Фото: News.ru/Сергей Булкин
Konstantin Titov — oncologist, Head of the Oncosurgical Department of Skin and Soft Tissue Tumors, MD, Associate Professor, Professor of the Department of Surgery and Oncology of the Faculty of Advanced Training of Medical Workers of the RUDN - gave an interview to our editorial office.
— What symptoms can indicate the presence of cancer?
— It is easier to detect cancer with its external localization. For example, breast cancer. A woman can feel it on her own: some kind of dense nodule is formed, a compaction area in the chest area. It is necessary, of course, to contact an oncologist-mammologist in a timely manner. He will conduct a mammogram and can detect a malignant tumor, melanoma or what is the precursor of melanoma – dysplastic nevus, that is, an uneven, asymmetrical and multicolored mole. If the mole suddenly changed edges, changed color, began to increase in size, then you should contact a dermatologist.
There are certain signs of even an early form of melanoma (malignant tumor *). In women, this can be found in the discharge from the genital tract. This will be an occasion to be examined in a women's consultation with a gynecologist. Such a syndrome can mean precancerous cervix, and maybe even early forms of cancer.
— How to understand that you have cancer if there are no such obvious external manifestations?
— There are no specific symptoms to detect cancer of internal localization. These same symptoms may coincide with other non-oncological diseases. But if there are already such vivid symptoms as: weight loss, lack of appetite, jaundice of the skin, coughing with blood, increased shortness of breath, then we are talking about the late stages.
Konstantin Titov during the operation
— How to detect cancer in the early stages?
— In order to detect cancer early, you need to go to screening and medical examination. When a patient is examined without symptoms, he considers himself practically healthy, but this may not be the case. In order not to miss cancer at a late stage, we need to detect it at an early stage. Then we can cure him completely.
— What precautions should be taken to reduce the risk of developing cancer?
— Acquired cancer is about 90% of cases of the disease. The older a person is, the higher the risk of getting cancer. Almost everyone gets sick from cancer, only some do not live to see it. There is even such an expression "lived up to his cancer"
The risk of developing cancer increases, for example, in a smoker. During smoking, chemicals and carcinogens enter the body. They affect the bronchial epithelium or enter other tissues, which causes mutations in the DNA of the cell.
Sunburn can also affect the development of cancer. In people with light skin color, a tan is formed poorly. They have burns, freckles and small moles instead of sunburn. With prolonged exposure to the sun, sunburn forms on the skin, which can subsequently lead to the formation of melanoma (malignant tumor *).
In addition to physical exposure, there is also an infectious one. It can worsen in the case when a person has chronic gastritis, but he does not go to a gastroenterologist and does not do a gastroscopy. The bacterium Helicobacter pylori (a bacterium that causes diseases of the gastrointestinal tract*). It lives in the gastric mucosa and gradually causes long-term chronic inflammation. As a result, there is a transformation of disorders in the work of the genome – mutations. This leads to a violation of the regulation of the cell cycle, and the cell turns into a tumor.
— Are there any prospects in the future to create a drug thanks to which cancer treatment could be less painful and more effective?
— Modern medicine has leapt forward a lot over the past 30 years. In addition to chemotherapy, there is also targeted therapy (when treatment is prescribed directly individually for each tumor) and immune therapy. The latter is the present and future of oncology. The meaning of immune therapy is that on the cells of the immune system, in addition to activating receptors that activate it, there are receptors that suppress it. They are called suppressor. They are necessary so that the body does not kill its own cells. When a tumor grows, the immune system does not cope with its functions, because tumor cells, like ordinary ones, secrete proteins. This is how they "mask" themselves from the immune system. In this way, it passes cancer cells into the body. Due to the fact that the immune system does not see cancer "in the face", it most often wins. However, if suppressor receptors are blocked, the immune system begins to find the very cancer cells. This is the essence of immune therapy.
— Which drugs are the most modern and effective in the fight against cancer?
— Now there are drugs that block both "inhibitory" receptors and invisible infected cells. Previously, they were only foreign and expensive. However, in 2020, our Russian scientists registered such a Russian analogue of prolgolimab, which is no less effective in the treatment of cancer.
* — примечание от автора
