February the 21st, 2023 - Many are quick to take a (usually warranted) swipe at the state of the Croatian healthcare system. They'd be right to do so. It is grossly mismanaged and chronically underfunded, with both patients and staff suffering the often severe consequences. Croatian doctors, however, just keep on impressing.

Medical wonders never cease at the Radiochirurgia Special Hospital in Zagreb, as the Croatian doctors there are the only ones in the entire world to perform radiosurgical procedures under general anesthesia, which in just one procedure, destroy cancerous tumors of the lungs, pancreas, and prostate without irradiating the delicate surrounding tissues and organs.

As Poslovni Dnevnik writes, this type of radiosurgery procedure can be performed with a patient referral from HZZO (the Croatian Health Insurance Fund), and the hospital which carries it out cooperates with KB (Clinical Hospital) Merkur and the Faculty of Electrical Engineering and Computing. The results in the fight against cancer are incredible, as reported by HRT.

In one patient, they managed to destroy a form of cancer which causes the deaths of millions each year - an inoperable pancreatic tumor - using radiosurgical ablation.

No blood, no pain, no long recovery

"Over 50 percent of patients live longer than 24 months, and somewhere around 13 percent of them live longer than 4 years. The reactions following the procedure are spectacular. There's no blood, no pain, no long-term recovery, and no postoperative complications. The patient comes, and otherwise it is done in one fraction that lasts for 45 minutes to an hour and a half, depending on the patient, and then the patient goes home. That means that this is actually an outpatient procedure", said hospital director Dragan Schwarz.

During the procedure, the patient must be under general anesthesia so that the radiosurgery procedure can be performed as accurately as possible.

"The problem is that cancerous tumors move within the body, due to breathing, peristalsis and other physiological processes. When under general anesthesia, we achieve a situation in which the patient is completely motionless. The anesthesia stops them breathing and reduces peristalsis. This results in heightened safety of over 90 percent. Even according to our own experience, there's a 98 percent chance that the treated lesion will necrotise and then be destroyed," said Hrvoje Kaucic, head of the radiosurgery and radiotherapy department.

A special role is played by medical physicists who are in charge of ensuring that the linear accelerator accurately and precisely delivers the planned and prescribed dose of radiation.

The pancreas is the biggest challenge of all

Cooperation with colleagues from electrical engineering and computing helps them to be more precise and without the anesthesia. They detect moving organs in order to spare them during the targeted destruction of the tumor. The pancreas, they say, is the biggest challenge within the human body when it comes to this.

"It's a challenge, but we managed through this work to carry out the procedure based on the knowledge of other organs and the mutual relationship between the organs and the pancreas, and we got a fairly precise position of the pancreas. From 80 to 90+ percent of the reliability of the position of an individual organ", said Zdenko Kovacic, head of the Laboratory for Robotics and Intelligent Management Systems.

Experts in radiosurgery together with Croatian doctors from KB Merkur provide patients suffering from the rare cancerous Klackin's tumor a fighting chance for a longer life.

"We've now created a model to start radiation with radiosurgical treatment, where a patient who is a transplant candidate and has a Klackin's tumor receives an ablative dose. After that, we put it on the list and after that we successfully transplant it. Survival is much higher and the odds are much better - oer three years," said Stipislav Jadrijevic, head of the Department of Abdominal Surgery at KB Merkur.

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February 16, 2023 - The five-year survival rate of children with malignant diseases in Croatia is above the European average, and according to data, in 2021, 16 children under the age of 19 died from malignant diseases in the Republic of Croatia, according to the announcement of the HZJZ on the International Childhood Cancer Day.

As 24Sata / HINA writes, according to the latest data from the Cancer Registry of the Republic of Croatia, in 2020, 159 children under the age of 19 were diagnosed with malignant diseases in Croatia, out of which 67 were female.

In the past ten years, an average of 157 children under the age of 19 were diagnosed, and 27 died of malignant diseases.

At the national level in Croatia, out of a total of 159 children with a newly diagnosed malignant disease in 2020, 49 were under the age of 4, 27 were between the ages of 5 and 9, 34 were between the ages of 10 and 14 and 49 between the ages of 15 and 15. up to 19 years.

The most common diagnoses of malignant diseases in children were leukemia, lymphomas and malignant brain and spinal cord tumors.

In treating malignant diseases, it is difficult to define a cure, but it is common to take five-year survival as a measure of cure. Data from the extensive global observational study CONCORD-3 published in the Lancet journal show that five-year survival from malignant diseases in children in Croatia is above the European average. It is 95 percent for childhood lymphomas, 85 percent for acute lymphatic leukemia, and 73 percent for brain tumors.

