IOB Institute of Oncology, located at the Hospital Ruber Internacional, is a pioneering medical organisation in Spain that transfers models successfully implemented in countries like the US, becoming a leading oncology centre in Europe.
IOB's hallmark is offering the best oncology treatments from a healthcare viewpoint with regard to innovation, investigation and patient care. All thanks to a comprehensive and prestigious team of professionals whose philosophy is none other than excellence.
We face cancer diagnosis, prevention and treatment with a comprehensive view, covering both medical and psychological and emotional aspects.
Oncologists, nurses, healthcare staff, additional service staff and administrative staff work towards a common goal: being with you throughout the different phases of the process and making your stay at Ruber Internacional a positive experience.
PERSONALISED TREATMENT
At Ruber Internacional we believe that the most important thing is not starting as soon as possible, but starting with a good diagnosis to be able to design the most effective personalised treatment for you.
Our model is based on the idea of multidisciplinarity, which means that we have a qualified team of competent professionals that ensure the highest quality, as well as professional, close, personalised and humane care.
The convergence of different points of view is important when facing a disease and its treatment. This is why our approach includes discussing each case in multidisciplinary clinical sessions where, after integrating the different points of view of each expert, a therapeutic plan adapted to each patient is designed.
IOB doctors at Ruber Internacional are pioneers in designing and developing clinical trials. In practice, this means that some of the latest technological, scientific and therapeutic advances have been created by our oncologists.
To guarantee precise oncology, at Ruber Internacional we have cutting-edge diagnostic resources such as genomic platforms, liquid biopsy, anatomical pathology and molecular biology.
We offer the latest treatments in the fight against cancer. From conventional chemotherapeutic agents to the latest designer drugs such as monoclonal antibodies, tyrosine kinase inhibitors, multi-target, anti-angiogenic drugs and immunotherapy.
CARE AND COMFORT
Our priority is to offer you the best service and the best quality care.
An oncology patient requires follow-up medical visits, additional testing and treatment at the day hospital.
We coordinate the services and plan all the appointments required by our oncologists to ensure the both patient's and relatives' peace of mind and comfort. Furthermore, we request the authorisations your insurance company may require on your behalf or offer you the payment convenience that suits your needs, always in order to make all kind of paperwork more manageable and to keep from adding to the disruption that a cancer diagnosis entails.
ONCOLOGY NURSING
The oncology nursing team is committed to helping and accompanying both the patient and their relatives throughout all the disease's phases. We contribute to reducing the impact the diagnosis and/or treatment may cause, to the best of our abilities. We work together with your oncologist by monitoring your disease and caring for your well-being.
Our nursing staff has extensive professional experience in the field of oncology, including handling, preparing and administering cytostatic drugs at the oncology day unit, aiding decision-making with regard to venous access, controlling side effect and advising on specific diets.
As well as being technically qualified, they have a close, warm touch that helps to make technical oncology therapy more humane. Their degree of coordination with the medical team is particularly noteworthy, both because of physical proximity and accessibility, enabling daily work and allowing for greater and faster knowledge of the problems that may arise once treatment has begun.
INTEGRATIVE ONCOLOGY
Integrative oncology combines conventional medicine with other complementary and alternative medical practices that have been proven effective in providing the patient with a more comprehensive treatment and care. They are used in conjunction with conventional medical treatment as support to control symptoms and improve quality of life by providing the cancer patient with comprehensive care, both physically and emotionally.
All therapies are performed under the oncologist's supervision, who can direct and monitor the patient from the conventional consultation with a comprehensive vision and thanks to team work. For this reason, we insist that before beginning any therapy not prescribed by the Oncology unit, please check with your reference oncologist or nurse to prevent potential interactions with the cancer treatment.
