Oncology in Tunis

Oncology is the branch of medicine that focuses on the research, prevention, diagnosis, and treatment of cancer. A medical professional who specializes in diagnosing and treating people with cancer is called an oncologist.

An oncologist can design a treatment plan based on detailed pathology reports that shows the type of cancer the patient has, how much cancer has developed, how fast the cancer is likely to spread, and what parts of the patient's body are involved.

The field of oncology has three main areas, which include:

• Medical oncologists use chemotherapy, hormonal therapies, and other types of targeted treatments to treat cancer. Most people think of medical oncologist as their primary cancer doctor. Medical oncologists help monitor and maintain patients' well-being, as well as helping patients manage side effects. Often patients follow up with their medical oncologist once their treatment is complete.
• Surgical oncologists perform the surgical removal of the tumor and surrounding tissue. They will help patients prepare for and recover from any surgical procedure they undergo during their cancer treatment. If your primary doctor suspects that you have cancer, a surgical oncologist is likely one of the first doctors you see. Surgical oncologists can perform biopsies, which involves removing a small tissue sample to be checked for cancer cells.
• Radiation oncologists treat cancer using radiation therapy. They use high-energy photon beams to target and destroy cancer cells. Approximately one-half of all cancer patients will undergo radiation treatment during their cancer care.

Because most cancers are treated with a combination of therapies, you could see two or all three different oncologists during the course of your treatment.

Besides the three main areas, there are also several other areas of oncology. These include:

• Pediatric oncologists diagnose and treat cancer in children. Some types of cancer appear more often in children and teenagers, such as leukemia, brain tumors, osteosarcoma, and Ewing’s sarcoma. Some pediatric oncologists focus on conducting research on childhood cancers, while others specialize in certain types of cancer.
• Gynecologic oncologists treat cancers that affect women, such as cancer of the ovary, cervix, uterus, vagina, and vulva. Additionally, they also treat complicated gynecological conditions that are not cancerous, such as fibroid tumors and endometriosis.
• Hematologist-oncologists diagnoses and treats blood cancers, such as lymphoma, leukemia, and myeloma. They may also specialize in the management of solid tumors.

Oncologists usually work with a variety of other medical professionals, including pathologists, diagnostic radiologists, oncology nurses, and oncology social workers. They may also work with doctors from other areas of medicine, such as neurologists, dermatologists, or urologists.

What does Oncology Involve?

There are many types of procedures to treat cancer. The types of procedures that you receive will depend on the type of cancer you have and how advanced it is. Some people who have cancer will only have one treatment. However, most people have a combination of treatments, such as surgery with radiation therapy and/or chemotherapy. Below are the types of procedures to treat cancer:

Chemotherapy

Chemotherapy is a type of treatment that uses drugs to kill cancer cells in the body and prevent them from growing. The drugs can prevent cell division, target the food source of the cancer cells’ (the hormones and enzymes the cells need to grow), and trigger apoptosis (a process in which cancer cells kill themselves).

• Chemotherapy drugs can be given in several different ways, including.
• Oral – taken in a pill or capsule form.
• Intravenously – through an infusion into a vein.
• Shots – injected with a needle.
• Topical – applying creams or gels into the skin. This type is used to treat certain types of skin cancer.

Chemotherapy drugs can also be given directly to cancer or directly to an area of the body, such as the abdomen or central nervous system.

Immunotherapy

Immunotherapy, or biologic therapy, boosts your body’s natural defenses to fight cancer. It uses substances made by your own body, or in a laboratory, to improve or restore your immune system function. It can stop cancer from spreading to other parts of the body, stop or slow the growth of cancer cells, and help your immune system work better at destroying cancer cells.

There are several types of immunotherapy to treat cancer, including immune checkpoint inhibitors, T-cell transfer therapy, monoclonal antibodies, treatment vaccines, and immune system modulators. Different types of immunotherapy may be given in different ways, such as intravenous (IV), oral, intravesical (directly into the bladder), or topical.

Targeted therapy

Targeted therapy uses drugs that are designed to specifically “target” cancer cells without affecting normal cells. It targets the cancer’s specific proteins, genes, or other tissue environment contributing to cancer survival and growth. These proteins and genes are found in cancer cells or in cells related to cancer growth.

The targeted drugs can block or turn off chemical signals that tell cancer cells when to divide and grow, stop making new blood vessels that feed cancer cells, change proteins within the cancer cells so the cells die, trigger the immune system to kill cancer cells, and carry toxins in the cancer cells to kill them.

• There are two types of targeted therapy:
• Small-molecule drugs, which is given through pills or capsules that you swallow
• Monoclonal antibodies, which are given through a needle in a blood vein.

