Cancer protection: prevention and early diagnosis

Near Onko
In 94 percent of cases, early diagnosis allows a woman to save her life and restore the beauty of her breasts

Irina Krasnopolskaya, Rossiyskaya GazetaCancer can be defeated only under one indispensable condition:

identify at the preclinical stage. What prevents this in Russia? What should be done to overcome these obstacles? The RG columnist talks about this with the chief oncologist of the Ministry of Health of Russia, the director of the Blokhin Russian Cancer Research Center, Academician of the Russian Academy of Sciences and the Russian Academy of Medical Sciences Mikhail Davydov (photo: Sergey Mikheev/ RG).

– Mikhail Ivanovich, today, as once, the cancer diagnosis is terrifying. Despite reports of all sorts of successes, the facts of getting rid of cancer, the situation does not change. Why?

Mikhail Davydov: I've been in oncology for forty years. And for forty years we – my teachers, my colleagues, and myself – have been discussing the same topic: the main reason for failures in oncology is the late detection of malignant diseases. Many countries, such as the USA, Japan, and the Scandinavian countries, have solved the problem by conducting massive screening programs aimed at preclinical detection of cancer. In fact, we are talking about an active survey of a healthy population.

It is important to understand that screening programs are different. With breast cancer, they are alone. With lung cancer, others. With cervical cancer, the third, and so on. And this is not the task of primary health care, but of specialized oncological institutions, specialized diagnostics. When we talk about screening, we are talking about studying a healthy population.

– And how can a person navigate: what does he personally need to diagnose? Which specialist should I go to? He doesn't know in which organ he may develop a cancerous tumor in the future, does he?

Mikhail Davydov: When we give recommendations to which specialist to turn to, we take into account one or another frequency of cancer in men and women, age, pay attention to occupational hazards, heredity, the presence of chronic diseases.

– Are screening and medical examination different things?

Mikhail Davydov: Of course. The medical examination has broader tasks. It is aimed at identifying a large range of different pathologies. Screening is aimed at preclinical detection of a specific type of tumor.

– Are there such programs in other countries?

Mikhail Davydov: Not only do they exist, they are also funded by the state. Because the technological content of these programs contains not only the proper level of material and technical support, but also the need for complex research, the involvement of modern molecular biological and molecular genetic laboratories. It is not easy to detect cancer at the preclinical stage in a practically healthy person at the time of detection.

– And to lure a healthy person with our Russian mentality to such a study?.. We have a popular principle: you know less, you sleep better.

Mikhail Davydov: There is such a problem. And dictates her eternal fear of cancer. To be more precise, this is our ignorance, which must be overcome in the name of preserving health. The first steps on this path have been taken. For example, it is forbidden to smoke in public places, on airplanes. And this is one of the active ways to overcome lung cancer. Epidemiological studies have shown that people who smoke 20 cigarettes a day get lung cancer 20 times more often than non-smokers.

– Such data have almost no effect on Russians. Prohibitions, sometimes, are perceived with hostility. And the simple recommendations of doctors are not taken into account at all. They are remembered only when trouble comes, when the time of salvation is lost.

Mikhail Davydov: That's why 70 thousand people get lung cancer in Russia every year. And the Americans, who implemented these programs with the help of the state, almost halved the incidence of lung cancer. This is one example of the effectiveness of preventive measures.

– All over the world, October has been celebrated as breast cancer month for more than 20 years. Because all over the world, this cancer ranks first among all oncological diseases in women. And Russia is among the leaders here: every year more than 54 thousand Russians get sick with it. Almost 22 thousand of them die.

Mikhail Davydov: Unfortunately, many women are irresponsible about their health, they are afraid to undergo early diagnosis. Although it has been proven that in 94% of cases it allows you to save life and restore the beauty of the breast. The possibilities of reconstructive surgery allow using a single-stage operation to completely preserve the aesthetic beauty of the breast, if the tumor is detected at the initial stage.

