Links to the 3 basic screening programs of the Czech Republic:
History and Tradition of the MMCI
The history of Masaryk Memorial Cancer Institute goes back to the second half of the 1920s when the surgeon and senior consultant Jaroslav Bakeš, MD, together with his mother Lucie Bakešová – a social worker – founded the “House of Consolation” association (21st June, 1928). The aim of the organization was to improve the care for patients with malignant tumors and, simultaneously, provide facilities for research in this medical field. The primary objective was therefore to build a dedicated institute where cancer patients could be treated and cured while a special emphasis would be placed on research work. The town and the site location were by no means chosen at random. Brno, where the House of Consolation, then the first cancer treatment center in Czechoslovakia, was to be located, was a university town with a number of colleges and, most importantly, a faculty of medicine, as well as several large hospitals. The chosen plot of land on Žlutý kopec immediately adjoined the surgical unit of the Provincial Hospital, which Dr. Bakeš, the co-founder of the association, headed as senior consultant.
Much welcome encouragement and a guarantee for the association was provided in form of support of the Czechoslovak president T.G. Masaryk who received Bakeš at the end of June 1928 to hear detailed information of the aims of the project and had two and a half million crowns allocated to the building of the cancer treatment center.
On 8th of June, 1930 he personally wrote to the Minister of Finance Karel Engliš:
“…Dear colleague… please be so kind as to tell Bakeš, or his association, to start with the construction and arrangements. I will allocate from the fund as much as you will need to make the institute a model establishment…”
Banks, industrial companies and other institutions soon followed suit with substantial amounts so that by the end of 1932 the association had raised enough funds to start the project. Construction work begun in 1933 to a design by architects from the Czech Technical University - professors Vladimír Fischer and Bedřich Rozehnal. The institute, named the Masaryk Sanatorium – “House of Consolation”, was formally opened on 13rd January 1935 and started work a week later – on 21st January. Unfortunately, its founder – Jaroslav Bakeš – did not live to see that celebratory moment, but in his last will he made the “House of Consolation” his principal heir and established a fund for scientific research into malignant tumors with a deposit of one and a half million crowns.
The first patient of the House of Consolation was Soňa Nováková, the wife of the Chief Railway Inspector. She was received on the first day the sanatorium started its work and died a few days later – on 26th January 1935. Professor Richard Werner, M.D., former director of the cancer institute in Heidelberg was appointed to the post of the senior consultant (head) of the clinical section of the facility.
It should be noted that at that time the clinical section of the House of Consolation consisted of a large outpatient department, diagnostic and therapeutic departments with a special radiology sector, a surgery ward with a separate radiology department, radiation baths and, naturally, an extensive inpatient ward. The patients’ rooms were intentionally small, with only a few beds, to provide a quiet environment to those staying in the sanatorium for a long period of time.
The biochemist, Professor RNDr. Vladimír Morávek of the Faculty of Sciences of the Masaryk University in Brno was appointed head of the laboratory section of the institute. The laboratory section, later split into biochemistry and hematology, consisted of diagnostic laboratories analyzing blood, urine and other bodily fluids. From the very beginning the focus of the laboratory section was its histological laboratory. The laboratory processed both human bioptic samples and material from experimental animal tumors from the research department so an indispensable part of the laboratories was the breeding of animals used in experiments. The second largest area of the laboratory section was taken up by the research department, comprising of laboratories for biochemistry, analytical chemistry and tissue cultures.
The pride of the institute was the library acquired through the will of Bakeš, which was carefully updated. Its most valued asset was represented by 18 worldwide medical journals specializing in the study of cancer.
The medical library was an example of a well designed, modern information center and fell within the cognizance of the laboratory section in the organization’s hierarchy.
As strict and complete centralization of all patients in specialized facilities was impossible and unmanageable at that time, the association concentrated on tasks related to the timely identification of patients and follow-up after their release. From its inception the institute endeavored to provide complex oncological care and, given its supraregional importance, partial centralization of oncological patients also created suitable conditions for scientific research.
During the WWII and in the post-war era the institute was directed by Jan Šprindrich, MD. When the nazis closed down Czech universities, lecturers from the theoretical institutes of the Brno and Prague medical faculties were taken on staff (Herčík, Uher and Řeřábková). Finding a refuge in the institute, they were given the exceptional opportunity of continuing their highly specialized work. Shortly after the war the sanatorium was renamed the “Masaryk Radiotherapy Institute” and the circle of collaborators further extended to embrace more employees of the Brno medical faculty, the future professors Hladký and Švejda. It was through these prominent figures that fruitful cooperation between the institute and the Faculty of Medicine of the Masaryk University began to blossom at the beginning of the 1950s. The activities were based on the contemporary interest of Professor Uher – the head of experimental pathology – in tumors of the reticulohistiocytary system and the endogenous effects on tumor development. At the same time Professor Švejda studied human hemoblastosis and hemoblastomas.
In 1954 the institute underwent reorganization as part of the rearrangement of health care administration, again receiving a new name “KÚNZ – Oncological Institute” and the laboratories, being a research unit of mostly biochemical orientation, became a separate entity, headed by Professor Brada who, within a short period, managed to bring oncological research in the biochemical field to an unprecedented level, comparable to world class institutions of that time. What truly rescued the research team and helped it to survive hard times of primitive pragmatism was the next reorganization through which, based on a government decision, the research laboratories including the complete staff and program went under the administration of the Research Oncological Institute of the Slovak Academy of Science, led by the academic V. Thursa from 1st January 1961.