Radiation Therapy

Radiation therapy uses intense energy beams to kill cancer cells and shrink tumors. It most often uses X-rays, but other types of energy, such as protons may also be used.

Radiation therapy can be done in two ways:

• External-beam radiation therapy – this type of radiation therapy delivers radiation from a machine outside the body. You will lie on a table, and the machine (called a linear accelerator) moves around you to deliver radiation from several different angles. It is a quick and painless procedure.
• Internal radiation therapy – also called brachytherapy, involves both temporary and permanent placement of radioactive sources in the body. During the placement of the radioactive sources, you will be given anesthesia.

Hormone therapy

Hormone therapy stops or slows the growth of cancer that uses hormones to grow. It works by blocking your body’s ability to produce hormones or interfere with how hormones behave in your body. It can reduce the chance that cancer will return by stopping or slowing its growth, as well as preventing or reducing symptoms in men with prostate cancer.

Hormone therapy is usually used to treat breast and prostate cancer. It can be taken in many ways, including orally, through an injection, and surgery.

Stem Cell Transplant

People whose blood-forming stem cells are damaged by the very high doses of radiation therapy or chemotherapy can undergo stem cell transplant to restore the cells. Blood-forming stem cells are vital since they grow into different types of blood cells that you need to be healthy. The stem cells will be given to you through an IV catheter. The process is very much like receiving a blood transfusion.

Surgical treatment

Surgical treatment for cancer is a procedure to remove cancer from your body. There are many types of surgeries to treat cancer, which differ based on the part of the body that requires surgery, the purpose of the surgery, the amount of tissue to be removed, and your preference. In general, the surgery can be open or minimally invasive.

• During open surgery, one large incision is made to remove the tumor, some healthy tissue, and some nearby lymph nodes.
• During minimally invasive surgery, a few tiny incisions are made instead of a large one. These incisions are made to insert a laparoscope (a long, thin tube with a camera on its end) and special surgical tools. The laparoscope allows your surgeon to see the inside of the body, and the surgical tools are used to remove the tumor and some healthy tissue.

How Long Should I Stay in Tunis?

For chemotherapy, radiation therapy, immunotherapy, hormone therapy, and targeted therapy, the treatment schedule may vary. You may have treatment every day, week, or month. It may also be given in a cycle, which is a period of treatment followed by a period of rest to give your body a chance to recover. For surgical treatment, you may need to stay in the hospital for a few days, and you need to stay in Tunis for at least 10 to 14 days. Your oncologist and/or medical tourism team will advise you on the length of stay in Tunis.

What's the Recovery Time?

The type of procedure you undergo determines the recovery period. While you may be able to get back to your normal routine within 10 days after laparoscopic surgery, you may need to wait around 6 weeks to fully recover from open surgery. Your oncologist will give you a detailed recovery timeline.

What About Aftercare?

You will be given instructions on how to take care of yourself. Your surgeon or nurse will explain how to control your pain, how to take care of your wound, activities you can and cannot do, and how to spot signs of infections. You may also need to talk to a dietitian to help with eating problems caused by the treatment. You will need to attend follow-up checkups to monitor your condition.

What's the Success Rate?

Cancer survival has improved significantly due to constant advancement and improvements in the field of oncology, including improvement in treatments and screening (allowing for earlier diagnosis). Still, you need to be aware of the risks, such as infection, bleeding, nerve damage, fatigue, nausea, vomiting, and hair loss.

Are there Alternatives to Oncology?

There is no other alternative than to see an oncologist when it comes to cancer treatments. Some people may choose to undergo meditation, hypnosis, and acupuncture as well, usually to relieve the stress, anxiety, and pain that cancer can bring.

Oncology in and around Tunis

About Tunis

Tunis is the capital and the largest city of Tunisia and is the center of government and administration as well as the center of commercial and cultural activities. It is divided into two parts, the old city known as Medina and the new city or Ville nouvelle. Even though it is located on the southern shores of the Mediterranean Sea, the city does not have many beaches. Still, it has managed to attract millions of tourists in 2018 thanks to its rich history displayed in numerous ancient buildings. These buildings have an enchanting blend of North African and French Architecture that will leave anyone in awe. Many tourists come to see the Roman ruins of Carthage or to stroll around and shop in the Medina.

Tunis is known to have a high standard of healthcare, which attracts an increasing number of medical tourists each year. Many of the medical tourists come from other African countries that have an inferior healthcare system. However, the city’s excellent reputation in cosmetic surgery and dental treatment appeal to many patients from Europe, the Middle East, and Asia. The private medical centers are armed with the best equipment and English speaking staff. The Tunisian Ministry of Health regulates cosmetic and plastic surgeons to ensure that there is a high standard. In addition to exceptional healthcare, Tunis also offer attractive prices for medical treatment and the cost of living. 