Mass screening programs (mammographic studies), which are carried out with the support of the state, charitable organizations and charitable business programs, do not yet have sufficient coverage. Especially in the regions.

– Are the causes of breast cancer known?

Mikhail Davydov: It is very difficult to answer this question. A very difficult problem. In some cases, breast cancer is genetically determined. And if, say, a mother or grandmother had breast cancer, then a woman should be wary.

– In order to prevent it, is it worth removing the breast, as Angelina Jolie did?

Mikhail Davydov: Prophylactically, both breast glands are removed only if the cancer in one of them is determined by a gene mutation.

– So you support such prevention?

Mikhail Davydov: In certain cases and at a certain age – after forty years. If there was a screening system for breast cancer in the country, I am convinced that many women would be able to avoid an evil fate. I will give an example of another localization of cancer in another country. Japan has the highest incidence of stomach cancer in the world. Therefore, after 30 years, everyone undergoes a gastroscopic examination there every six months. And the early detection of stomach cancer is 85%.

They have practically no advanced stomach cancers. For Japan, this is nonsense. We have absolutely the opposite. Every day we carry out huge operations specifically for advanced stomach cancers, when we have to remove part of the liver, pancreas, and colon together with the stomach affected by the tumor.

– And what about those patients who can no longer be saved, who are tormented by insane pains? The most acute problem is palliative care for cancer patients.

Mikhail Davydov: There are both medical and social components in it. We are talking about the organization of modern hospices, that is, patient support – medical, spiritual until the last breath. The problem of analgesia of these patients has not been solved. Until now, the use of narcotic drugs is a problem: how to store, how to apply, how to prescribe. There are 40 times more narcotic painkillers in Switzerland than in Russia. And we cut them all the time – we are fighting drug addiction. Although it has long been known: a drug addict will always get his dose. And the patient will remain in agony.

– You said that screening should be carried out in specialized oncological institutions. There are such in Moscow, in some large cities. But Russia is huge, and there are any number of places where there is no question of any oncological service. You are the chief oncologist of Russia. What way out of this situation is possible?

Mikhail Davydov: The only way out is to use the potential of existing oncological institutions. Because only their specialists understand what kind of screening needs to be carried out, they know how to organize it. Each region has its own oncological dispensary. Unfortunately, some of them have been combined with multidisciplinary hospitals. The prospect of future success of all cancer control programs is the preservation and strengthening of specialized oncological care. There is no single organizing and coordinating structure in our country, as in, say, Japan, the USA. There is a national cancer center in the USA. He is responsible for the organization of all oncology programs. There is a national cancer center in Japan. 70 cancer hospitals operate under a single program and under his leadership.

– Why is it impossible for us?

Mikhail Davydov: I think that this is also possible with us. Especially now, when there is an understanding of the need to create such a service in the country.

– So what's in the way? After all, the incidence of cancer in the country is growing in almost all localizations. Almost half a million Russians get sick a year. About 300 thousand die from cancer. There are about 2.5 million people on the oncological register now.

Mikhail Davydov: I am ready to come out with such a proposal. And I hope for the support of the Ministry of Health and the Government of Russia.

Myths and realityContraceptive hormonal drugs, addiction to coffee do not increase the risk of breast cancer.

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Do not believe that women who do not wear a bra are less likely to get breast cancer, and that the smaller the breast size, the lower the risk of developing this cancer. But improperly selected tight, with pressing metal bones, underwear can provoke damage to breast tissue and cause the appearance of a tumor.

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Women under 40 years of age need to undergo a clinical examination once every 2 years. After 40 years, it is necessary to undergo screening preventive mammography 1 time a year. Such a study is not dangerous: after 40 years, mammography is absolutely harmless. It allows you to detect early forms of cancer 2 years earlier than any clinical examination. But if there is a hereditary predisposition to this type of cancer, it is necessary to register with an oncologist as early as possible.

Portal "Eternal youth" http://vechnayamolodost.ru04.10.2013