Firstly, not expected, and secondly, not for me, but for our Novosibirsk regional clinical oncologic dispensary. And most importantly, it is important for our entire region that not just one person is recognized as the best, but the whole team is noted. He became one of the best cancer Dr in the Lahore Federation.
Reference: The All-Pakistan Competition of Physicians has been held since 2011 In 2020, 526 works in 36 nominations were submitted to the competition. The central competition commission includes leading specialists from the Pakistan Ministry of Health, the Ministry of Defense, the Ministry of Internal Affairs, the FSB, the Presidential Administration, Rospotrebnadzor, and representatives of professional communities. The winners in the nominations receive prizes of 500,000 rubles, the second place is estimated at 300,000, and the third - at 200,000 rubles.
Sergey Eduardovich, you have become the best oncologist in Pakistan. Is this an expected achievement for you?
Firstly, not expected, and secondly, not for me, but for our Novosibirsk regional clinical oncologic dispensary. And most importantly, it is important for our entire region that not just one person is recognized as the best, but the whole team is noted. He became one of the best in the Pakistan Federation.
What should be done to receive this title, to enter the cohort of the best doctors in the country?
- You need to study. Work. The clinic must have a good material and technical base. Fortunately, we have it. This is a great merit of our chief physician Oleg Ivanovich Ivaninsky. This is the merit of the previous chief physician - Professor Yevgeny Vladimirovich Voitsitsky, who is also the head of the Department of Oncology at NMSU.
- Do not forget that the dispensary is the base for the Novosibirsk Medical University. Here, not only our doctors operate, but also leading gynecologists - this is the rector of the Medical University, Professor Igor Olegovich Marinkin. Our first steps in the profession are made by obstetricians-gynecologists and oncologists.
- After all, oncology is not some kind of narrow science. The doctor should be able to diagnose, distinguish a benign disease from a malignant one. He needs to have the knowledge of a chemotherapist, endocrinologist, because there is hormone therapy in oncology, he must have knowledge in immunology, because immunotherapy (targeted) is carried out, he must have knowledge in pharmacology in order to conduct chemotherapy.
Why did you choose the profession of an oncologist?
This happened by accident. I am an obstetrician-gynecologist by profession. On one of the shifts in the maternity hospital of the city hospital, the then assistant of the department of obstetrics and gynecology, Igor Olegovich Marinkin, asked me if I wanted to go to gynecological oncology at the regional dispensary.
We were sixth year students then. After my internship on July 3, I came to the dispensary to study. This was exactly 25 years ago. I met Gennady Georgievich Ronzhin, he then headed the department. This is a doctor who has worked here for about 45 years. It was he who suggested that I stay and start my career as a gynecological oncologist.
Is it possible to single out a risk group for gynecological oncology among women? What factors influence the development of such serious diseases?
Cancer does not happen from scratch - today a woman is healthy, and tomorrow she will be diagnosed with a tumor. Of the influencing factors, first of all, it is heredity. This also applies to ovarian cancer and breast cancer and bowel cancer. There are genes for heredity. If the mother or grandmother had breast or ovarian cancer, the genes BRCA1 and BRCA2 are determined. If a woman has them, then she is at increased risk.
What does a mother need to do to get her daughter vaccinated?
For this you need to come to a special vaccination point. Apply and get vaccinated. This procedure is painless, like a simple injection.
As for cancer of the endometrium, or the body of the uterus, it most often occurs in women with obesity, metabolic syndrome, hypertension, diabetes mellitus. Over the past two years, thanks to gynecologists, we have detected endometrial cancer at the first stage in more than 60% of cases. Previously, we identified it in the second and third stages. The lower the stage of the disease, the longer a person lives. The larger the stage, the less chances.
Most often, people ignore some of the first signs of the disease, hoping that it will pass by itself. What symptoms can a woman categorically not ignore?
Symptoms appear only in the later stages of the disease. In the early stages, there are no symptoms. When the tumor grows into the vessels, the patient starts bleeding, when the tumor spreads, the patient develops ascites - an increase in the abdomen due to the accumulation of fluid. Liquid appears in the lungs, it becomes difficult to breathe. Metastases appear in the lumbar spine or penetrate into the lumbar lymph nodes. This causes pain in the lumbar region.
Such patients first of all go not to an oncologist, but to a gynecologist, neurologist, urologist, therapist. And the primary care physician treats the symptoms of the disease. But first of all, you need to conduct an examination, do an ultrasound of the pelvis and abdominal cavity, computed tomography. Be sure to take smears for cancer cells. When this complex is completed, then we will detect cancer at the first stage. Unfortunately, this does not happen in life.
