Express analysis for oncology. Oncology examinations: early manifestations, diagnostic methods, cancer and organs
According to statistics, almost 2% of all people living in the Russian Federation today are cancer patients. Every year more than 500 thousand Russians are diagnosed with cancer. Despite the frightening statistics, experts say that cancer is not a death sentence.
“Oncology is certainly a dangerous and very serious disease. However, you need to understand that there are thousands of types and subtypes of cancer. And most of them are curable, subject to high-quality diagnosis and therapy,” says Founder and CEO of the cancer diagnostics service “UNIM” Alexey Remez.
According to the expert, the earlier cancer is detected, the higher the chance of recovery.
“A very good example is melanoma, a well-known aggressive skin cancer - when detected at stage zero, when germination is still very small, and with high-quality removal, recovery is achieved in 99% of cases, while when treating melanoma at stage 4, the chance of living for five years with such a diagnosis is about 15%,” Remez noted.
Find and neutralize
Treatment of cancer in any country is based on protocols developed by the international medical community, which are based on an analysis of collective medical experience. However, before starting to treat a person, it is important to make an accurate diagnosis.
A person should be wary and consult a doctor if he begins to rapidly lose weight for no particular reason, nausea, weakness and pain appear, explained oncologist Andrey Koritsky.
“In addition, a person should be wary of unusual discharge (bloody, purulent, mucous), a prolonged causeless increase in body temperature, frequent exacerbations of a chronic disease and the appearance of a new formation,” the oncologist warned.
The first stage of cancer diagnosis is screening.
“Screening is a mass examination of people at risk for a certain type of disease in the absence of symptoms,” explained the doctor.
There are a series of screening measures that help detect cancer at an early stage. For example, women aged 20 to 40 years are advised to undergo an annual breast ultrasound, and after 40 years, replace the procedure with mammography.
“To exclude cervical cancer, women over 20 years of age should undergo a liquid oncocytological examination (smear) using the Papanicolaou method (PAP test) and testing for the presence of oncogenic types of human papillomaviruses using the polymerase chain reaction (HPV test) every three years.” , said Koritsky.
Men and women over 40 also need to have a colonoscopy every five years. And representatives of the stronger sex should additionally take a blood test for prostate-specific antigen (PSA) to prevent the development of prostate cancer.“Representatives of all groups of the population should also undergo an annual abdominal ultrasound and chest x-ray. Recently, periodic gastroscopy with biopsy of the mucous membrane to exclude stomach cancer has also come to the fore,” noted the oncologist.
If, after screening, the therapist suspects a malignant neoplasm or the doctor is alarmed by the patient’s complaints, the person is prescribed additional tests.
“These can be laboratory tests and instrumental studies - MRI, CT, endoscopic studies (FGDS, colonoscopy). If cancer is suspected, the patient is sent to an appointment with an oncologist, where the issue of conducting a histological examination is decided,” Koritsky described the procedure.
To confirm or refute the diagnosis, the specialist first performs a biopsy - cutting out a piece of tissue or organ from the patient for examination. The procedure is performed under local anesthesia or during surgery. Next, the resulting material enters the pathomorphological laboratory, where it is processed and stored, making paraffin blocks and histological slides, which will then be examined by a pathologist under a microscope.One step away from error
Having received the results of histological examination, the oncologist can select the treatment that is most effective for this type of cancer - surgery, chemotherapy, radiation therapy, immunotherapy, etc.
However, experts advise not to rely on the opinion of one specialist, but to seek advice from several centers with test results. In this case, the patient can independently send histological slides to another laboratory so that another pathologist can confirm or correct the diagnosis.
“One of our clients was diagnosed with an epithelial tumor, but the origin of the tumor could not be determined locally. She turned to us for research because the laboratory of the oncology clinic did not do the immunohistochemistry she needed. Based on the results of the study, a rare form of a dangerous lymphoproliferative disease was identified - myeloid sarcoma with monoblastic differentiation. However, due to the peculiarities of the form of this disease, the patient's blood test was ideal, and she did not fully appreciate the complexity of the situation. The pathological process was already developing, and in the absence of treatment, the prognosis would be sad - no more than a month of life. Ultimately, we managed to convince her to consult a specialist again and begin treatment for the disease,” Remez gave an example.
At the same time, according to the expert, according to the company’s internal statistics, more than 40% of incoming diagnoses turn out to be erroneous when reviewed.
Immunohistochemistry is a highly accurate diagnostic method that allows the detection of tumor antigens. It is widely used to establish a final diagnosis in oncological practice.
Lymphoproliferative disease is a group of diseases in which the cells that make up the immune system—lymphocytes—grow. If the tumor arises in the bone marrow, the term "leukemia" is used. Neoplasms that arise in lymphoid tissue outside the bone marrow are called lymphomas.
