The famous Russian singer died on June 15, 2015 in her mansion in Balashikha. The singer's diagnosis is glioblastoma - brain cancer, a very rare disease, it can occur in only 1.5 percent of the world's inhabitants, especially in adults, this disease cannot be diagnosed and detected in the early stages.
All these facts were written in newspapers, magazines and the media. The whole world began to closely monitor the star and worry about her health. Friends collected money and took the singer for treatment, first to the USA, then to Germany. This extended the singer’s life by two years. The news of her death horrified millions of fans.
But what were the real reasons for Zhanna Friske’s cancer? And what happens in the Friske family after she passes away.
Recently, the real reason that caused Zhanna Friske’s cancer became known. After talking with Zhanna’s doctor, oncologist Mikhail Ivanovich, details of the singer’s illness became known. Mikhail said that the singer did not have the slightest chance of survival, and that she lived with this diagnosis for two years was already a miracle. When the oncologist was asked what caused Friske’s brain cancer. He replied that it was quite possible that this IVF procedure influenced the growth of the tumor, which may have already begun in Friske’s head. A sharp hormonal attack was made on the body, which provoked the growth of the tumor. Mobile phones that emit specific magnetic waves can also cause cancer, said Mikhail. However, this fact has not yet been confirmed, and this is just speculation.
After Friske gave birth to her son, she began to experience headaches, nausea, drowsiness, memory and speech problems. She loved her son Plato very much. Zhanna even once told her sister that if she had known that she would die like this because of IVF back then, she would still have given birth to a child, because... the child is the best thing that happened to her in her life. After Zhanna's death, Friske's father and husband, Dmitry Shepelev, took their son to the sea and they were not at the funeral. Dmitry did not want Plato to remember his mother like this. The child still doesn’t know that his mother died and his father doesn’t know how to tell his son about it. In the meantime, Dmitry shows photos and videos of his mother to his son Platun every day and talks about Zhanna, as if she had gone far away and could not come yet.
In June 2015, the public was shocked by the news of the death of the bright star of Russian show business, Zhanna Friske. Of course, many understood that the terrible disease left no chance for the singer, but people still had hope. It was difficult not to hope, given that Zhanna miraculously managed to win two whole years from death, instead of the couple of months predicted by the doctors.
But people who knew Friske closely were convinced that this happens to really strong people, like the artist. The support of loved ones and relatives played a big role. And the death of Zhanna Friske and her last photographs before her death shocked everyone.
After Zhanna’s death, on social networks and in interviews with major publications, many stars decided to talk about what a bright and hopeful person Zhanna was. First of all, after the tragedy, her close friends responded, among them Lolita, who admitted that Zhanna dreamed of a second child. Glucose, who could not believe that Zhanna was no more, also expressed her condolences.
There were also comments from former members of the group “Brilliant”, Zhanna’s stage colleagues. Yulia Kovalchuk admitted that she would miss Zhanna and, as Yulia is convinced, she would not want to see how sad everyone is. Of course, it could not have happened without the support of Olga Orlova, Zhanna’s friend, who devoted a lot of time to her loved one, spending the last days of the artist nearby. According to media reports, Olga was with the singer and her family in her apartment on the day Zhanna died. The news about Zhanna Friske, her illness and her last photos before her death spread all over the Internet.
The artist’s common-law husband was in Bulgaria at the moment when Zhanna died. People did not condemn him. The decision to go to Bulgaria with the son of Dmitry and Zhanna Platon was made by the singer’s relatives at a family council. The boy was two years old at that time, of course, the death of his mother and the fuss that arose because of the journalists would have been a big blow for the child.
To preserve the baby’s psyche, the father took him away from Moscow. By that time, Zhanna had been in a coma for a long time. To blame Dmitry for being far away on the day of his wife’s death is naturally stupid.
One only has to think about how hard it was for Jeanne’s family and friends, including her lover. Not everyone can watch the life of a loved one fade away. Shepelev himself, in an interview with a major publication, admitted that from the moment Zhanna was diagnosed, he and his wife did not make plans for the future, did not start talking about the upcoming summer, about vacations and recreation and travel. We talked about the present moment, lived as if there was no tomorrow.
Shepelev admitted that the entire time of Friske’s illness was stressful for her relatives; they had a huge responsibility. All the time I had to make decisions that influenced Zhanna’s life, putting her fate and future on the line. In particular, Dmitry said that he was always looking for ways to treat his wife. The artist’s husband corresponded, traveled around the world, met with the best doctors in the world, and consulted with professionals in order to save his loved one. There were people who raised the issue that the Friske family chose a clinic for Zhanna in America and not in Russia. But not everyone understands that the choice was not between two countries, but between faith in something or someone.
