What are the biggest challenges facing the oncology sector today? What is the level of prevention and treatment of certain types of cancer? One of Kazakhstan's leading oncologists, Bolat Kalkamanovich, answers these questions to kazinform.
Dr. Kalkamanovich, what factors determine cancer?
Cancer is a disease of the elderly population. Lifestyle also plays a significant role. According to WHO, 50-60% of cancer cases are related to lifestyle. These include alcohol, smoking, a sedentary lifestyle and obesity. Viral factors also play a role: for example, cervical cancer is caused by the human papillomavirus. Vaccination against it has just begun. This is a good program that has proven its effectiveness. Many countries have already completed all stages of vaccination and cervical cancer is so rare there that every case is treated nationally when detected.
What are the current challenges facing oncology units?
The first problem is the shortage of specialists at the primary care level, including oncologists. This is largely due to problems at the educational level. Currently, to become an oncologist, you have to complete six years of training, then three years of specialization and another three years of surgery and oncology.
At what stages of cancer can a person still get help?
Help can be provided at any stage. The stage determines the prognosis and the chances of recovery. If it is stage 1, then the chances of complete recovery are from 90 to 100%. At the following stages, depending on the location of the tumor, the chances are smaller and smaller. At stage 4, thanks to new drugs, it is already possible for a person to survive up to five years. We are no longer talking about a cure, but about prolonging life.
They say that doctors do not treat seriously ill patients in the last stages of the disease. Is this true?
Yes, this also happens. And here everything depends not only on the stage, but also on the general condition of the person. A person may have diabetes, heart problems or concomitant diseases that do not allow specialized treatment. This usually involves large, extensive surgeries, the use of quite toxic chemotherapy drugs and radiotherapy. We always assess the patient's ability to tolerate this. There are times when extensive specialized treatment no longer makes sense. In such a case, a person should not prolong his suffering. There are times when it is necessary to allow the process to take its natural course. But the majority of our population is not ready to face death. Although the main goal in such a case is to ensure a dignified end for the patient.
Recently, the term “commercialization of oncology“ has appeared. Many clinics offer treatment, and people collect money for it... So does this mean that the state cannot provide the full range of necessary assistance?
I believe that most technologies are used in Kazakhstan. Of course, there are the most modern methods of treatment, but none of them offer 100% guarantees. Yes, now there are more modern drugs: if before they extended life by 3 months, then by 6, now, in certain places, the average life expectancy with medication is increased to 5 years. But this does not mean that if a person starts taking the drug, he will definitely live to see these 5 years. This is an average figure. It is different for everyone, and for some this drug will not help at all. Previously, chemotherapy was carried out with one drug, now we conduct research, identify the specific tumor, and there is a drug for everyone. Now we even use molecular genetic studies of tumors, identifying the presence of certain types of mutations. And here we are again with our own drugs.
The media periodically report that a vaccine against cancer has been invented...
Vaccination in oncology is one of the methods of treatment. It is also used in our country. For example, for bladder cancer. And every year somewhere they say that they have invented a cure for cancer. But not for all types of cancer and not 100%. For example, the treatment of melanoma is one of the greatest achievements in oncology. Just 10-20 years ago, the annual mortality rate from this disease was 50%. In recent years, it has been discovered that it can be influenced immunologically, i.e. by vaccination. In addition, the vaccine is personalized for each person.
Could you list the warning signs that should prompt a person to seek medical attention before it is too late?
First, the presence of any formation. If you feel a lump on or under your skin, you should see a doctor immediately. Second, blood in bodily fluids: saliva, semen, feces, urine. If you experience unexplained weight loss without dieting, this is also a sign. Weakness and a persistent, relentless cough in smokers are another such symptom. And, of course, pain. If even one of these symptoms appears, it is worth consulting a doctor, because in oncology every minute counts.
The news was published on the basis of an information exchange agreement between Fakti.bg and Kazinform