*** Myeloid sarcoma is a malignant tumor consisting of immature white blood cells of the bone marrow (leukemic myeloblasts).
In Moscow it will be possible to undergo free tests for various cancer diseases. Deputy Director of the Moscow Clinical Scientific and Practical Center Evgenia Zadiran told the site about this. The campaign is timed to coincide with World Cancer Day. Over the next month, all Muscovites will be able to come to a center or clinic on Saturdays, which has special equipment, to undergo free diagnostics.
The study lasts about 15 minutes. Each applicant will receive results and recommendations from a specialist immediately after the procedure.
“Diagnostic days will be held for various nosologies. All interested Muscovites can undergo diagnostics to detect, for example, colorectal cancer, breast or prostate cancer. Tests will be carried out in our center, in the women’s health clinic, in the 50th hospital, as well as in clinics and some hospitals where there is the necessary equipment,” Zadiran said.
Representative of hospital No. 50 named after S.I. Spasokukotsky clarified that it will conduct testing for men for prostate cancer. The dates are February 13 and 27.
According to Zadiran, the examination procedure will not take much time, and the patient will receive the results and recommendations of a specialist immediately after its completion.
"Since this is screening, that is, early detection, on average the procedure takes 15-25 minutes. For women, the procedure may take a little longer. For example, if you do a mammogram, it may take about 40 minutes. If everything is clear, the person will be recommended preventive examination. If there is a suspicion of malignant formations, they will be sent for further examination to a specialized center,” she added.
The press service of the Department of Health explained that the diagnostic days will be held as part of the month against cancer. This action, in turn, is timed to coincide with World Cancer Day. However, due to the quarantine associated with the outbreak of colds, the start of the action is planned no earlier than February 20.
The Moscow Clinical Scientific and Practical Center is located in the east of the capital at Shosse Entuziastov, 86. City Clinical Hospital No. 50 is located in the Northern Administrative District of Moscow at Vucheticha Street, 21. The Women's Health Clinic is located in the Central Administrative District, at Goncharnaya Street , no. 23. District clinics and hospitals, which will also conduct cancer screening examinations, have not yet been named.
World Cancer Day was first celebrated in 2005, a memorable date proclaimed by the International Union Against Cancer (UICC). Every year it is celebrated throughout the planet on February 4th.
The goal of the project is to popularize information about cancer as one of the most serious diseases. The organizers note several basic principles that could help reduce the risk of cancer by more than 40 percent. Among them, the first place is the fight against smoking, a balanced diet and physical activity. The need to vaccinate against viruses that cause liver and cervical cancer is also reported. Prolonged exposure to the sun and tanning beds also contributes to the development of cancer.
Professor of the Department of Palliative Therapy at Moscow State Medical University named after. A. I. Evdokimova, Doctor of Medical Sciences Lali Kogonia notes that the express examination does not give a clear picture, but is necessary in order to understand whether a person needs to undergo a serious examination.
“If some indicators coincide with the existing palette, it is possible to determine the prognostic level of tumor markers. That is, to understand whether there is a danger of developing malignant tumors or not. But this is not an absolute indicator. It can only be used relatively. Nevertheless, the task of primary diagnosis in oncology – to understand who needs to be referred for further examination. And for this, this method is quite suitable,” she said.
The expert also added that in practice only certain types of cancer are most common. “In the structure of the incidence of malignant tumors, gender is important. Thus, in men, lung cancer and gastrointestinal cancer come first. In women, breast cancer is most common,” explained Kogonia.
The President of the League of Patient Defenders, Alexander Saversky, believes that such diagnostic campaigns must be carried out systematically.
“People’s fear of cancer is growing. And, of course, the opportunity to take a free rapid test for cancer will be popular. It’s also good that diagnostic days are scheduled for Saturday, which means that working citizens who do not have the opportunity to come for an examination will also be able to ask for time off on weekdays. But one month will not be enough - such actions need to be carried out regularly, throughout the year,” he emphasized.
Note that about half of cancers in Moscow are detected when the chances of curing the patient are high enough. The capital's doctors also have the ability to cope with cancer in the terminal stage. With timely diagnosis and early detection, the chances of completely curing cancer in most locations are close to 100 percent. Modern advances in medicine also make it possible to help people in advanced stages of cancer.
In December, it became known that all metropolitan oncologists, palliative care specialists and psychiatrists are trained in psycho-oncology. Doctors are told how to properly communicate with patients, how to identify depression and the risk of suicide, and how to deal with burnout at work. The first stage of training lasts four days – that’s 32 academic hours. This is especially important since more than 60 percent of calls to the cancer hotline concern. The remaining 40 percent are requests to a lawyer, assistance with routing and information support. Every year, about 30 thousand calls are received via the support line.