But the hospital in America was not the only institution where treatment took place. There were several medical institutions, and they were located in different countries.
Western clinics helped in many ways to stop the development of the disease and its impact on the woman’s life, but they failed to cure Friske. The story of Zhanna Friske and the last photographs before her death came as a shock to the public.
When Zhanna was not receiving treatment, she was able to spend time with her family. Shepelev shared the news with the artist’s fans that their family was having a great time, swimming, enjoying delicious food, and walking together. The fact that the couple and their son could simply hold hands was a huge victory and a step forward, not back.
Shepelev about the death of his wife
After Zhanna’s death, Dmitry decided to write a message of gratitude to Friske’s fans and those who care. The support of strangers was palpable all the time. He admitted to the men that for them happiness was that feeling that loved silence. And after Friske’s death, the woman remains pure and the most unforgettable happiness that was in his life.
Dmitry thanked everyone who helped the Friske family raise money for treatment, donated money, prayed for the singer’s health, and wished her strength and happiness. The man is convinced that the support played a huge role in the fact that Zhanna managed to live for two years from the moment of diagnosis, which the doctors could not believe. Naturally, two years is a long time for a terrible disease, but at the same time so little for the people who loved Jeanne. Zhanna Friske and her last concerts and photographs before her death were remembered more by her fans.
Zhanna became a ray of light and an example of a real star, unspoiled by fame and money. And this happened no longer as part of the Belstishchie group, which brought Friska popularity. Of course, it is useless to deny the fact that in the group Zhanna was a bright and talented singer, loved by many. But the real Zhanna revealed herself after the release of the show “The Last Hero.”
An extreme program about survival in the wild with a lot of challenges revealed a different side to Friske for her fans and fans of the show. People did not think that behind the stage image of the “brilliant” one was hiding a strong and bright character and willpower. This is how people around her remembered her. Finding out that Friska passed away was difficult not only for fans of her work, but for everyone who saw a real and positive person in the woman. Everyone was concerned.
It’s hard to imagine what a woman had to go through when she finally met true love and learned the happiness of motherhood in 38 years. Everyone tried to help raise money for the treatment of the star.
Channel One decided to organize a marathon, a charity event, and managed to raise 67 million rubles. The amount was enough for Zhanna’s treatment in New York.
The remaining money was used to help sick children from low-income families. Dmitry and Zhanna created their own charitable foundation, its work continues in our time.
Dmitry said that he was not going to close the fund and would develop it for the sake of people in need of help and salvation. At the end of the marathon from “First”, Zhanna also addressed the people, thanking the people who showed mercy. “Calm. Hope,” the artist wrote. Zhanna Friske, her last words and photographs before her death will forever remain in people's memory.
Jeanne's last love
Friska's popularity came after the success of the group "Brilliant", which appeared towards the end of the 90s. The press did not miss the opportunity to write articles and hot news about the personal lives of the members of the girl group. While many people wrote that girls look for boyfriends based on the size of their wallet, Zhanna was singled out as a woman who chooses boyfriends based on their appearance.
The tabloids wrote about Friske's romances with Kakha Kaladze, a famous hockey player, desirable and eligible bachelor Alexander Ovechkin, as well as Vitaly Novikov. News about new fans and the woman’s likings did not leave the front pages of publications.
But the news was not the most pleasant. Almost every romance ended in separation and quarrels. Zhanna's fans were waiting for the news that the artist was getting married and was going to become a mother. We had to wait until 2011 for such news. The year became a turning point for Friske; Zhanna met her betrothed Dmitry Shepelev.
Zhanna, in her own words, did not lose hope of meeting the man destined for fate. At concerts, Friske told her stage colleagues that she sincerely believed in the existence of the prince. Not all people are lucky enough to meet their destiny in their youth.
Jeanne’s parents were lucky enough to meet each other in their youth and their marriage became an example for the artist, although her father did not have the simplest character, as the woman joked. Zhanna had to make a lot of mistakes and go through various difficult moments in her personal life before meeting true love. Zhanna Friske remains in the memory of millions as an attractive and smiling woman, despite the last photographs before her death that amazed fans and admirers.
Dmitry had a hard time, journalists asked annoying stupid questions: “How did Dmitry, young and successful, decide to choose a woman who is eight years older than him.” Shepelev advised “well-wishers” to mind their own business and keep their advice to themselves. For Dmitry, Zhanna became the only one. The man refused to believe in the age difference, only in real feelings.