An important move for the clinical section was that professor Šprindrich and his colleagues, after the reorganization of 1954, when the overall concept was adversely affected by the severance of the theoretical research section, at least succeeded in removing the Brno Oncological Institute from the communal health system. As a result the institute was directly administered by the regional health department. In spite of all efforts for an interdisciplinary approach to treating a tumor-related illness, the institute remained a predominantly radiation therapy establishment throughout the mid-1950s.
It was also a period when a new concept was developed which ensured the prominent role of diagnostics in the complex approach to clinical oncology. The new X-ray ward was equipped with two diagnostic devices. As far as therapy was concerned, in addition to radiation therapy and surgery, chemotherapy also gradually gained importance; besides, efforts to introduce further treatment modalities represented mainly by then largely popular immunotherapy appeared. Thanks to V. Kolář immunotherapy started to be applied in experimental practice in the institute in the mid-1960s.
The 1960s saw the emergence of separate departments: chemotherapeutic and internal, where the interest later polarized between the treatment of hemoblastomas and hemoblastosis and the problem of solid tumors. Oncological surgery was significantly extended and a new surgery department, completely independent of radiation therapy, was established. From the very beginnings of the institute the therapy of gynecological malignancies had always held a special position. An independent gynecology department originated at the turn of the 1950s and 1960s. The nuclear medicine department was set up towards the end of the 1960s. From the 1960s the medical treatment strategy began to reflect the interdisciplinary approach. Malignant melanoma and mammary carcinoma multidisciplinary committees were established. The problems of melanomas and other skin tumors were solved in collaboration with dermatology and plastic surgery clinics. Collaboration gradually extended to the field of lung tumors – with the respiratory disease clinic, and central nervous system tumors – with the neurological clinic. A commissioning approach was also adopted in the treatment of lymphomas, testicular tumors and other urological malignancies. In collaboration with doc. Bozděch and as part of complex oncological treatment a joint center for the treatment of bone and soft tissue tumors was established at the orthopedic clinic of the St. Anne’s University Hospital and the Oncological Institute. The institute also worked closely in tumor treatment with both the respiratory disease and the neurological clinic.
The new concept of oncological treatment, tradition and the organic merging of the clinical and research sections within a single facility enabled the establishment of the “Research Institute of Clinical and Experimental Oncology in Brno” (VÚKEO) to be confirmed at the end of 1975. Its concept was based on its historic predecessor – the “Oncological Institute”. In terms of its administration, VÚKEO, as a departmental research institute, was to join the scientific-research base of the Ministry of Health of the Czech Republic. Professor Jaroslav Švejda, MD, was appointed the director.
The tried and tested direction of the institute’s progress which developed over half a century was interrupted in the second half of the 1980s. After the forced politically motivated departure of Professor Švejda at the beginning of 1986 the orientation of the therapeutic section of the institute was remodeled to emphasize the surgical component of oncological therapy. The restricted research and therapeutic work of VÚKEO was significantly eroded mostly by a politically tinged merger of the institute between 1988 and 1990 with the conceptless and monstrous Medicinal Research Institute in Brno.
In the spring of 1990 the then director doctor Kašťák (who had held the position since 1986), was forced to step down and the senior consultant Ladislav Červ, MD, CSc, who originally performed general surgery in Žilina and followed Kašťák to the institute in 1988, was temporarily appointed to manage the institute.
The institute management was also partly controlled by the short-lived Civic Forum committee whose two leading proponents were doctors Rejthar and Drbal. The competition for the post of the director in the spring of 1991 was won by the young internist Josef Drbal, M.D., who previously worked as a house physician at the internal department and specialized in hematologic oncology. Drbal held the position of the director of Masaryk Memorial Cancer Institute until the end of May 2000 when he was called off by the minister of health.
Immediately after November 1989 the staff of the institute started a campaign to regain independence for the Oncological Institute. Their efforts were met with success in July 1990 when the Ministry of Health of the Czech Republic approved the renewed status of an independent oncological institute, starting on 1st January 1991 under the name of Masaryk Memorial Cancer Institute Brno.
The first half of the 1990s was marked by important structural developments, when the construction of a new, modern building with inpatient and outpatient wards was finished, followed by setting up a new radiation oncology department in the reconstructed old section of the institute complex.
At the turn of the millennium the institute was re-integrated into the Brno academic community with the help of then director professor Jan Žaloudík, MD, Ph.D. On 1st January, 2001, the Complex Oncological Treatment Clinic was established for the first time – headed by professor Rostislav Vyzula, MD, Ph.D., who became the director of the institute one year later. The clinic brings under one roof specialists from different oncological fields. In terms of its organization the clinic consists of diagnostic-therapeutic groups for mammary and digestive diseases and for general oncology. It also incorporates other specializations related to tumor treatment - oncosurgery, radiation therapy, genetics. The activities of the clinic also include pregraduate and postgraduate oncological education.
In February 2007 the Radiation Oncology Clinic was officially established as an education center of the Masaryk University Faculty of Medicine, equipped by the latest technology and employing top specialists, thus becoming one of the best departments of its kind in the Czech Republic. Professor Pavel Šlampa, MD, Ph.D. is a head of the department.