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:
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.
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.
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.
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:
Being overweight or obese also likely raises the risk of other cancers:
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.
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:
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).
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.
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.
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.
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.
Early Detection Saves Architect's Life
God Sent Me Angels in Disguise
Giving Voice to Tongue Cancer
(Head and Neck Cancer)
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.”
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.
The Medical City's Augusto P. Sarmiento Cancer Institute is staffed by an excellent team of cancer care professionals:
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
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
Dr. Daniel Alonzo
Dr. Samantha Castaneda
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
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
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
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
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
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
Dr. Cesar Dimayuga
Dr. Rafael Claudio
Dr. Albert Jerome Quintos
Dr. Richard Rotor
Dr. Amelito Sia
Dr. Maria Fidelis Manalo
Dr. Agnes Bausa-Claudio
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
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)