Integrative medicine includes:
- Psycho-oncology
After a cancer diagnosis, it is normal to feel conflicted, anxious and sad. The team of psychology specialists will help both the patient and their relatives or carers with tips and strategies throughout the process and will help ease the emotional pressure of the disease. - Hair Loss Prevention
Hair loss is one of the most upsetting and irritating side effects of chemotherapy for the patient. Cooling the scalp with a cap connected to a machine that electronically controls the temperature has been proven effective in many cases to prevent or reduce hair loss during chemotherapy treatment. We have a new machine that causes the blood vessels in the dermis to contract, which leads to less blood flow to the hair follicles during the period of maximum chemotherapy drug plasma concentration. - Aesthetic advice
During the oncology treatment, skin issues may arise such as irritation, redness, itchiness, desquamation, dryness or acne. Taking into account the impact and discomfort these effects cause, workshops are organised to advise you on basic skin care tips, make-up to correct blemishes and eyebrow design, among others. Additionally, our nurses can advise you on how to minimise these effects and give you simple recommendations so that you look good and feel better.
Breast cancer unit
The Breast Cancer Unit at Hospital Ruber Internacional (IOB Institute of Oncology), directed by the prestigious oncologist Javier Cortés, cares for patients with symptoms of potential breast cancer that require a diagnosis to confirm or rule out the presence of a tumour, as well as patients who have been previously diagnosed at other centres and that come to Ruber Internacional to receive treatment. In addition, it offers a second opinion service to guide individual decision-making by each patient according to the genetic and molecular characteristics of the tumour cells.
Patients treated at the Breast Cancer Unit are seen by a multidisciplinary team made up of oncologists, specialised breast surgeons, pathologists, radiotherapists, radiology and nuclear medicine specialists and nursing staff. Different specialists make joint decisions for each patient, so that the sequence of treatments is planned individually, making it as beneficial as possible for each case.
Furthermore, this multidisciplinary team enables patients to undergo all the tests and receive all the treatments they need in the same place an in the least amount of time possible, with no need for transfers or managing appointments with different specialists separately.
Early detection
Any "lump" in the breast, change in colour, nipple retraction or abnormal secretion must be checked with a specialist to ensure that they are not due to a tumour. Although mostly these symptoms are not related to cancer, any of them can be considered a warning sign and can allow for an early diagnosis. If breast cancer is diagnosed in its early stage, the likelihood of recovery is very high.
Periodic mammograms are advisable to help detect breast cancer before it causes symptoms. Mammograms are recommended for all women above 40 years of age. For women under 40, undergoing a mammogram must be assessed by each woman with their gynaecologist.
Furthermore, self-examination is recommended once per month to get to know your own breasts well and detect any changes that may arise. This method allows 50% of breast tumours to be detected early, which is why checking yourself regularly is recommended. However, since it is not a foolproof method, it must be complemented with mammograms.
Fast diagnosis
Before any suspicion of breast cancer, diagnosis begins with imaging tests that usually include a mammogram (X-ray examination) and an ultrasound (ultrasound examination). If these tests confirm the suspicion of cancer, a biopsy must be performed to establish the definitive diagnosis.
In some cases, the oncologist may consider it appropriate to request additional diagnostic imaging tests to check if the cancer has spread to other organs, as well as a full blood test. The biopsy consists of extracting a sample of cells to analyse them in the laboratory. It is usually performed with ultrasound monitoring to ensure that the cells are extracted from the right area. The analysis, performed by a specialist in anatomic pathology, reveals if the cells are cancerous or not. If they are, the analysis allows us to determine which specific type of cancer it is.
The fast diagnosis circuit implemented at Ruber Internacional allows us to reduce the time from the patient's first consultation due to suspected breast cancer to performing the biopsy to 24 hours. The biopsy result that determines if the cells are cancerous or not takes between 48 and 72 hours. Identifying the specific type of tumour takes between 4 and 7 days from the moment the biopsy is performed.
Personalised treatment
Given that there are more than 50 types of different breast tumours, it is essential that this diagnosis is precise in order to decide the best treatment for each patient individually. Ruber Internacional is a leader introducing genetic analyses that allow us to determine the detailed characteristics of each tumour and figure out with is the most suitable treatment in each case.
Treatment is decided on an individual basis depending on the result of these analyses that indicate the specific type of tumour a patient has and how advanced the disease is at the time of diagnosis.
In cases where the cancer is diagnosed before it has extended to other organs, which are most cases, the treatment must include surgery to remove the tumour. In two-thirds of patients, surgery allows us to remove the tumour and preserve the breast. In the remaining third, the breast must be removed, a plastic surgery specialist participates in the intervention so that the breast can be reconstructed during the same surgery. During reconstruction, the skin of the original breast is preserved if possible, as well as the areola-nipple complex, with generally excellent aesthetic results and minimal psychological impact on patients.
