How to beat cancer
By Vestnik Kavkaza
The number of cancer cases will increase by 30% by 2030, according to the experts of the World Fund of Studying Oncological Diseases. At the same time, all specialists are sure that oncological diseases should be diagnosed in infancy.
Professor Mircha Safroniy, director of the Center for Gynaecological Oncology
100 grams of prevention are tons of treatment later. After the collapse of the Soviet Union the specialty "Oncology" in medicine is the only one which organized the Association of Oncologists of the CIS. We remember with great pleasure Nikolai Trapeznikov, who gave birth to this direction. We meet together at our congresses that have been held for four years, now they are held every two years. According to the International Agency for Research on Cancer, each year about 13 million people turn sick, and about 7 million die; in the Republic of Moldova in 2012 there were about 8,000 new cases of cancer, and about 5000 died. As for localization, in the world the first place is taken by lungs, followed by breast, colorectal cancer, stomach and prostate. In Chisinau we have colorectal cancer in the first place, followed by breast, skin, lungs, stomach and blastosis. These five or six localizations form more than 55% of all the cases.
Mack Maglakelidze, deputy director of the National Center, head of the oncology department
The problems are the same everywhere. First and foremost, these are probably the late-seeking patients, and the lack of access to cancer services. In Georgia we have rapidly developing medical insurance services. Medical insurance must be supported and controlled by the state. In Georgia, the main treatment of oncological patients comes through private insurance companies, which are paid by the government for oncological treatment; these patients are mostly children and retired people. People who are below the poverty line also receive oncological treatment. However, our new government is currently working on developing a public insurance program, and we hope that soon every citizen of Georgia will be able to get oncological service, diagnosis and treatment. The fact is that the biggest problem of private health insurances is that in the search for a cheaper service, private insurance companies are trying to send patients to less specialized clinics, to places where the service is available at a lower price. As a result, no definitive treatment is conducted, and these patients come to specialized cancer centers already with advanced diseases, with recurrent cases, with metastases, with progressive diseases. The treatment of such patients is of course much more costly for the state and their families than it would have been if they received correct and adequate treatment on time. Despite the fact that there are rather good screening programs in Georgia - already for the fourth year in a row Georgia is conducting breast cancer, cervical cancer, colorectal cancer and prostate cancer screenings - despite all that, all the people who have passed through this screening cannot be given adequate treatment in specialized institutions. That is the biggest problem we have at the moment.
Azad Kerimli, chief oncologist of Azerbaijan
In 2006, President Ilham Aliyev issued a decree on the treatment of cancer patients. With the implementation of this decree, in 2009, an Oncological Center was created in Baku, equipped with the most modern equipment. At the first and second stages of cancer diagnosis it is very difficult to determine its stage and acuteness. Therefore, this issue requires further attention. Very recently the modern Oncological Center in Baku has been built and put into operation. It provides a significant range of services, including those related to the diagnosis and treatment of the disease. Last year we have entered into a new era. A Children's Oncological Center was opened in Baku.
Michael Lichinitser, deputy director of the Blokhin Cancer Research Center
In Russia even in the big cities there are 50% cases of advanced breast cancer. Clinical examination should include an organizational component. We do not just need to purchase scanners - we need to establish a system of education. In Russia there is the problem of availability of early diagnosis and analyzing its results. This is a big problem, which, unfortunately, is solved on a formal basis. We should change the system of organizing diagnostic and cancer care. We are a civilized country, and it is necessary to put a stop to this. This is the aim of the state programs, but the important thing is that the oncologists or specialists who provide the diagnosis make a decision. We are very far from the world level up to this moment, we must admit this.
Mukhtar Tuleutaev, chief medical officer of the Oncological Clinic of Astana
Today the question of availability of early diagnosis of cancer among the population of Kazakhstan is resolved, I think, at the state level. In 2012 the president of our country Nursultan Nazarbayev announced the Year of Oncology. A government decree adopted a program of development and cancer care in the Republic of Kazakhstan for 2012-2016, which implies greater financial investments annually for early diagnosis and treatment of cancer. In Kazakhstan 100% of cancer patients are provided with medication - both at outpatient and in-patient level. Since 2008 a screening program for breast cancer and cervical cancer has been implemented. In 2012, a screening program for colorectal cancer began. Since 2013 in the republic the screening for esophageal cancer, stomach cancer, liver and prostate cancer has been introduced. Last year, in a pilot mode in one region in eastern Kazakhstan, screening for prostate cancer was implemented, which has shown the effectiveness of this work. This program is being implemented in pilot mode in six regions of Kazakhstan. Today breast cancer is in first place in terms of frequency and in third place in terms of mortality rate. But it is not a new problem that some oncologists cannot cope with the problem of early detection. We should work with physicians of primary health care, that is, health clinics, and the population of our republic, our countries should pay attention to their own health, that is, to raise the level of culture in terms of healthy living and paying attention to it.
Dmitry Osinski, deputy chief physician of the City Cancer Center (Kiev)
It is important to educate the population in terms of self-consciousness, it is necessary to see a doctor, to undergo medical examinations, preventative checkups. If a woman finds it necessary to attend cosmetology or a nail salon, she also needs to understand that she must once a year undergo a mammogram, be examined by a mammologist and protect not only herself from the disease, but also her family, because it's not just her personal problem, it is a problem of her family and friends. During the year we hold a variety of events - health days and open days of our clinics. We began to publish a newspaper "Foundations of Health." In the Cherkassy region with a mobile mammography complex, when the complex comes to a remote village and examines all the women who are in the village and in the surrounding villages. We have large countries, and I think it would also be useful for us in the future to develop here mobile cancer counseling centers, which will include mammography, fluorography and professionals.
Gagik Bazikyan, Deputy Director of the National Cancer Center of Armenia
Primary care physicians study a very short course of oncology at the institute, and they forget a lot. We must raise the level of suspicion of primary care, in connection with which we issued guidelines, where there is a brief set of symptoms of various diseases, and we published the age groups and the sex of the patient and the examinations connected with these data. Once a year people have the right to undergo sonography and fluorography, blood tests, etc. The patient has the right to conduct these examinations at the expense of the state, followed by consultations with an oncologist, if something is found, and to receive feedback, he is registered in our lists, and we are already dealing with him.