Vitaly Volovatov, Nikita Shchurenkov
In the coming years, in Russia, on behalf of Vladimir Putin, a program to combat cancer will be created - this order was made today in the Address to the Federal Assembly. In Moscow, a step has already been taken towards this: the capital’s doctors have begun to diagnose some types of cancer using blood tests, head of the city health department Alexey Khripun said at a press conference.
Almost 288 thousand Muscovites are currently registered for oncology in the city, and this figure is constantly increasing. First of all, due to early diagnosis. Prostate, breast and ovarian cancers are most successfully detected. Predisposition to these types of disease is determined by a blood test.
Doctors will be alerted to possible prostate cancer by an excess of the PSA antigen concentration. A “female” doctor will definitely pay attention to mutations of the BRCA1 and BRCA2 genes. They protect cells from malignant degeneration. Any deviation indicates an increased risk of developing ovarian and breast cancer. This analysis itself is a matter of minutes. The preparation is also very simple: do not smoke for half an hour, do not carry heavy objects, abstain from sex and alcohol for two days. After analysis, the biomaterial is sent to the city blood transfusion station and tests are carried out within three months. Having its results, the doctor can easily determine treatment tactics.
These tests are also included in the annual medical examination, noted the capital’s chief oncologist Igor Khatkov. Moscow doctors have also learned to identify other types of cancer better than 7 years ago. Tumors of the stomach and intestines can be quickly detected by colonoscopy; this unpleasant procedure can now be performed under anesthesia. Compared to 2010, the proportion of patients whose cancer was diagnosed at the first stage in Moscow increased from 12 to 20%. Over the same period, the one-year survival rate of “severe” cancer patients increased by 10%, and the five-year survival rate by 7%.
By the way, on March 17 and 18, an examination is planned for everyone in the capital. They will be able to donate venous blood and, based on the results, find out whether there is a predisposition to cancer. “The analysis will make it possible to diagnose the disease at an early stage,” Khripun emphasized. “In this case, the chances of a full recovery will be above 90%.”
Tests can be taken from 8 a.m. to 2 p.m.:
– March 17 in clinics at the following addresses: st. Kuusinena, 6B, st. Bestuzhevykh, 15, st. Altayskaya, 13, Yeseninsky Boulevard, 9, bldg. 1, st. Podolskikh Kursantov, 2, bldg. 2, st. Miklouho-Maklaya, 29, bldg. 2, st. Ramenki, 29, st. Dolgova, 1, bldg. 4, Zelenograd, bldg. 911, Troitsk, st. Yubileinaya, 5.
– March 18 in the medical offices of schools at the following addresses: st. Kuusinena, 13, st. Bestuzhev, 25 B, st. Kamchatskaya, 6, st. Yunykh Lenintsev, 68, building 2, st. Dorozhnaya, 22 A, st. Akademika Artsimovicha, 7, Michurinsky Prospekt, 23, st. Svobody, 42, building 2, Zelenograd, bldg. 1017, Troitsk, Oktyabrsky Prospekt, 6.
Every year, approximately half a million Russians are diagnosed with cancer, and about 280 thousand of our citizens die due to this disease. Moreover, if a neoplasm is detected at the first or second stage, it can be cured in approximately 95% of cases. On the eve of World Cancer Day, the director of the Herzen Moscow Research Oncology Institute, Professor Andrei Kaprin, spoke to RIA Novosti about how to detect cancer at an early stage, what examinations need to be carried out and how to minimize the risk of cancer. Interviewed by Tatyana Stepanova.
— Andrey Dmitrievich, tell us how things stand in the country today with regard to morbidity and mortality from malignant tumors?
— In the structure of population mortality, malignant neoplasms occupy second place (14.9%) after cardiovascular diseases (54.8%).
Every year, approximately 480 thousand new cases of cancer are detected, and more than 280 thousand people die. Of these, a sufficiently large number of people of working age (15.5%). This situation is largely due to the fact that people seek medical help late. In an advanced stage, cancer is detected in every fifth patient, and this leads to the fact that mortality in the first year after diagnosis in our country reaches 26%. And when cancer is treated at an early stage, the 10-year survival rate reaches 95% or more.
The disease is mainly diagnosed in older people - 60 years and above. The probability of developing cancer in men under the age of 60 is 8.2%, in women at this age - 8.7%. And after the age of 60, these figures look like this: 21.6% for men and 17.3% for women. Thus, the longer life expectancy in a country, the more attention should be paid to preventive examinations.
In those Russian regions where there is a high depopulation of cities and villages (young people leave, old people remain), mortality from malignant neoplasms indirectly increases, while the detection rate remains the same. At our institute, we maintain an all-Russian cancer registry, and this is nothing more than the best epidemiological study, thanks to which we receive all the information on cancer diseases in the regions.