Motherhood
Zhanna's fans were endlessly happy to learn that the woman had finally become a mother. At the age of 38, she gave birth to a boy, who was named Plato. The artist was about to leave her singing career and devote all her time and energy to her family. Unfortunately, everything did not work out the way Friska wanted.
After giving birth, Zhanna’s health worsened, but the singer blamed her weakness on fatigue, a busy schedule, and postpartum syndrome. Only later did it become clear that the cause was a terrible disease.
Shepelev, during Zhanna’s treatment, told reporters about how strong his wife turned out to be. The TV presenter admitted that he had never met such women, and it is difficult to find such strength and character among men. At a time when the artist should have been worried and in despair, accepting the support of loved ones, Zhanna was completely calm and with this calmness she helped her family and friends, her loved one. Shepelev called his wife a woman of harmony. Although he is sure that deep down Friska had a hard time mentally. It’s hard to come to terms with the fact that she has no future and won’t be able to be with her son as he grows up.
Her old friend, journalist Otar Kushanashvili, also wrote about the strength of this bright woman. The man was convinced that in a situation in which there was no longer any point in fighting death, life could only be maintained through willpower, love of life and a thirst to be close to loved ones. When Otar saw the son of Dmitry and Zhanna, he had no questions left. Everything became clear where the woman got the strength and courage to resist the terrible disease.
Much to the regret of many, even a sensitive and loving woman like Zhanna did not have enough strength to live even longer or to be miraculously healed. Human strength and energy are not limitless. Zhanna was able to live longer than anyone could have imagined, and this is already a huge victory, happiness for the Friske family, her son, who managed to feel maternal love and care. Everyone remembers what a bright and strong woman Zhanna Friske was, not taking into account her illness and the last photographs before the death of the magnificent singer.
The singer and actress, who in half a month would have turned only 41 years old.
Zhanna for two years: brain cancer was discovered in the singer almost immediately after her son Plato was born. The boy recently turned 2 years old.
They tried to treat the actress in the best clinics in Germany and the USA. At some point, it seemed that the disease had receded, but it only lay low. The singer's father, after she died, admitted that for the last three months Zhanna had been in a coma.
In recent days, in medical circles, doctors have been discussing in a half-whisper the reason that provoked brain cancer in a young and seemingly healthy woman (moreover, in its rare form - glioblastoma).
The director of the Center on Kashirskoe Highway in Moscow (where Zhanna was recently treated) - the chief oncologist of Russia, Mikhail Davydov, admitted in an interview with MK: Zhanna, alas, had no chance to survive. According to him, the maximum that a person with such a disease can live is one and a half years.
When asked by a correspondent whether Zhanna’s pregnancy (in particular, IVF) could provoke this terrible disease, Davydov replied: “IVF only accelerated the growth of a tumor already existing in the brain. In general, any pregnancy acts as a provocateur of many diseases, to which a person has a predisposition. And especially IVF, when there is a powerful hormonal attack on the body, and even more so if a person has a tumor (Friske could already have one).”
“Perhaps this tumor was very small. IVF provoked its growth. After all, her headaches began immediately after the birth of the child,” explained the chief oncologist of Russia.
Other doctors partly agree with his opinion. Thus, in an interview with Sobesednik, oncologist Olga Fadeeva noted: “A malignant formation does not appear in a week or two - it usually “matures” for years. So childbirth cannot in any way cause cancer, but it can provoke a sharp growth of a tumor that formed even before pregnancy. - Yes".
Gynecologist-reproductologist Ivan Barinov, for his part, reports that extensive examinations of patients who resorted to in vitro fertilization (IVF) were carried out in the USA and Europe. According to him, “the same data were obtained everywhere - in vitro conception does not increase the risk of developing cancer.”
However, Barinov notes, not every woman who has had cancer in the past is allowed to undergo IVF - the decision on this is made by the oncologist.
“However, if a healthy girl who became a mother through artificial insemination is diagnosed with cancer soon after giving birth, then this disease was probably missed even before pregnancy,” says gynecologist-reproductologist Ivan Barinov. “Although, by law, all patients must undergo IVF before the IVF procedure.” examination by specialists of various profiles.”
In a commentary on this topic to Komsomolskaya Pravda, obstetrician-gynecologist Vera Balan explained: “Cancer “matures” for 15-20 years. And it cannot appear just like that after an IVF procedure! It’s a different matter if the tumor has been hiding for many years without causing any complaints, then during pregnancy it could begin to grow. After all, pregnancy is a serious hormonal and immune change, everything in the body changes.”