Malignant diseases in childhood have significant social and medical consequences. The diagnosis and the changes in everyday life due to the new situation represent a significant stressor for the child and their family. To overcome the daily difficulties they face in caring for their child, it is necessary for parents to have help: equal access to care and modern treatment procedures and, just as importantly, families need psychological support in a timely manner, the Croatian Institute of Public Health (HZJZ) points out.

They also emphasize that support is needed even after the end of therapy because patients and their families can face the physical and psychological consequences long after a diagnosis of a malignant disease and the often very intensive treatment.

International Childhood Cancer Day is celebrated on February 15 with the aim of raising awareness about malignant diseases in children and providing support to ill children and adolescents, as well as their families and survivors.

Based on the decision of the Croatian Parliament, since 2006, February 15 has been celebrated in Croatia as National Childhood Cancer Day.

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November the 14th, 2022 - Croatian students have generously and selflessly donated their hair to other children who are suffering with cancer and needing to undergo chemotherapy which more often than not results in hair loss.

As Poslovni Dnevnik writes, Noelle Suler Bistre is just eight years old, she attends the second grade of Eugen Kumicic Elementary School, and for her seventh birthday she decided she didn't want any presents. This school year, Noelle donated hair she had cut off to the Iskra Association of Parents of Children Suffering from Malignant Diseases from Banja Luka, and she decided on this venture two weeks ago thanks to her friend Dior, who is one year older than her, and with whom she goes to ballet.

It was Dior, according Noelle, that motivated her to donate 36 centimetres of her own hair to make a wig that will brighten up the days of a child dealing with not only cancer but the often extremely harsh realities of cancer treatment.

However, Noelle is not the only student who decided to make this humanitarian move, because in the last three years, three other Croatian students have done the same thing, and they have jointly donated a total of 148 centimetres of hair. Sixth grade student Natali Bozic was the first to do it three years ago, followed by Masa Stevanovic, then fifth grader who has been attending the Josip Pavlisic Catholic Elementary School since this school year, while eighth grader Ana Prtenjaca did it this September, according to Rijeka portal Novi list.

Regardless of what was the impetus for the donation, all four of these kind and generous Croatians students agree that they have never regretted doing it, and as Natali says, her older sister encouraged her to donate her hair.

All of these Croatian students, according to the principal of Eugen Kumicic Primary School, Ana Anic Opasic, regularly participate in various humanitarian actions that the school organises, and within the framework of which the school designed and had umbrellas made with the motto "Svaka kap je bitna/Every drop counts".

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November 12, 2022 - Private healthcare in Croatia is increasingly focused on treating malignant diseases. Some modern methods of cancer treatment are already proving successful.

As Poslovni writes, the expert team of the Special Hospital Radiochirurgia Zagreb has so far had the opportunity to treat more than seven thousand patients and has analysed more than ninety thousand cases, among which all forms of cancer were represented. Lung, liver, and prostate cancers were the most common types. These figures and the latest cancer treatment achievements were presented at the 8^th Croatian Surgical Congress with international activities. As part of the Congress, surgeons from leading hospitals in Heidelberg, Dallas, Tel Aviv, Athens, Liege, Basel, Ljubljana, Maribor, Belgrade, and Zagreb visited Radiochirurgia Zagreb Special Hospital in Sveta Nedelja.

"In six years of operation, Radiochirurgia Zagreb has grown into one of the leading regional and European cancer treatment centers. Using the linear accelerator Varian Edge and CyberKnife S7, which enables the treatment of cancer with the help of artificial intelligence, as well as a superbly equipped oncological-surgical theatre, the expert team of Radiochirurgia Zagreb was the first to introduce modern adaptive-hybrid surgery into practice in this part of Europe, which, in cases where it is indicated, combines classic surgery with radiosurgery and interventional radiology", they point out from the institution headed by Dragan Schwartz.

What the expert team of the Special Hospital is most proud of are the results of the treatment of pancreatic cancer, which they treated in the last five years in 340 patients, 120 of whom were diagnosed with an inoperable locally advanced form, where the survival rate for 50 percent of patients was longer than two years and 13 percent longer than four years. According to available data, this is currently the longest survival rate for this form of cancer worldwide.

At Radiochirurgia Zagreb, they believe that the hybrid approach to treatment will become more and more common in practice, and concrete cooperation with several leading institutions was also agreed upon at the congress.

Private healthcare in Croatia is increasingly focused on treating malignant diseases - this is confirmed by the announcement of the University of Pittsburgh Medical Center's (UPMC) investment of around 15 million euros in Zabok, based on a cooperation agreement with the St. Catherine's Special Hospital. As announced this week, the establishment of the new Center for the Treatment of Malignant Diseases in Zabok will provide Croatian patients with diagnostic and therapeutic services fully equivalent to those in the USA, in accordance with the current prices of the HZZO.

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ZAGREB, 5 June 2022 - Croatia on Sunday marked for the first time National Cancer Survivors Day, and on that occasion Health Minister Vili Beroš pointed out the importance of prevention of malignant diseases.

