8988-7000 ext. 6214

Email: cancer_institute@themedicalcity.com@themedicalcity.com

SERVICES OPERATING HOURS LOCAL TELEPHONE NOS.

Cancer Coordinating Center (Consultation, Multidisciplinary Team Meeting, Care Coordination, Telemedicine): Mon-Fri (8:00am-5:00pm)

Radiation Oncology: Mon-Fri (7:00am-3:00pm)

Colorectal Clinic (Consultation, Telemedicine): Mon-Fri (9:00am-5:00pm)

Multispecialty Cancer Clinic: Mon – Friday, 8am – 5pm local 6214

Breast Center (Mammogram and Breast Ultrasound): Mon – Sat, 8am – 4pm local 6527 or 6528

Chemotherapy Unit: Mon – Fri, 8am – 5pm local 6256 or 6652

Head and Neck: Mon – Sat, 8am – 5pm local 6250 or 6251

Center for Liver Disease Management and Transplantation (Consultation, Multidisciplinary Team Meeting, Fibroscan, Telemedicine): Mon – Fri, 8am – 5pm local 6506 or 6507

Palliative Care: Mon - 1pm – 5pm local 6214

Pain Management Clinic: Mon – Fri, 8am – 4pm (OPD) local 6453; Mon 6am – Sat 10pm (In-patient)