- What is pediatric oncology today?
- Pediatric Oncology - is one of the newest trends in medicine, but in spite of this, one of the most successful.Contrary to popular belief - successfully cured cancer in 80% of cases.One of the main challenges in oncology is the unexplained nature of the disease.In the development of cancer into play a variety of factors, including genetics, and ecology - pollution of the environment by various carcinogens, into the soil, water and the atmosphere
- How did you come into the profession?
- The Children's Oncology I came, one might say, by chance.The institute in the student scientific circle engaged in pediatric surgery, pediatric otolaryngology, continued residency in Filatov and Morozov Hospital Moscow.I advise patients to different wards, and even had no idea that there is a pediatric oncology.Then it was the first office in Russia, which was in charge of Professor Lev Abramovich Durnov - the father of the Soviet Children's Oncology, is that the direction of both the Russian Federation and in all former Soviet republics.Lev Abramovich invited me, and I was interested in a totally unique and very interesting part of the medicine.So I went to the children's oncology.Then built-Union Cancer Research Center Kashirskoye (now State Organization "Russian Oncological Scientific Center named after NN Blokhin" Russian Ministry of Health - Ed ..), The structure of which entered the Pediatric Oncology and Hematology.Here I work to this day.
- What are the difficulties faced by Russian specialists and who supports you?
- Difficulties begin already with training.In order to get a diploma, a certificate of Pediatric Oncology, you need two years to unlearn residency.The internship can be reached at graduation, with specialty "Pediatrics" or "Pediatric Surgery" or "oncology".Previously had the opportunity to reclassify any doctor in pediatric oncology, it was easier.Now there is a fork, which does not allow us to attract a large number of physicians in pediatric oncology.The younger generation we are slowly losing in residency can only be reached in a federal hospital, it is very difficult for young people who live in other cities - Ulan-Ude, Irkutsk, Magadan.Even living in the not too distant regions have to leave the family to live in Moscow, pay a hostel, food and all on ordinatorskuju penny scholarship - is extremely problematic.The difficulties with the financing - it is no secret, money for medicine is not enough.Because of GDP on health care is allocated less than 4% in developed countries this indicator is usually 5 times higher.Of course, the Ministry of Health can distribute only what distinguishes the industry the government and the Ministry of Finance.Lack of funding leads to a shortage of medicines and low salaries of health workers.This applies not only oncology and medicine in general.With such difficulties faced by all experts.There are, of course, government programs and projects, there is additional funding infusion.Scientific reports, research funded through grants.But it is very weak support.
- How many children are now being treated in the country?
- In the world there is a tendency to an increase in cancer in general, children in particular.Over the past 20 years, this figure has increased by 15%.In Russia today about 30 million children.According to official statistics, in the year ill 3-3.5 thousand children under the age of 15 years.In fact there is quite a serious underestimation of the sick, and if we assume that children from 0 to 18 years old (and now it is up to the age of the patients belong to the children's age), then a year sick to 5 thousand. Children.Under the supervision of pediatric oncologists are about 20 thousand children, 3/4 of which we have already cured, and 1/4 of them -. It is receiving active treatment at the moment.Extracted children remain under the dynamic supervision until the age of 18, after which we will pass on to their adult oncology network.
- As parents and pediatricians may notice initial signs of cancer?
- Unfortunately, the specific pathognomonic symptoms in the early stages of cancer does not exist.If, for example, appendicitis or other inflammatory diseases are manifested by pain, fever, that person is alerted that the body that something was wrong, in the case of tumors that usually does not happen and the disease to a certain point develops gradually, stealthily.Parents and pediatricians should be alert and pay attention to a number of signs of a general nature.Against the background of the development of malignant disease children become lethargic, moody, lose their appetite and body weight, decreased skin turgor, the child may appear symptoms of anemia - pale skin, mucous membranes, the tendency to hemorrhage.Only in some diseases can note specific symptoms, such as the glow of his eyes, which happens in retinoblastoma.The Soviet Union was not a bad system - detailed regular examination in nurseries, kindergartens, schools and other educational and training institutions.If children observe, identify chronic diseases, to identify patients with poor health, which should be attributed to the risk group, including oncology, then it will be possible to identify the disease at an earlier stage.
- you spend a special work with parents of children who undergo treatment for you?
- The work begins with the first step, when the parents come to the clinic for the first appointment.As a rule, such a diagnosis - a shock for parents.And the first impression is the most unpleasant, most terrible, because the parents are turning to the federal center in the hope that still exclude disease which suggested or established in the community.Our institute has a counseling service, a team of psychologists.The first reception in the clinic doctor explains what the problem is, what is the possible nature of the disease, what are the prospects, forecasts, some diagnostic tests be carried out to clarify the diagnosis, what should be done to heal and what opportunities exist for this.If you need psychological support for patients and their relatives in the mandatory support of our entire team of psychologists who work both in the outpatient clinic, and after the child's admission to the department.The psychologists also work with the medical staff, because when constantly confronted with tragedy, with a negative mood, it is also very long time is not enough.There is a so-called "burnout."This is not new, it has long been accepted in Western countries.We now also runs such a service.