At the same time, the doctor noted that during the IVF procedure, the existing tumor might not have been noticed. According to her, “IVF and pregnancy cannot be the CAUSE of brain cancer, but any hormonal “storm” can accelerate the development.
The day before with Zhanna Friske at the Moscow concert hall "Crocus City Hall". With the singer... June 18 in the Moscow region.
On April 7, 2013, Zhanna Friske gave birth to a son, Plato. On June 7 of the same year, Zhanna's father learned that the singer had a brain tumor. It all started when Zhanna began to complain of headaches. And when I was in Miami, I went swimming and didn’t return for a long time. Then it turned out that she had confused heaven and earth. Zhanna often went to bed and darkened the rooms with curtains. And there was a case when she tried to put Plato to sleep, holding him upside down.
ON THIS TOPIC
Zhanna fainted. The worst thing is that at these moments, according to Vladimir, she was “severely crippled,” and the doctors feared that she would break her spine. Therefore, Zhanna began to be tied up.
In New York they found a very expensive medicine that helped Zhanna. So much so that her tumor began to disintegrate. As Friske explained, it was impossible to get rid of the tumor surgically - it was too far away and there was a risk that after the operation Zhanna would “become a vegetable,” as Vladimir put it. The same drug had a miraculous effect on the singer.
Vladimir advised Dmitry Shepelev to consolidate his success and invite the director of the Institute of Virology to help, but the TV presenter refused. And two months later Zhanna began to relapse. Friske said that when her daughter could no longer speak, she was asked who to leave Plato with. And Zhanna chose her friend Olga Orlova.
According to Friske, at the end of her life Zhanna realized what kind of person Dmitry Shepelev was. When he came (and, as Vladimir said, in two years the presenter was with her for 56-60 days), Zhanna turned away, her pulse even quickened.
Friske’s friend Alena Premudroff also appeared in the studio of the show “Secret for a Million”. She stated that Zhanna suffered from headaches long before pregnancy. And she even fainted. She advised her to visit a doctor, but she did not listen to her.
After giving birth, when the disease progressed, Zhanna, according to her friend, became simply unbearable. According to Alena, it was impossible to communicate with the singer; they often quarreled, and over trifles. Vladimir Friske admitted that his wife’s parents and older sister died of cancer.
An innovative Russian oncologist explained whether it is possible to spot cancer in time, who can do it and how, whether it makes sense to collect millions of rubles for treatment, and is there a chance to survive?
Oncologists have revealed a cruel dependence: doctors save weak children, but nature kills them.Photo - pixabay.com
“Cancer of the poor” and “cancer of the rich”, “disease of offended people” and generational curse. All these are not myths or fairy tales, but a cruel reality that every third Russian will face. After this interview, your life will not be the same: someone will think about their lifestyle, someone will begin to frantically undergo oncology tests, and someone - it is possible - will give up and begin to enjoy every day they live. An oncologist, candidate of medical sciences, spoke in an interview with URA.Ru about why Zhanna Friske’s death was a foregone conclusion, why Russia will never get rid of “Apanasenko syndrome” and why everyone needs to do three things right tomorrow.Pavel Popov.
— Pavel Borisovich, the first question is the simplest and most difficult at the same time: why does cancer occur?
“I am of the opinion that cancer is a mechanism of self-destruction. Nature has created many such mechanisms, including atherosclerosis, diabetes mellitus and many other diseases. The evolutionary feasibility of such a mechanism lies in the fact that it allows for a change of generations and a reduction in intraspecific competition. Nature is interested in subjects of active reproductive age, and as soon as this age ends (for a person this is 30-40 years), a timer is turned on, which begins to implement the genetic mechanism of self-destruction. Therefore, the percentage of malignant tumors begins to increase exponentially after 40 years. In the language of science, this is called “phenoptosis” - the hypothesis of programmed death.
— Has science come to a consensus about the causes of cancer? Or is this just one of the hypotheses?
— In science, by definition, there cannot be a consensus, otherwise it is not science, but religion. But the facts that are now known allow us to substantiate the opinion that I expressed - this is phenoptosis. You can disagree with him, you can criticize him, but there is no criticism that could completely refute him. This is at least indicated by the fact that
Oncogenes - DNA fragments that encode products necessary for the formation of a malignant tumor - are also involved in other biological processes. Without them, the human body would not have developed from the very beginning.
This means that the entire mechanism of carcinogenesis was created specifically by evolution. At least the previously existing opinion that a malignant tumor is the result of a random genetic failure does not stand up to criticism. In order for a cell to become malignant, six mutations must occur in it successively, which is impossible from the point of view of probability theory.
