10 embarrassing questions about cancer: oncologist Ilya Fomintsev answers

In this series articles, well-known experts answer questions that are usually awkward to ask: it seems that everyone already knows about it, and the questioner will look stupid.

Today we talked with oncologist Ilya Fomintsev. You will find out whether microwave ovens cause cancer, whether it is possible to get rid of this disease using unconventional methods, and where is the best place to be treated for oncology.

1. What exactly is cancer?

Cancer is a disease in which the body's cells begin to multiply uncontrollably. This happens because the DNA structure inside the cell is disrupted. The issue may be a replication error, viral or radiation injury, or some other reason.

Normally, cells grow, multiply, age or become damaged, die, and new ones take their place. This is a cycle that is damaged in cancer cells. Therefore, they can form benign and malignant tumors. The latter are capable of spreading in the body and creating new tumors - metastases.

Benign tumors do not act in this way and rarely grow back after removal. But malignant ones can with a much higher probability return to their place or spread throughout the body.

2. Is cancer a disease of our time or has it existed before?

He has always been there. The word “cancer” itself is a term coined by Hippocrates. True, in his writings it was called “crab”. He described the “robbing” - karkinos - of the mammary gland. Indeed, there are forms of breast cancer when it comes to the surface. And perhaps it reminded Hippocrates of a crab shell.

But the term turned from “crab” to “cancer” by mistake. The disease was named this way by the doctor Celsus of Rome, who translated the works of Hippocrates. Since then, this term has gone into all languages.

That is, the disease was known since ancient times. Since cancer is more likely to occur with age, as people live longer, the incidence rate also increases. Then antibiotics were invented, which allowed people to be treated and live even longer, which means they will survive cancer more often. Around the 1950s, humanity began to better understand the dynamics of cancer and began to keep statistics.

3. How often should you be tested for cancer as a preventive measure?

It is necessary to get checked, but not everyone. The fact is that screening can bring not only benefits, but also harm. And to prevent this from happening, a lot of research is being conducted on at what risk, by what criteria and what methods should be checked. There are international ideas about this. They are very vast and cannot be described in two words.

It is very important that the risk from the examination method does not exceed the risk of the disease. There are ways that can directly harm the body. For example, colonoscopy, which can cause intestinal damage. There are methods that can lead to false positive results, for example, a blood test for tumor markers.

Thus, the ovarian cancer marker CA 125 can be elevated not only in tumors or inflammatory diseases ovaries, and, for example, in case of liver dysfunction, inflammatory diseases of the cervix and the uterus itself. Such false positive results can later lead to actions that harm the body.

Therefore, tumor markers are not used anywhere in the world for cancer screening - the likelihood of causing harm when using them is much higher than the likelihood of bringing at least some benefit.

To make it easier for everyone personally to understand whether it is worth checking or not, I have developed a tool “Screen». In it, you answer questions about yourself, and the system, based on research data from all over the world, determines what exactly you need to do, whether you are at risk and whether it is worth getting checked.

In general, risk groups cannot be described simply, because in each case there are many factors. If we take smoking, then this is an experience of more than 30 years, smoking a pack a day and age 55 years or more. If mammary cancer - age over 55 years. But there are many but‎. For example, if you have first and second degree relatives (parents, children, brothers and sisters, grandmothers and grandfathers, aunts and uncles) who suffered from lung cancer or breast cancer, then the examination will be to others. That is, in the case of cancer, there is no single recipe for everyone. The most convenient way to find out which group you are in and what you personally need to do is to take the Screen test.

4. Is cancer inherited? And if so, does this mean that cancer will definitely appear?

Oncological diseases are genetic because they are based on DNA damage. But it cannot be said that they are hereditary unless it is a familial syndrome. If you have a family history of cancer, your risk of cancer does not automatically increase.

There are several things to think about:

• first-degree relatives—that is, parents, children, brothers and sisters—had cancer;
• close relatives were sick at a young age - up to 50 years;
• one relative had several different types of cancer;
• Several relatives had cancer on at least one side - father or mother.