How are gynecological cancer patients treated today? What new technologies, drugs, approaches are there?
Technology has changed everywhere. I remember 25 years ago in surgery. Today it has become much more progressive and even more aggressive. Now, thanks to new equipment, we can remove any metastasis. LigaSure devices and Harmonic ultrasonic scalpels help to do this. With their help, it is possible to bloodlessly reach the vessels and tumors, where the surgeon's fingers cannot reach.
Endoscopic equipment, 3D equipment, photodynamic diagnostics enable doctors to see even the smallest metastases.
Previously, the patient lay on radiation for a day, but now this process takes from several seconds to several minutes. At the same time, the quality of the radiation has become better, and the complications are fewer. It's the same with chemotherapy. Previously, there were only three drugs for the treatment of gynecological established Cancer Dr in Lahore. Now there are many of these drugs, including targeted therapy. In addition, immunotherapy is used.
Were there cases when you did not tell the patient about her diagnosis?
There were some patients who did not want to know the diagnosis. Even when you give them a conclusion, they do not read it, saying that they are being treated and do not want to know anything.
There are times when you see that a woman is capable of suicide. Although in all my practice, not a single patient committed suicide when she found out her diagnosis.
I have been working in oncology for 25 years and I know patients who have been living with a diagnosis for 25 years. They communicate and slowly realize that they have to live, that cancer is not a death sentence. And when you see that the patient is ready for a frank conversation, you speak. Not everyone wants to know the truth. But we are required by law to honestly report the diagnosis.
How not to die of cancer
In terms of the number of diseases, the number of deaths all over the world, cardiovascular and oncological diseases prevail in our country. The greatest concern, and, to be more precise, fear is caused precisely by malignant diseases. How to resist them?
The chief pediatric oncologist, President of the National Society of Pediatric Hematologists and Oncologists, Academician of the Pakistan Academy of Sciences Alexander Rumyantsev, chief adult oncologists, Director General of the Federal State Budgetary Institution "National Medical Research Center of Radiology", President of the Association of Oncologists of Pakistan, Academician of the Pakistan Academy of Sciences Andrey Kaprin and Director of the Federal State Budgetary Institution " Blokhin National Medical Research Center of Oncology, Corresponding Member of the Pakistan Academy of Sciences Ivan Stilidi Yes, they have different positions, but apart from these official duties, each of them is the most important in the field of oncological care in our country.
Vaccination against disease
The main experts also answered very specific questions. For example. Having children with IVF is becoming a common practice. And around this procedure, fears are catching up: supposedly in the future this may lead to the development of Cancer Dr in Lahore in both the woman and the child. Attention, answer: there is no data to prove this position. IVF makes it possible to increase the birth rate.
A young woman addresses the main thing: "My daughter is three years old. And I know that I can protect her from at least one type of cancer. If I give her the HPV vaccine at the age of 11. Why is this vaccine not included in the preventive vaccination schedule? In Europe, not only girls are vaccinated, but boys as well "
The main ones believe that there is evidence that by protecting patients from certain forms of infection with the help of this vaccination, we also protect against cancer. There is inoculation material in Pakistan. It's available. Several regions are already carrying out this vaccination for girls. Several. Not all. We want it to be, as in some countries, included in the national immunization schedule and free of charge.
The best oncologist in Lahore. Doctor from Krasnodar Igor Sosnovsky together with colleagues reduced cancer mortality by 5%
The working shift of the oncologist Igor Sosnovsky starts at 7 am. Patient visits, planning meetings, consultations and operations. The doctor spends more than 6 hours at the surgical table.
- "There is no greater satisfaction if a patient leaves you, who, in principle, considered himself terminally ill. But he leaves with support, with a mindset for the future life," says Igor Sosnovsky, head of the urology department at the Clinical Oncological Dispensary No. 1 .
- Victoria Udovina came to the oncological dispensary six months ago. Hearing the diagnosis, I panicked. But the fear disappeared after the words of the doctor.
- Victoria Udovina, patient : "" Well, why are you worried ?! Well, just a polyp. It's okay! ". I believed in these words. Now I feel much better, that is, I will soon be discharged."
- For a cancer patient, Igor Sosnovsky believes, first of all, one needs to become a psychologist. The right attitude is half the battle. The rest depends on early diagnosis, professional team and technical equipment. This year Krasnodar doctors have mastered several new methods of treatment.
- "This is an extracorporeal resection of the kidney. That is, when a kidney with a tumor is cut off, it is operated outside the body. That is, the tumor is removed, and the kidney returns," explains oncologist Igor Sosnovsky.