Depending on the type of tumour, surgery is complemented with chemotherapy, hormone therapy and/or drug therapy aimed at specific molecular targets of tumour cells. For each patient we individually assess if it is best to begin these treatments before surgery or to postpone them until after the operation. In addition, we must assess for each patient if administering radiotherapy after surgery is suitable or not.
Lung Cancer Unit
The Lung Cancer Unit at Hospital Ruber Internacional cares for patients with a suspicion of potential lung cancer that require a diagnosis to confirm or rule out the presence of a tumour, as well as patients who have been previously diagnosed at other centres and that come to Ruber Internacional to receive treatment. In addition, it offers a second opinion service to patients from other centres to guide individual decision-making taking into account the type of lung cancer, how far the disease has spread and the genetic and molecular characteristics of the tumour cells.
Lung cancer unit patients are seen to by a multidisciplinary team made up of oncologists, pulmonologists, radiotherapists, surgeons, pathologists and specialised cancer nursing staff. Ruber Internacional also offers psychological or psychiatric care to patients who need it, advice from nutrition specialists and alternative treatments such as acupuncture and hypnosis to treat anxiety and pain.
Early detection
This multidisciplinary team enables patients to undergo all the tests and receive all the treatments they need in the same place an in the least amount of time possible, with no need for transfers or managing appointments with different specialists separately.
Lung cancers do not usually produce easily-identifiable symptoms during their initial phases and at this time there is no early detection test for lung cancer equivalent to the mammogram for breast cancer. However, there are certain symptoms that may be a warning sign for lung cancer and that warrant a medical consultation to achieve the earliest detection possible. Although in many cases these symptoms obey causes different to cancer, promptly consulting a specialist is advisable if one or several of the following symptoms appear:
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- appearance of cough that persists for more than ten days with no apparent cause, or worsening of a chronic cough.
- appearance of blood in the sputum for several days in a row.
- persistent bronchitis.
- recurrent respiratory infections.
- difficulty breathing.
- thoracic pain.
- weight loss or tiredness for no apparent reason.
Lung cancer can affect anyone, so these early detection recommendations can be applied to the entire population. People who have smoked for years must exercise caution, even if they have quit smoking, or have been passive smokers, since smoking is the main risk factor for lung cancer.
Fast diagnosis
Lung cancer diagnosis begins with a chest X-ray to check the source of the symptoms that cause the suspicion of a potential tumour. If the chest X-ray confirms the presence of a mass of abnormal cells in the lung, additional imaging tests are usually performed to obtain more information regarding these cells. These additional tests can include a computerized axial tomography (CAT scan). To definitively confirm the diagnosis, a biopsy must be taken, consisting in extracting a sample of cells from the potential tumour to analyse them in the laboratory.
Analysing these cells clarifies if they are cancerous or not, and if they are, what type of cancer they are. Given that there are multiple different types of lung cancer, detailed analysis of the cells is indispensable for a precise diagnosis. Ruber Internacional is a leader introducing genetic analyses to determine the molecular characteristics of each tumour and prescribe the most suitable treatment for each patient.
If the cancer diagnosis is confirmed, another imaging test (a positron emission tomography or PET scan) must be performed to determine if the tumour is located at its point of origin, if it has begun to invade adjacent tissues or if it has extended to other organs. Furthermore, a full blood test, including tumour markers, offers additional information to assess how far the cancer has spread.
The fast diagnosis circuit at Ruber Internacional allows us to reduce the average time from the first consultation of a patient recently diagnosed with lung cancer, or with suspected lung cancer, to beginning treatment, to less than a week.
Personalised treatment
Lung cancer treatment must be decided on an individual basis for each patient based on the exact characteristics of each tumour and how far the disease has spread at the time of diagnosis. Personalising the treatment is key for therapy to be as effective as possible. As with other types of cancer, the goal of the treatment can be curative (aimed at completely removing the tumour) or palliative (aimed at prolonging life and reducing suffering cases where completely removing the tumour is not possible).
