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February 4 is World Cancer Day. What factors can influence the development of oncological diseases and is it possible to cure cancer forever? Igor Khatkov, chief oncologist of the Moscow Health Department, answers.

Metropolitan doctors are sure that cancer is not a sentence, but a complete recovery, especially if treatment is started as early as possible, it is absolutely real. Moreover, Moscow medicine today is not inferior to world medicine and it is no longer necessary to go abroad for treatment. At the end of 2019, a new standard of oncological care began to be introduced in Moscow. Now patients are treated in specialized oncology centers, organized on the basis of six large hospitals, where patients go through all stages – from examination to therapy. And even in a pandemic, oncological assistance in the capital is provided in full.

Chief Oncologist Department of Health of the city of Moscow, Director of the Moscow Clinical Research Center named after A.S. Loginov, Igor Khatkov, in an interview with mos.ru, told how the approach to cancer treatment in the capital has changed, whether it is possible to get rid of cancer forever, and why early diagnosis is so important.

The new standard: world-class treatment

— How have approaches to the treatment of oncological diseases changed in recent years?

— Approaches have changed dramatically over the past few decades. Now personalized drug treatment, targeted therapy, immunotherapy are used. High-tech surgical care is developing. Doctors can perform both open and minimally invasive surgeries. Radiation therapy is improving, more and more high-precision accelerators appear (devices that irradiate the tumor, adjusting to each patient). As technology advances, so does the treatment strategy.

In recent years, new types of drugs have appeared that allow in some situations to do without surgical intervention or minimize it. This is important for maintaining the functioning of the organs, as well as from an aesthetic point of view (if the tumor is outside). On the other hand, after modern drug therapy, it is possible to surgically remove tumors that were previously considered inoperable.

Today, all types of treatment are based on a very accurate diagnosis. This allows you to select specific drugs for each person that will be effective for a particular tumor.

— And what is the new standard of cancer care? Why is this approach effective?

— Six multidisciplinary oncology centers have been set up in Moscow, which also include centers for outpatient oncology care. The outpatient and inpatient links were made a single whole, and a person goes through all the stages of treatment much faster.

It is easier for us to refer the patient to all the examinations that he needs. Within the framework of one institution, a single information system, all analyzes are visible. Survey data are available to doctors, you can quickly get acquainted with them. Then promptly hold a consultation, where the tactics of treatment are determined. The meeting is attended by specialists from at least three specialties: oncological surgeon, chemotherapist and radiotherapy specialist. If necessary, other doctors are also involved if the patient has concomitant diseases: a cardiologist, an endocrinologist, and so on.

Is it still fashionable to be treated abroad? At what level is oncological care provided in Moscow?

— Treatment in Moscow is at a very good world level. We have patients who come abroad, and they are told: “Why did you come here, they do it just as well here.” Sometimes, something is better, especially surgery. Medical care is also at the highest level.

Of course, this is the choice of the patient, he can be treated abroad and in general in different institutions. The staff of our center has just returned from the world congress, which was dedicated to the treatment of tumors of the gastrointestinal tract. Believe me, our possibilities absolutely correspond to how they are treated in the world today.

Healthy lifestyle and regular screening

When is cancer most often diagnosed?

The disease is diagnosed in different ways. This may be during a medical examination, when a person undergoes a standard examination. Oncological diseases in the first stages have practically no manifestations, so it is simply important to undergo screenings and early diagnosis. And in Moscow all the possibilities have been created for this.

The second option – a person comes to the reception when something bothers him. Unfortunately, in our country, many people do not go to the doctor at the first symptoms. This may be weight loss, a decrease in appetite, the presence of discharge (bloody and so on) – all this requires appropriate research.

After a diagnosis of malignancy or suspicion of malignancy is made, a person is biopsied and referred to an oncologist at a specialized center. If the diagnosis is confirmed, the patient receives care according to approved standards.

Is it possible to insure yourself against cancer? For example, if you lead a healthy lifestyle?

– You can only reduce the risk of cancer. The World Health Organization, based on large scientific studies in various regions of the world, has approved risk factors, they are completely banal. These are smoking, alcohol, obesity, a sedentary lifestyle, insufficient fiber intake. Not so long ago, excessive consumption of thermally processed red meat was added.

It is enough to exclude these factors and follow the diet – then, of course, the risk is reduced, even if there is some kind of predisposition, for example, if different relatives had cancer. Then it is necessary to exclude risk factors and undergo regular screenings to detect the tumor at an early stage.

– What examinations should everyone undergo in order to be calm?

Everything is standardized here. Women from the age of 21 need to see a gynecologist regularly, have a cervical cancer screening every three years, and after 40 years, a mammogram should be performed (once every two to three years, if everything is fine). From the age of 45, everyone needs to do a gastrocolonoscopy (if everything is clean – once every five years), and for men – a PSA study (screening for prostate cancer once every one to two years).

In addition, smokers with an experience of 10 years, even if they quit, at any age, computed tomography of the lungs is indicated. These are basic screening programs that identify the most common cancers.

Trust in doctors and complete healing

Is it possible to cure cancer once and for all? Has this happened in your practice?

Yes, we have many such cases. At the same time, the probability of recovering from oncological diseases is higher if treatment is started at an earlier stage. We have cases in practice when people were cured even at advanced stages, but this requires more physical and moral efforts, more drug treatment, surgical interventions. After recovery, the patient is still monitored, usually this lasts five years. Then the person is advised to contact oncologists only if complaints arise.

Is it possible to predict recovery? Why can an elderly smoker live with cancer for years, and a young athlete burn out in six months?

– It is possible to predict, but there is nothing 100% in medicine. In general, there are certain criteria on the basis of which it can be assumed whether the tumor will develop rapidly or not.

Often, cancer in young people is more aggressive than in older people, especially in old age. The rate of tumor development depends on what cells it consists of. The more they are differentiated (similar to the normal cells of the organ where they formed. — mos.ru note), the slower the disease will develop.

Accurate standards of care must always be adhered to, regardless of prognosis, which can be misleading. It happens that in old age the tumor progresses rapidly. We also have very good results in the treatment of young patients.

— How important is the psychological attitude for the treatment of cancer?

– The emotional state of the patient affects the course of treatment of any disease. You need to trust the doctors, listen to the recommendations, but at the same time live a normal life. Work, relax, solve everyday issues, travel, just periodically being distracted by treatment courses. This also helps to achieve better results.

Psychologists and psychiatrists deal with patients, if necessary. In addition, there are oncologists for Muscovites. They help to adhere to the treatment strategy.

Cancer care during a pandemic

— How has the pandemic affected the work of oncologists and their patients?

“We have not stopped caring for cancer patients. Moreover, the amount of high-tech assistance provided has increased significantly. Even in the first wave, we minimized patient contacts as much as possible, prescribed medicines for longer periods so that patients would not come back for prescriptions again. Now we continue to work according to the worked out schemes.

How dangerous is coronavirus for cancer patients? Can they get vaccinated?

Yes, vaccination is very important. In almost all cases, cancer patients can be vaccinated. People with cancer experience the coronavirus differently. But it is absolutely certain: any infection, even the mildest, prevents any systemic therapy – surgical, radiation or drug. Therefore, the risk to patients is high if specialized treatment is delayed.

EDITOR’S NOTE: This article is a translation. Apologies should the grammar and or sentence structure not be perfect.

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