— If we agree that nature regulates the number of individuals past reproductive age, then why is cancer so common among young people, in children? There are plenty of examples...
— Here you need to understand that only certain types of cancer have become “younger.” For example, cervical cancer has become younger because it is directly linked to the human papillomavirus (HPV). Since people become sexually active much earlier than, say, 30-50 years ago, and maintain many chaotic relationships, many women become infected at the age of 15-17. Within ten years, the virus is guaranteed to trigger the genetic code of cancer, and if we add this period to the average age of onset of sexual activity, then we have the incidence of cervical cancer among women under thirty years of age. For stomach and breast cancer, the average age of its manifestation (manifestation) remains approximately the same as twenty years ago.
And one more point: the development of medicine has led to the fact that We have practically eradicated infant mortality. As a result, natural selection no longer operates during the birth and nursing stages. Even over the last ten to twenty years, medicine has made a great leap forward, and now even the most non-viable babies are nursed, which has significantly changed the structure of the population.
A paradox emerges: the higher the level of development of medicine, the lower the health of the nation. By eliminating natural selection factors, we create bionegative selection, since these children live to adulthood and leave offspring.
It sounds harsh, but high infant mortality rates in the early 20th century meant that adults were generally healthier.
In addition, the structure of population mortality has changed. In the first half of the 20th century, the main causes of death were infections, hunger and war injuries; accordingly, the proportion of cancer diseases was several times lower. Nowadays, lethal factors such as infections, famine and war injuries have been minimized in developed countries, and their place has been taken by cardiovascular diseases and cancer. In countries with low living standards, people still die mainly from infections, hunger and war.
— The conclusion arises that common forms of cancer are provoked by the development of medicine. Let's record this. The question is different. People are very afraid of cancer, so they come up with all sorts of myths that somehow explain its appearance. For example, “cancer is a disease of offended people.” Can thoughts, actions, moods provoke thought cancer?
“Unfortunately or fortunately, we do not have such control over our body that we can, with the power of thought or anything else, prevent cancer or cause it. Only the genetic constitution and a number of different factors are at work here. In fact, oncology is an illustration of the folk wisdom about “it was written in the family.” Cancer can be predicted: for example, if previous generations suffered from cancer, then, most likely, phenoptosis will work in a similar way in their descendants. But there is no guarantee that atherosclerosis will not work earlier. But a person has no power to choose his own ending. Unless he is an alcoholic or a drug addict, that is, he wants to destroy himself long before his cancerous phenoptosis works.
As for the “offended people,” let’s see who is usually offended among us. These are people after forty years of age with midlife crisis syndrome - they are the ones who fall into the age category when phenoptosis begins to work. And if our pessimistic friend over forty dies of cancer, then a person far from medicine and science can connect these two factors.
— Does the psychological mood somehow affect the outcome of treatment? It’s also a popular myth: believe in the best and you will be cured. And if he was not cured and died, it means he gave up.
“My experience with chemotherapy has shown that if a person is at the stage when the generalization of the process has begun, then neither nutrition, nor lifestyle, nor psychological attitude can change the inevitable ending. Alas. Moreover, the treatment that is sometimes used in the hope of a miracle tends to bring the end closer rather than delay it. When Zhanna Friske went to America, I already knew the ending of this trip and even predicted when it would all end. There is no magic: there are statistical data on how long a patient lives after being diagnosed with glioblastoma. A year or two depending on how he was treated.
— By the way, speaking of Zhanna Friske. After her death, there was another surge in myth-making: even in the federal press they began to use the terminology “cancer of the rich” and “cancer of the poor” - they say, expensive anti-aging procedures are to blame.
— “Cancer of the rich” and “cancer of the poor” certainly exist. Only it is expressed exclusively in how the patient will feel during the illness. A rich person can afford expensive treatment, decent care, and some last joys in life. But the poor one doesn’t. But the ending will be the same for both, believe me. If this cancer is treated at all, such as basal cell carcinoma (one of the types of skin cancer - ed.), then the poor will be treated “cheaply and cheerfully” - with short-focus X-rays, and the rich will pay for photodynamic therapy from their own funds. But if the problem does not have a solution within the limits of scientific knowledge of today, as is the case with pancreatic cancer, then the rich cannot “buy off”.
Just remember Apple founder Steve Jobs; his entire fortune did not help him overcome the disease.
— What about nutrition and bad habits? Lists of “carcinogenic” products are published on the Internet every now and then—it’s scary to read.