In cases where the cancer is limited to its point of origin, treatment is based on a surgical intervention in order to remove the tumour in its entirety. After the intervention, we administer a chemotherapy and/or radiotherapy treatment to eliminate the tumour cells that may have been left behind after surgery. After surgery, the patient's progress is strictly monitored, especially during the first three years. Medical check-ups consist of undergoing full blood tests with tumour markers every three months and imaging tests every six months.
If the cancer has spread to other organs and the surgery was not able to remove all the tumour cells, treatment is usually based on chemotherapy and radiotherapy. Numerous patients may also benefit from next-generation drugs that selectively attack some tumours or others based on their molecular characteristics.
Gastrointestinal cancer Unit
The Gastrointestinal cancer Unit at Ruber Internacional cares for patients diagnosed with tumours that affect the digestive system. The unit offers the most advanced treatments, both for relatively common tumours such as those affecting the colon, rectum, stomach or pancreas, and more unusual tumours such as oesophageal cancer, liver cancer, bile duct cancer or neuroendocrine tumours.
Patients who come to the unit may have been previously diagnosed at another medical centre, or may be people who suspect they suffer from a gastrointestinal cancer and require a first diagnosis. The Gastrointestinal cancer unit offers a second opinion service to patients treated by oncologists at other centres.
Gastrointestinal cancer unit patients are seen to by a multidisciplinary team made up of oncologists, internists, pathologists, radiology and nuclear medicine specialists and specialised cancer nursing staff.
This multidisciplinary team enables patients to undergo all the tests and receive all the treatments they need in the same place an in the least amount of time possible, with no need for transfers or managing appointments with different specialists separately.
Early detection and prevention unit
The Early Detection and Prevention Unit at Ruber Internacional guides people who suspect that in their families there is a particularly high risk of some type of cancer for hereditary reasons. It also guides people who have non-hereditary cancer risk factors who wish to be informed regarding early detection and prevention measures.
Genetic testing, generally performed on a blood sample, can detect the hereditary risk of developing some kinds of cancers.
It also allows us to identify relatives who have a high risk, so that early detection and prevention measures can be taken. At the same time, it allows us to identify those who have not inherited the genetic alteration that raises the risk of cancer, so that they do not have to follow specific monitoring.
When a person's study rules out the risk of known hereditary cancer in their family, the results are useful to provide peace of mind to those who feared being carriers of a genetic alteration related to cancer.
Most people who come to the Early Cancer Detection and Prevention Unit are cancer patients that want to figure out if their relatives are at a high risk of developing the same disease, or if they themselves have a predisposition to developing a second cancer.
Sarcoma unit
The Sarcoma Unit at Ruber Internacional cares for patients diagnosed with tumours that affect the connective tissue, including bones and the so-called soft tissues such as muscles, cartilages, fat or blood vessel or nervous system tissues. Patients who come to the unit may have been previously diagnosed at another medical centre, or may be people who suspect they suffer from a sarcoma and require a first diagnosis. Furthermore, as with other cancer units at Ruber Internacional, the Sarcoma Unit offers a second opinion service to patients treated by oncologists at other centres.
Sarcoma unit patients are seen to by a multidisciplinary team made up of oncologists, surgeons, radiotherapists, pathologists, diagnostic imaging specialists and specialised cancer nursing staff. This multidisciplinary team enables patients to undergo all the tests and receive all the treatments they need in the same place an in the least amount of time possible, with no need for transfers or managing appointments with different specialists separately.
Early detection
The earlier a sarcoma is detected, the higher the likelihood of treating it successfully and for the treatment to cause the patient as few sequelae as possible. The appearance of a mass that measures more than five centimetres in diameter on the extremities or the trunk is the most characteristic symptom that can make us suspect of a soft tissue sarcoma and, although it may not cause any discomfort, it requires consulting a specialist in this type of tumour. The fact that most of these masses are not painful misleads a high percentage of patients who do not pay enough attention and delay the diagnosis.
If a person detects a mass measuring less than five centimetres in diameter, this also requires consulting a specialist if the mass has grown in a few months or if it located in a deep area such as a leg, for example. This recommendation is justified because it is in deep areas where most soft tissue sarcomas are located and where it is more difficult to precisely establish their diameter.
For less frequent bone sarcomas, the first warning sign that requires consulting a specialist is usually bone pain of unknown origin.