- How patients can get to you for treatment?
- Despite the fact that this research institutes, the federal center to our patients can get just from the street, without a referral.The only time that those who come to us "from the street" himself, their first visit paid.Because it is not known what came to us, maybe just with pneumonia, that is not addressed in the profile.But as soon as the diagnosis is confirmed, the patient is transferred to free health care regime.Those patients who are sent for consultation of the oncologist, if they have a direction, they get a free appointment with the doctor on the same day.Often, if a person comes to us after the examination at another institution with a ready diagnosis, immediately consult with a senior researcher, professor's consultation, during which the decision is made, what to do, how and where to treat, whether and how urgent surgical intervention is necessary.And if there is a problem of priority, it exists only in the hospital because they do not have enough beds.As for the initial reception, all those who came and directed us to the patients will be necessarily taken in the clinic on the same day.
- quality treatment in the capital and in the provinces differ greatly?
- Of course, different.It depends on the power department, the level and complexity of patients.We have the most sophisticated, the most serious cases, which fall from the regional offices of Pediatric Oncology at the federal center.Those patients who can conduct standard types of chemotherapy, surgery, standard radiation therapy can be provided via this everywhere.In any case, now in many regions quite intensively developed cancer care.Hard in regions with low population density, where it is very difficult to get to the regional or regional center, where there is a pediatric oncology.And the level of care are lower.Not only oncological and any.treatment protocols for patients undergoing treatment, are different in intensity depending on the risk group to which the patient falls.Patients who need to spend vysotehnologichnoe, a complex combination or complex treatment, of course, need to get into the lead centers.If not in the federal, at least in the boundary.In addition, the federal center is certainly concentrated the best experts, who have extensive experience of conservative treatment and surgical interventions.
- The difference between Russian and foreign clinics?
- the federal center is not much different, because filled with costly modern equipment and diagnostic laboratory.This ultrasonic devices, computer and magnetic resonance tomography, radionuclide diagnostics, cytology, immunohistochemistry, cytogenetics, the identification of markers of tumor growth, and so on.That is, we have all those modern facilities that exist in the West.With regard to treatment protocols, they are fundamentally different from spent in western Europe, the USA or Japan.We use virtually the same preparations the same combination and accompanying therapy.Difference in foreign clinics in our country lies in the fact that the load on the medical staff we have is completely different.If there is the accepted norm is considered 6 patients at the doctor and 5 patients at his sister, then we have the figures to 2 times higher than for the physician and is 4-5 times higher for nurses.Personnel policy suffers.This is especially true nursing care, because if our medical institutions doctors more or less may be considered provided, the nursing staff provided very bad.You know, from where it goes.It's all on the level of wages, which receives staff.If we had the financial support, both in the West and the appropriate number of nurses and doctors, the care of the sick would have been much better.When instead of the 5 patients under the supervision of her sister 20, the quality of care and medical assistance is reduced.
- Which platform for the exchange of experience between doctors, you can advise your colleagues?
- First of all, it is necessary to develop new modern protocols that we create, implement and promote the practice, and, of course, read the contemporary medical literature.This study - training the doctors who come to the department of the Russian Academy of Postgraduate Education once every 5 years as required by law.In addition, doctors can come to study in the workplace in the federal centers where are concentrated the most complex and serious cases to look at the latest achievements and developments in diagnosis, chemotherapy, radiation therapy, surgery, are being introduced in the federal center.Even if the doctors will be able to visit the pediatric oncology different regions of our country, they will still get new experiences and enrich their skills.In addition, it is necessary to train abroad, where it is necessary to try to go as much as possible, rather than stewing in its own juice.Necessarily it is necessary to take part in all conferences, congresses, forums and meetings.And it is desirable that it was not a passive participation, and performance with some theses presentations.All this allows us to communicate, to change experiences and improve their skills.For example, Mr. and VI Congress of Pediatric Oncology Russia with international participation "Achievements and prospects of Pediatric Oncology» will highlight p azlichnye aspects of the most recent advances of pediatric oncology, which we have in the country and abroad.This is a great opportunity to share their own experiences.
- What do you say to yourself in the morning, when you go into the hospital building?
- I wake up, come to work, and I think each time: "Give me, my God, my strength, and mind, so that day was successful for me and for my patients."This, in fact, so ... What's missing from all the doctors, and what I wish to put forth that they fulfilled?First of all, I do not have time, and I would put forth a desire to sleep.And, of course, be fully funded and ensuring our industry to avoid any problems: went to work, and the head does not hurt due to the fact that something is missing or lacking.And, of course, in front of my windows prolonged by 18 years of construction - construction of our institute, which is not completed.I would really like me to live to see the happy moment when we move into new housing, fill them with the equipment and will have a great opportunity to provide more high-quality assistance to our young patients in more comfortable conditions.
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