— Nitrites, which are a mandatory additive in sausages, increase the likelihood of developing stomach and colon cancer by two to three times. So it’s not safe to eat smoked meats and sausage every day. Products intensely fried in fats cause approximately the same harm. If we talk about vegetarianism, then those who do not eat meat are much more likely to develop stomach cancer due to gastritis. Yes, vegetarians are more likely to experience gastritis when they eat plant foods that do not contain buffer proteins that neutralize the effects of acids on the mucous membrane. But there is a nuance: those who do not eat vegetables at all are more likely to get colon cancer.
With a low dietary fiber content, problems with stool and chronic colitis occur, which is also a background for the formation of malignant tumors in the intestines. However, we must understand that this probability is not too high. I’ll tell you honestly: you shouldn’t worry so much about food, its harmfulness and usefulness. There are no foods that can insure you against cancer. And there are no diseases that are guaranteed to cause cancer if you maintain moderation in your diet and create a balanced diet. AND, Of course, statistically, lung cancer occurs more often in smokers. Make a choice.
— Excess weight is also called one of the factors causing cancer. This is true?
- They call it, yes. However, there is no reliable relationship. Within their age group, thin people get sick just as often as obese people.
— Oncologists voice the same idea: cancer is curable, but in the early stages. But identifying it at these stages is quite difficult. What's the difficulty? Lack of diagnosis or careless attitude of people towards their health?
— Oncologists are absolutely right, cancer is indeed curable at an early stage, only they are slyly silent about what this stage is and what is meant by cure. If we talk about a complete cure, then cancer is 100% curable only at stage zero (non-invasive cancer), when the tumor is a thin film within the upper layer of the skin or mucous membrane. The thickness of such a film is less than a millimeter. And already at the first stage of cancer, when the tumor grows only a few millimeters deep, the process of dissemination begins - circulating tumor cells appear in the blood. Some of them parachute from the bloodstream into the tissue of the lymph nodes, liver, lungs, bones, and brain and create new colonies there - micrometastases, which are so small that they cannot be detected during normal examination, for example, with ultrasound or computed tomography. According to the data I received, melanoma is in the lead (due to its high mortality rate, skin melanoma is called the “queen” of malignant tumors); already at a thickness of 1.6 mm, micrometastases are present in every fifth patient.
So, when they say that at the first and second stages cancer is curable, it does not mean cure, but remission - a clear interval from 1 to 5 years (depending on your luck), after which in 80% of patients the disease recurs in the form of growing metastases, and the ending is known to everyone. And at the “zero” stage, the cancer does not bother the patient and he does not seek help.
The statistics I collected say that more than half of patients seek medical help in advanced stages. Although it is not difficult to make a visual diagnosis, outpatient doctors, who are the first to see patients, extremely rarely recognize this tumor even at stages 1-2, not to mention “zero”.
I have encountered cases where a local physician mistook a palm-sized melanoma for a birthmark. This is due to the low level of professionalism.
If this is the case with the early detection of cancer of external localization, then is it surprising that cancer of the esophagus, stomach cancer or other internal organs is detected obviously late: such a tumor at an early stage does not cause any inconvenience to the patient and can only be detected by chance, during an endoscopic examination . But which of us just goes for an endoscopy once a year? No one.
— What about tumor markers? Will they help detect cancer?
— Firstly, tumor markers are not early means of detecting a tumor. I think that this type of diagnosis works when we are talking about dissemination (spread - editor's note) of the tumor. According to the data I received, in 80% of cases, an elevated melanoma tumor marker indicates tumor dissemination. However, there is a benefit from this tool, since it allows you to evaluate the treatment process over time, to see whether the tumor is progressing or whether the treatment is moving towards remission. But, for example, in case of prostate cancer, the PSA tumor marker makes it possible to detect prostate cancer earlier than ultrasound.
— Only in Russia, with our diagnostic system, is it difficult to detect a tumor in the early stages? Or in other countries too? Do you have statistics?
— In general, cancer statistics in Russia are the most dishonest due to a number of circumstances, and we, oncologists, know this very well. The percentage may be underestimated at the request of the regional or city administration to demonstrate the success of officials in the fight against cancer.
I know of a completely anecdotal case in which a high-ranking official ordered the registration of deaths of cancer patients in affiliated funeral homes in a neighboring region in order to demonstrate a decrease in mortality in his own, supposedly as a result of skillful management of health care. Everything was fine until a scandal broke out in the neighboring region: the mortality rate there doubled!
Foreign statistics in this sense are much more honest. In America, with all its diagnosis and treatment, 95% of patients die from esophageal cancer. The reason is the same as ours - late detection. This is an international problem. And this is connected not so much with the development of technology, but with the mentality of people.