— Which regions have achieved success in treating cancer?
— In Kazan and Khabarovsk they work quite well to identify and treat such patients. There, primary care doctors are on an oncological alert, special tests are taken en masse: for men - for prostate specific antigen (PSA), for women - for CA 125. These studies make it possible to detect prostate cancer at an early stage in men and cervical cancer in women. In women, unfortunately, the incidence of cancer in this particular location is now growing very strongly. Over ten years, the increase was about 30% overall among women, and at the age of up to 29 years it almost doubled, and up to 44 years - 1.5 times. We believe that this is due to the early onset of sexual activity, promiscuity and the spread of the human papillomavirus.
— What studies need to be done for men, women and at what age in order to diagnose the disease at an early stage?
— Women over 39 years of age should undergo regular cervical and breast examinations. Men over 45 years of age should be examined by a urologist for prostate cancer. Hidden blood in the stool can be a very important indicator. We recommend that women and men over 45 years of age get tested to detect it.
Despite the prevalence of these diseases, lung cancer still ranks first. Unfortunately, fluorography is not enough to detect it at an early stage, so we recommend that you undergo an x-ray examination annually. Skin cancer is also a fairly common neoplasm.
Moreover, the most malignant skin tumor is localized on the back, on the shoulder blade. Unfortunately, it is not very disturbing at the beginning of the disease.
— Does this mean that sunbathing is harmful?
- Of course, it’s a disgrace when we go to regions where the sun is very hot, and we don’t think at all about protecting our skin. When the local population wears completely covered clothing, we lie in the direct rays of the sun and “sunbathe” - this is no good. I also think that we have a lot of unlicensed solariums, the activities of which no one controls, this has been written about more than once.
— Can a person himself suspect or recognize the first signs of cancer?
— A person may suspect lung cancer only at a late stage of the disease or when the bronchus is affected and coughing and hemoptysis appears. Before this, it is completely asymptomatic. Of course, at the initial stage, lung cancer can be seen on an X-ray, but the radiologist must also be experienced and competent.
That’s why I keep repeating: women should have an ultrasound of the mammary glands and mammography every year. Men should see a doctor if they have urinary problems. You need to donate blood for PSA. This does not require special preparation and does not take much time.
— Why do you think some of our citizens still prefer to receive treatment abroad?
— Modern medicine has no boundaries, the best ways to combat the disease are quickly becoming available to doctors from different countries. Treatment both abroad and here follows the same international protocols. Nevertheless, there are those who prefer to go to a foreign clinic. Everyone has their own reason for this. Some doctors have stopped maintaining medical confidentiality. If a person holds certain positions, he, of course, will not want his illnesses to become public. The second reason lies in the fact that some charitable organizations raise money for help abroad, in fact, children are treated in our clinics, and charitable organizations help these centers survive.
And finally, rehabilitation after surgical interventions is still poorly developed. Our specialists perform operations just as well. We recently discharged a 19-year-old girl who was refused treatment in Germany as inoperable. She had an extensive malignant substernal tumor. And after we operated on her, this girl’s mother showed the pictures to German doctors. They gave a standing ovation for three minutes. Now the girl has already gone to work.
— Do you think it is necessary to change the procedure for medical examination, especially in terms of examinations for cancer? Can primary care doctors detect a tumor at the first or second stage?
— The oncological component of clinical examination of the adult population involves two stages. The first is to identify a risk group using the studies we talked about. At the second stage, the diagnosis is clarified. I believe that medical examination in the form in which it is currently taking place is fully justified.
— Early diagnosis of cancer would significantly reduce mortality. Nevertheless, unfortunately, most people in Russia prefer not to be examined, but to live according to the principle “until the thunder strikes...” How to convince the population not to adhere to this rule?
- Convince, show, prove. For example, on the basis of our institute, we created the National Center for Oncology of the Reproductive Organs, the goal of which is to strengthen cooperation between doctors and patients and popularize medical knowledge in this area.
Starting this year, we regularly begin holding open days on Saturdays for residents of the neighboring Northern District, inviting them to a free initial diagnosis of the most common diseases. And we do it quite successfully - people go and get checked.
In order to organize a direct channel of communication with the population and receive feedback, we created, together with the prefecture of the Northern District, the Public Committee “Medical Control” and intend, in cooperation with public organizations, to monitor how medical care is provided in our city. These measures, I am sure, will increase the level of mutual trust and medical literacy of the population.
— How can you minimize your risk of developing cancer?
— Among the main causes of cancer incidence, as statistics show, the leading position is occupied by unhealthy diet - up to 35%. In second place is smoking - up to 32%. Thus, two thirds of cancer cases are caused by these factors. We also recommend not to get carried away with tanning and not to consume products with dyes. And visit your doctor regularly.