WHEN Dr Kate Hamilton became Ballarat Health Services' full-time oncologist four years ago, she inherited a "minimal public service".
BHS's oncology program was getting by with locums, with a lot of patients travelling to Melbourne or Geelong for cancer treatment.
Dr Hamilton set about "building a service I'm comfortable with providing", including an inpatient service and a day oncology unit, both at the Base Hospital.
When she first began her clinics - she holds four each week - in 2004, Dr Hamilton was seeing one or two patients each time. Now, she sees 20 patients each clinic, or 80 patients a week.
On any given day, the day oncology unit waiting room is full, along with the eight chairs where patients receive treatments ranging from chemotherapy to blood products.
"We're always full to overflowing," Dr Hamilton said.
So is cancer reaching epidemic proportions in Ballarat or are there other reasons for the demand for Dr Hamilton's services?
1. Ageing population
According to Dr Hamilton, the incidence of cancer is rising all over Australia, mainly linked to our ageing population.
The National Cancer Prevention Policy 2007-09 estimates cancer cases will rise by 30 per cent in the next five to 10 years.
"People are living longer and the diseases that used to kill them, such as heart attacks, strokes and diabetes, we are better able to control," Dr Hamilton said.
However, this does allow them to get cancers they may have never lived long enough to develop before.
2. Lack of regional services
BHS also has the only public oncology service between Melton and the South Australian border.
"The pressure on our service is enormous," Dr Hamilton said, especially as she is the only full-time oncologist, with one part-time cancer specialist and an advanced trainee.
The oncology nursing staff, for whom Dr Hamilton has a lot of praise, are also kept extremely busy.
"Our growth has been at 20 per cent every year for the past four years."
3. Improved treatments
Improved treatments for many cancers now mean patients who previously wouldn't have benefitted from treatment can access the service.
"There's a wider range of options now. For example, there are now a few different chemotherapy treatments for lung cancer.
"Our aim is to provide the best quality of care for people who come through the door.
"As well, because treatments have improved, local doctors are happier to refer patients."
4. Adjuvant chemotherapy
Clinical research results have shown that adjuvant chemotherapy, which mops up any rogue cancer cells left behind from initial cancer operations, can help prevent the disease recurring, especially in breast, bowel and lung cancers.
This means more patients are now getting preventative treatment.
5. Improved service
Dr Hamilton describes the oncology program as a joint effort involving herself, doctors, nursing staff, social workers and the pharmacy.
"We have the ability to treat just about everything here."
The only patients referred to Melbourne now are acute leukaemia and sarcoma cases, which need highly specialised treatment.
"We offer a comprehensive service for our patients. ``We have a fabulous palliative care service and an excellent radiotherapy service."