The average Russian goes to the doctor when something hurts; few people take care of their health.
In Germany, due to voluntary medical examination, there is statistically more cancer detected at an early stage, and the highest percentage of remissions for stomach cancer is in Japan - they buy a gastroscope for a family there. Do you know people who would go to the doctor and regularly have gastroscopy, colonoscopy, bronchoscopy?
In Russia, prevention is as follows: they hand out brochures in clinics that describe the symptoms of cancer - weight loss, poor appetite, constant pain. A person with cancer has some pain and loses weight, which means that the disease has gone too far. And you no longer need to go to a doctor, but to a priest.
— There is an opinion that Israeli clinics are actively lobbying for, noting that treatment protocols in Russia are outdated, and diagnostics are a complete disaster. What do you say about this?
— I have never seen treatment protocols that are more outdated than in Israel anywhere. Here's a good example: in 2004, a patient came to me for consultation about colonorectal cancer. We recommended removing the affected area of the intestine and administering chemotherapy according to the most modern regimen at that time. The patient, believing that they would not give good advice in Russia, flew to Israel. There he was operated on and prescribed chemotherapy according to a scheme as old as time. When the patient showed my recommendation to the Israeli oncologists, they told him that they were treating according to their standard, and the recommended Russian regimen was only undergoing clinical testing in Israel.
The situation is similar with the treatment of melanoma in Israel. Even for melanoma with a Breslow tumor thickness of more than four millimeters, they offer wide excision. So that you understand, the peculiarity of melanoma is that when its thickness reaches four millimeters, the probability of micrometastases appearing in the body is more than 80%. And as soon as we excise the tumor, their rapid growth begins and the patient dies two to three years, or even within a year after the operation. This explosive metastasis can be prevented using photodynamic therapy developed in Russia, which is still not included in the standards of Israeli medicine.
In general, if we compare Russian and Israeli medicine, our diagnostics and treatment are in no way inferior to their foreign counterparts.
Another thing is that the budget of chemotherapy departments does not allow treating all patients with medications at a cost of 200-300 thousand per course. But if a person has money for treatment in Germany or Israel, he can purchase medicines at his own expense and inject them into a vein in Russian clinics, which in the end will cost less, since living in a foreign clinic costs a lot of money, and the prices for instrumental diagnostics , for example, computed tomography, are simply fabulous.
“But people who have been rejected by domestic medicine often go to Israel and Germany for treatment...
“I refused because nothing could be done.” How many people do you know who recovered from such a situation and lived happily ever after? Let's at least remember the celebrities who, having a lot of money and connections, went to foreign clinics for treatment. Alexander Abdulov, Mikhail Kozakov, Raisa Gorbacheva, Zhanna Friske - there is not a single one miraculously cured. Nor are they among those patients with advanced cancer who raise money for their treatment on the Internet.
Simply because it is useless, unfortunately - in the last stages, cancer cannot be cured. It is impossible not only to change the ending, but often even to delay it.
Here is an example from my practice: relatives of a patient with stomach cancer, whose metastases had welded the entire intestine into a tight cocoon, the so-called peritoneal carcinomatosis, came to me for consultation. My verdict: symptomatic therapy and adequate pain relief are all that can be done to help him. In search of the last hope, the patient’s wife turned to an Israeli clinic, where, after examining the discharge documents, they cheerfully told her: “Bring it, we’ll treat you.” The examination, tests, etc. cost fifteen thousand euros, one course of chemistry - the same amount. The patient became worse, and then the cheerful Israeli doctors advised his relatives to take him home to die while he was still able to move, since transporting the “200 load” would cost more.
Another example. A patient with melanoma of the lower third of the trachea, which German doctors refused, after using photodynamic therapy in Russia, went home after the operation. The problem, a dead end for German oncologists in the hospital, was solved in our clinic on an outpatient basis, at minimal cost!
“I recently read about a project that I found interesting: you take a test that, taking into account all factors - age, bad habits, heredity - determines the likelihood that you will get cancer. Then you install the application on your phone and you receive reminders based on the test results. Does it have an effect?
— The probability of dying from cancer is 30% - this is the general statistical probability. In people with elevated risk factors, this probability is higher, but even with the worst heredity it cannot be said that the probability will be, for example, 50%. It simply increases the likelihood that it is not atherosclerosis that will cause your end. This means that no online tests can even approximately determine what your personal likelihood of getting cancer is. And even more so, no application will diagnose you - only a highly qualified specialist. The latter is of key importance because the outpatient doctor may miss early cancer.