He went on to say that all cancer survivors deserve the biggest respect and praise for their courage, enthusiasm and power they show in overcoming malignant diseases.

According to him, every third person in Croatia is affected by malignant diseases.

He highlighted the importance of timely checkups and national preventive screening programmes.

According to the latest Eurostat data for 2020, in terms of the cancer-caused mortality rate Croatia ranks fourth after it was second in 2019.

This is positive headway, however, the minister warns that the national cancer incidence rate in Croatia is higher than in the EU average rate due to late checkups with physicians, unhealthy habits, insufficient health literary and an aging population.

The health ministry's state secretary Silvio Bašić said at a ceremony marking the day in Cvjetni Trg Square today that the action plan for the next three-year period was being hammered out.

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ZAGREB, November 12, 2020 - President Zoran Milanovic on Thursday met with representatives of the Croatia against Cancer initiative, an association of cancer patients, supporting their demands for the adoption of a national cancer strategy as soon as possible.

Croatia is the only EU member state that still hasn't adopted a national cancer strategy which would represent a model of true and more than necessary reform of the health system which Croatia has to implement with the aim of improving the outcome of treatment and ensuring patient rights guaranteed by the Constitution, the meeting was told.

The initiative's representatives warned that adopting the strategy would put Croatia in a position to use EU funds intended for the fight against cancer, which now is not possible.

August 29, 2020 – The team of Croatian scientists' published results prove that extracts from a medicinal fungus stop tumours growing, spreading and help chemotherapy.

A team of Croatian scientists has proven that a known medicinal fungus can be used in effectively fighting colon cancer. They published their findings in a renowned science journal over the past week.

The team, led by Boris Jakopović (Dr Myko San, Croatia), presented the results of effects on colon cancer by a complex series of extracts from the Agarikon.1 medicinal mushroom. They proved that the extracts strongly inhibit the growth of existing tumours and prevent the spreading of the disease. Boris Jakopović has been testing the effectiveness of medicinal mushrooms on cancer for several years.

A further positive effect on a number of other proteins - biomarkers associated with a better prognosis for progression of the disease - was also found and detailed in the study. This effect of the mushroom extracts can significantly enhance the effectiveness of standard chemotherapy and also alleviate its side effects.

Croatian scientists who also undertook the work and co-signed the published findings were Anita Horvatić from the Faculty of Veterinary Medicine in Zagreb, Nada Oršolić from the Faculty of Science in Zagreb, Marko Klobučar, Sandra Kraljević Pavelić and Petra Grbčić from the University of Rijeka. Andrea Gelemanović from the Mediterranean Institute for Life Research in Split and Ivan Jakopović from the company Dr Myko San.

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As Glas Istre/Borka Petrovic writes on the 10th of January, 2020, one incredibly brave sixteen year old girl from Pula has taken on and successfully beaten cancer.

''Instead of getting nervous about receiving my exam results in the semester of first grade in high school, I was waiting for my blood test results, and instead of reading for school, I was reading about the side effects of medicines I was going to be taking, and learning about them. As my friends swam in the sea in the summer, I was throwing up. I'm sorry I went through such a difficult period, but my illness was not only a huge burden for me, but kind of a gift, too,'' Erin says.

In the Republic of Croatia, about 150 children become ill each year with malignancies. Erin Rupčić is one of them. She found out that she had malignant Hodgkin's lymphoma at the age of just fourteen, in the final grade of elementary school. Today, the worst of the cancer is now thankfully behind her. Brave Erin from Pula went through everything she went through while being treated for cancer, the day after her sixteenth birthday was celebrated.

It was 2018, just before the spring holidays. I remember it was Wednesday, because on Friday I was supposed to perform for the senior volleyball team for the first time and I was really excited about that. After school I decided to take a little stroll around the city and I noticed a little lump on my neck. It didn't seem like a scary thing to me, but I showed it to my mum anyway, and that's when the visits to the wards of the Pula hospital began,'' Erin recalls.

After several diagnoses, from it being a simple cyst to her just having had a mere swollen lymph node, at the insistence of her parents, Erin went for more intense tests in Rijeka. After the results from the PET / CT scans caused alarm, they were followed by a biopsy and an irrefutable diagnosis - lymphatic cell cancer. Her childhood was instantly interrupted in the most unimaginable way possible, and this schoolgirl from Pula was forced to grow up much more quickly than she should have.

''I didn't even know what cancer was, I was fourteen and had never been seriously ill before. Almost all of my hair fell out after I underwent my first chemotherapy, so I decided to shave the rest of it off. First, I was a little ashamed of it, you don't see girls without any hair very often. But in the end, it wasn't that much of a problem for me. I knew my hair would grow back and that I needed to survive,'' concludes Erin, who has now beaten the disease and can return to her normal life after a difficult but victorious battle.

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