Popular Areas in Tunis

Although it is the largest city in Tunisia, Tunis can feel like a compact city and can be explored on foot. The city has a number of famous attractions that are always packed with tourists.

• Carthage was founded in the 9th century BC and was once a powerful empire of the Mediterranean as well as home to a wonderful civilization before being destroyed by the Romans in the Third Punic War. It was then to become an important Christian center until the Islamic invaders destroyed it. Today, the ruins have become a UNESCO World Heritage Site that tourists can visit.   
• The Medina in Tunis is one of the most remarkable medieval medinas in North Africa. There are over 700 monuments within the area, from mosques to madrassas to historical places. It is easy to get lost in the impressive maze-like alleyways, but tourists are encouraged to admire the Islamic architecture and art or learn more about the city’s history. Tourists can also shop in one of the souqs selling everything from shisha pipes to shoes or enjoy one of the cafes.
• Sidi Bou Saïd is a picturesque cliff-top village with cobbled streets, blue-and-white walls, and glimpses of pristine blue waters. It is probably one of the most beautiful places in Tunisia. The beautiful architecture is a blend of the Ottoman and the Andalusian. It is now a sleepy fishing village perfect for anyone who wants to get away from busy city life. The village has been a gateway for artists, bohemians, and pilgrimage for centuries.
• Bardo Museum is the second-largest museum in Africa and the main attraction of this museum is the ancient Roman mosaics recovered from Carthage. The museum also exhibits Greek statues, artifacts of the region’s Berber, and the accomplishments of the Islamic culture in the country. Other than the exhibitions, the building itself is decorated in impressive historic Islamic decorative arts.

Weather and Climate in Tunis

Tunis has a hot-summer Mediterranean climate meaning the city enjoys warm and sunny weather all year round. The summer can be hot and dry because rain is very rare and the summer usually lasts from June to August and the average temperature is around 25 °C but can get as high as 40 °C. July and August are the high tourist season, especially at the beach resorts. The city begins to get rain in autumn, often accompanied by a short thunderstorm. The winter is the wettest season of the year because it can rain every two or three days and the temperature can drop to 7 °C in the morning and 16 °C in the afternoon. The rainfall decreases in spring, and in March, the temperature ranges between 8 °C to 24 °C and the sunshine usually becomes dominant in May.

Getting Around in Tunis

Tunis-Carthage International Airport is the main airport in Tunisia and the airport connects Tunis with other cities in the country as well as the rest of the world as it serves flights to and from the Middle East, Africa, and major Europeans countries. It is the hub for Tunisair, Tunisair Express, and Nouvelair, but there are not many budget airlines operating flights from the airport. To get to the city center from the airport, tourists can opt for a taxi or bus. The bus is operated by the SNT bus line and departs every 30 minutes. It is very affordable with a single ticket costing less than 1 TND. There is also a more luxurious and expensive bus line known as the TUT bus and the bus departs every 15 minutes. If you want a more private mode of transportation use an airport taxis and they are usually metered.

Tourists have plenty of options to get around Tunis. There is a tram system in the city with inexpensive tickets, usually around .48 TND. However, be aware that it can be packed during the rush hours. Taxis are a good option to get around, the taxis are metered, and the base fare is around .4 TND but can be much more expensive if you hail one off the street. 

Tourist Visas in Tunis

Nationals of 97 countries including Australia, China, Singapore, the United States, and Russia can enter and stay in Tunis for up to 90 days without a visa. Other nationalities not listed in the visa exemption agreement are advised to check at their nearest Tunisia embassy or consulate. The country provides an online visa application to simplify the process of obtaining a visa to enter the country.

Additional Information

1. Local Currency: Tunisian dinar (TND) is the official currency of Tunisia. 1 USD will get you 2.61 TND. 
2. Money & Payments: ATMs are widespread in Tunis. Credit Cards, particularly MasterCard and Visa, are accepted in most top-end restaurants, hotels, and shops. Tipping is by no means mandatory but will be greatly appreciated.
3. Local Language: Arabic is the official language and French is very common. English is not widely spoken except in tourist areas and hospitals.
4. Local Culture and Religion: Most of the population follows Islam, but there are small groups of Christian and Jews.
5. Public Holidays: The city celebrates major nationals and Islamic holidays such as Independence Day, Eid Al-Fitr, and Prophet Mohammed’s Birthday.