Fast diagnosis
Diagnosis is based on an MRI to assess the size, shape and location of the potential sarcoma and a biopsy to obtain cells that will enable a precise diagnosis. Cell analysis at the anatomical pathology laboratory indicates the type of sarcoma and, together with the size of the tumour at the time of diagnosis, allows us to anticipate if it is a more or less aggressive cancer and decide on the most suitable treatment. In some patients, diagnostic tests are complemented with a thoracic CAT scan to check if the cancer has spread to the lungs or not.
The fast diagnosis circuit at Ruber Internacional allows us to reduce the average time from the first consultation of a patient with suspected sarcoma, to beginning treatment, to less than a week.
Personalised treatment
Sarcoma treatment is based on surgically removing the tumour. Surgery must remove the tumour in its entirety, as well as a thin layer of cells surrounding the tumour. Given that this type of surgery can be very mutilating, especially with large sarcomas, it is fundamental to wait for the results of all the diagnostic tests before performing the surgery. We can therefore precisely establish which cells need removing and which can be preserved.
Surgery is sometimes combined with a radiotherapy treatment lasting six to eight weeks that can reduce the size of the tumour and enables a less aggressive surgical intervention.
In cases where the sarcoma has spread to the lungs at the time of diagnosis, chemotherapy is administered. A 5-month chemotherapy treatment is also administered in the case of sarcomas that, despite being localised, are considered of high risk to prevent them from spreading to other organs.
Furthermore, Ruber Internacional is pioneering by introducing personalised genetic analyses to identify patients who may benefit from next-generation drugs that selectively attack some tumours or others depending on their molecular characteristics.
Once the treatment is completed, and during the first two years, check-ups consist of physical examinations and blood tests every three months to check that the sarcoma does not reappear, as well as thoracic X-rays also every three months to check that it has not spread to the lungs, and a yearly MRI of the affected area. From the third year onwards, when the risk of recurrence is lower, check-ups will be every six months. Given that some cases of sarcoma exceptionally reappear long term, check-ups must be followed for ten years.
Genitourinary cancer unit
The Genitourinary cancer unit at Ruber Internacional cares for patients diagnosed with tumours that affect the male reproductive system, as well as those that affect the urinary system of both sexes, including prostate cancer, testicular cancer, bladder cancer, kidney cancer and other less frequent tumours such as adrenal gland cancer and penile cancer.
Most patients who come to the unit have been previously diagnosed by a urologist, who derives them to this unit to be cared for by a team specialised in treating genitourinary cancers. Furthermore, as with other cancer units at Ruber Internacional, the Genitourinary cancer unit offers a second opinion service to patients treated by oncologists at other centres.
Genitourinary cancer unit patients are seen to by a multidisciplinary team made up of oncologists, urologists, surgeons, radiotherapists, pathologists, radiology and nuclear medicine specialists and specialised cancer nursing staff. This Unit also offers psychological or psychiatric care to patients who need it, advice from nutrition specialists and Eastern medicine treatments such as acupuncture and hypnosis to treat anxiety and pain.
This multidisciplinary team enables patients to undergo all the tests and receive all the treatments they need in the same place an in the least amount of time possible, with no need for transfers or managing appointments with different specialists separately.
Gynaecological cancer unit
The Gynaecological cancer unit at Ruber Internacional cares for patients diagnosed with tumours that affect the female reproductive system, including endometrial cancer (also called uterine cancer), cervical cancer and ovarian cancer.
Most patients who come to the unit have been previously diagnosed by a gynaecologist, who derives them to this unit to be cared for by a team specialised in treating gynaecological cancers. The Gynaecological cancer unit also offers a second opinion service to patients treated by specialists at other centres.
Gynaecological cancer unit patients are seen to by a multidisciplinary team made up of oncologists, gynaecologists, surgeons, pathologists, radiology and nuclear medicine specialists and specialised cancer nursing staff. Ruber Internacional also offers psychological or psychiatric care to patients who need it, advice from nutrition specialists and Eastern medicine treatments such as acupuncture and hypnosis to treat anxiety and pain.
This multidisciplinary team enables patients to undergo all the tests and receive all the treatments they need in the same place an in the least amount of time possible, with no need for transfers or managing appointments with different specialists separately.