If this is the case, you can consult a geneticist, who can prescribe special testing to determine the possible mutations you have. There are now about 200 known, and their presence may increase the risk of cancer. Geneticists interpret these mutations and tell you whether you are at increased risk. Sometimes in this case something can be done, sometimes not and you just need to wait.

5. If you drink and smoke, will you definitely get cancer?

In general, alcohol and cigarettes increase your risk - although much of this, of course, depends on how much you drink and smoke. But consuming them does not guarantee that you will get sick, and stopping them does not guarantee that you will not get sick.

A so-called healthy lifestyle may reduce your risk of cancer, but it does not guarantee that you will avoid the disease. Factors that reduce the risk of cancer include:

• good dream,
• regular balanced meals,
• moderate consumption of fats and sugar,
• absence obesity,
• physical activity,
• no excessive tanning,
• giving up alcohol and smoking.

These simple principles can reduce your risk of disease. But they still do not guarantee that it will not happen with 100% probability.

6. Can radiation from electrical appliances cause cancer?

Electrical appliances do not cause cancer. Ionizing radiation at high frequencies—X-rays, gamma rays, and some types of ultraviolet radiation—has enough energy to damage DNA and possibly lead to the development of malignant tumors. But electrical appliances cannot do this: their radiation is radio frequency and too low. But there is no evidence that it can actually cause cancer.

7. Why is cancer treatment so expensive? Are there ways to get treatment for free?

Cancer treatment is expensive because it is combined and complex. It requires the involvement of various doctors and uses very expensive radiation therapy equipment. One such device can cost several million dollars.

Medicines are also expensive. Billions of dollars are invested in them around the world. Development sometimes takes decades, and you need to pay the scientists and institutes that do it. Moreover, it often happens that the work of 9 out of 10 such researchers does not lead to results.

Surgery for the treatment of cancer is the cheapest.

In Russia there is an opportunity to receive treatment according to Compulsory medical insurance, and you can get a lot: diagnosis, early treatment, hospital stay, drugs, chemotherapy and radiation therapy, surgical treatment, examinations. Not all countries have such an extensive list.

However, you must understand that if all of the above is included in the compulsory medical insurance, this does not mean that you will immediately have access to it. When dealing with cancer, time is of great importance - you need to act on time, without delaying the stages of treatment. You may have an MRI examination at compulsory medical insurance, but you will have to stand in line to get in. Or you are prescribed some medications that are not available. And you will have to wait for them too.

8. Where is the best place to get treatment for cancer?

If you are a rich person and you have no problems with money at all, you can safely spend half a million dollars for treatment - and at the same time you are mobile and transportable, then it makes sense to go somewhere leave.

If these two components are not present, then treatment should be done where the patient is. There's no point in this sell apartments and get into debt. Also, in the overwhelming majority of cases, there is no point in going somewhere just for one stage of treatment - this can only be done if if you are sure that you have doctors at home who speak the same conceptual language as those who treated you for border.

Cancer treatment methods are approximately the same in all countries.

In Russia you can also find a good surgeon and drugs. Most often we are talking about capitals, in the regions everything is much worse. The difference between Russia and some other countries is the basic safety of the patient - this is everything that surrounds him while he is in the hospital. This could be poor nursing care or a hospital-acquired infection. It is not a fact that you will encounter these problems, but it may happen. Basic patient safety may be higher in some other countries.

But such departures for treatment are justified only if the patient can do this without harming his life and health, and also if he has enough money for this.

9. Is it possible to treat cancer without chemotherapy and without surgery?

It all depends on the type of cancer. Sometimes you can only get by with drug treatment, sometimes only with surgery, sometimes only with chemotherapy. It all depends on the biology of the cancer, on the prognosis, on the development of the disease. But most often cancer is treated with combined methods.

10. Is it possible to be cured using unconventional methods, as some people claim?

All non-traditional methods that work immediately fall into the traditional category. Research is ongoing. And if something works, this method or ingredient begins to be studied more closely, it very quickly moves into the section of traditional medicine. Therefore, only by definition ineffective methods remain in non-traditional methods.

None of the doctors sets themselves the task of using only certain methods, protecting them at all costs and not using anything new. If something undergoes clinical trials and proves its effectiveness, it is adopted.