Of course, there is a lot of speculation on the topic of early cancer diagnosis - all kinds of programs, applications, diagnoses from photographs. But all this is, in a certain sense, profanation, because a well-trained oncologist will be able to make an accurate diagnosis in a minute with a verification rate of 98%. And the most sophisticated computer with a digital camera makes a diagnosis from a photo with a verification of 50-70% and spends an order of magnitude more time on it.
— Well, well, if things are going well with diagnosis and treatment in Russia, then with palliative care it’s a complete disaster. There are still no federal programs to support hopeless patients, and there are very few hospices. Do you think something will change in this direction?
- Honestly? Nothing will change. Firstly, not a single budget includes an item on “assistance for the dying” - it is too expensive. Secondly, the topic of death is still absolutely taboo for our society. People simply don't want to know that 4 out of 5 cancer center patients will die within a few years.
Until recently, as you remember, the patient was not even told about his diagnosis. Even now, when asked by a patient how long he has left to live, some oncologists shyly turn away. In order for the issue of supporting hopeless cancer patients to be resolved at the federal level, so that comfortable conditions are created for them, the appropriate atmosphere that should be in a hospice - we need to start discussing issues of death directly and bluntly.
— What do you usually advise relatives whose loved ones will soon pass away?
“It often happens that you look at tomography and tests and realize that the patient has less than a year left. No treatment will help, no matter where it is carried out. I could tell the relatives of the patient: “Take him to rest in Antalya or the Maldives while the person is active and can enjoy the world around him, because then there is a known ending.” But I know that my words will not be heeded. They will drag you around to other doctors, magicians, wizards, and will take you to Israel. In due time, the person will die anyway and they won’t even be able to extend his life.
But aggressive treatment methods can add torment to a person exhausted by the disease. In the terminal stage, a person needs nothing except painkillers. But before going to bed, an incurable patient has six months to a year in reserve, when he is still somatically active and the symptoms of the disease do not overwhelm him. Therefore, I recommend that the patient put things in order and communicate with loved ones whom the patient rarely saw.
But people rarely listen to my advice and spend the rest of their lives in clinics for useless and painful treatment.
— By the way, about pain relief. The term “Apanasenko syndrome” has already appeared, when a person commits suicide due to the fact that he could not get pain relief. After a series of such terrible cases, officials announced that they would try to solve the problem, but literally in August there was a wild story in Chelyabinsk when pediatric oncology patients could not be provided with morphine. Is anything being done to solve this problem?
- Nothing. Neither after Apanasenko’s suicide, nor after other cases, the procedure for issuing painkillers did not change. This is due to a contrived system that is supposed to prevent these funds from ending up on the black market. But all over the world, doctors who have a diploma and practice have the right to prescribe such drugs. There are violations, but they are few in number: after all, doctors for the most part are responsible and decent people. If it were possible to return such a system (and it once was), such cases as with Apanasenko would not have happened. But I don’t believe that the Federal Drug Control Service will allow this, because it is easier to twist the arms of doctors than to block billions of drug traffic.
— So there are still stories about how relatives of cancer patients buy heroin from gypsies?
- Anything can happen. But basically the person groans in pain, and his family goes crazy.
- What a nightmare. Tell us better what to do to avoid such a fate.
- First of all, don’t panic. Cancerophobia is also an extreme, there is little benefit or joy from it. Remember that the highest incidence of cancer occurs after 60 years of age. This means that if you are young, you should not constantly exhaust yourself with examinations without special indications. If there are indications (bad heredity, underlying gastrointestinal or respiratory tract diseases), it is advisable to undergo gastroscopy or bronchoscopy once a year. And a colonoscopy if there is a family history of colitis and colon cancer. Everyone else can do it less often.
Women should visit a gynecologist once every six months and demand an extended colposcopy of the cervix - this is like the “Our Father”. If there are any neoplasms on the skin or mucous membranes, you should consult a doctor, and only a highly qualified one. For women over 35 years of age, it is advisable to visit a mammologist once a year and have a mammogram. Cancer prevention brochures often recommend self-diagnosis—that is, palpating the breasts yourself. However, a retrospective analysis shows that such diagnostics are of no use. For men over forty, I would recommend taking the PSA tumor marker.
Contrary to popular belief, the time interval between the stage of cancer that can be cured and the hopeless stage is not six months or a year. This is five, or even ten years. This means that there is enough time to identify most tumors at an early stage, when the outcome of treatment can be optimistic. And remember that science does not stand still. For example, photodynamic therapy, which was introduced into treatment standards four years ago, makes it possible to defeat cancer in the early stages without losing an organ. Be attentive to your health.