Diagnosis of cancer

Early diagnosis of cancer is the main task in oncology, determining the effectiveness of treatment and ultimately the life expectancy of the patient. This problem is especially relevant in connection with the steady growth of cancer morbidity. In addition, oncological diseases have a significant feature of the appearance of the first signs of the disease already in the advanced stage, which significantly reduces the possibilities of early diagnosis. Often, the first signs of a tumor, developing, as a rule, against a background of chronic diseases, disguise themselves under the symptoms of the latter and make it difficult to recognize the oncological process.

Therefore, the successes of the anticancer struggle depend mainly on the work of the polyclinic. It is important that at the very first stage of the patient's treatment, all measures are taken to exclude or confirm the diagnosis of a malignant disease.

The reasons for medical errors in the diagnosis of malignant diseases are different. These include insufficient knowledge of the semiotics of malignant tumors, and tactical errors are the long-term observation and treatment of chronic inflammatory processes without verification of the diagnosis, the appointment of inadequate methods of treatment (physiotherapy for malignant soft tissue tumors). As a rule, the cause of errors is the absence of oncological alertness.

The founders of the national school of oncologists NN Petrov, PA Herzen, AI Savitsky developed the principles of oncological service and the basis for early diagnosis of malignant tumors, stressing the need to educate oncologists on alertness and prevent unreasonable optimism in patients with mild symptoms of diseases .

Oncological vigilance reduces to the following:

• knowledge of the symptoms of malignant tumors in the early stages;
• precancerous diseases and their treatment;
• principles of organization of cancer care, which allows you to immediately send a patient with a suspected tumor to the appropriate specialist;
• careful examination of every patient who has consulted a doctor of any specialty, in order to exclude a possible cancer;
• in difficult cases of diagnosis - the suspicion of an atypical or complicated oncological disease.

Diagnosis of cancer in the preclinical period is possible with active screening or accidentally during the examination. The absence of clinical symptoms does not mean that the neoplasm is in the early stages of development, since there may be an asymptomatic course of even advanced cancer. But the chances of finding a tumor in the early stages are much higher. It should be well represented the difference in the following terms:

• the detection of neoplasm in the preclinical period is the detection of it before the onset of clinical symptoms;
• early detection corresponds to the detection of a tumor before it spreads to neighboring anatomical structures, when the presence of regional and distant metastases is unlikely;
• timely detection corresponds to the stage of tumor development, at which special radical treatment is possible, but there is no absolute certainty in the absence of distant micrometastasis;
• later detection corresponds to the advanced stage of tumor development, at which the disease is in the final stage of development and radical treatment is not feasible.

Obviously, the most promising is the detection of cancer on the preclinical stage. The main obstacle to diagnosing the tumor at this stage is the absence of complaints from the patient, as a result of which he has no reason to call a doctor. Therefore, the only way to diagnose early is active search.

Active search is realized through screening (selection). The screening system can be organized in a complex way with the coverage of various organs and systems of the organism or by individual, most probable localizations of tumors. For example, a well-known and long-established system of examinations aimed at detecting pathology in the lungs and mediastinum - prophylactic fluorography, mammography in women over 40, taking cytological smears from the cervix with a gynecological examination, finger examination of the rectum in men over 50 years and hemocult test. A certain value in the early detection of cancer have preventive examinations.

Each cancer patient diagnoses cancer includes two stages:

• primary diagnosis of cancer, which is carried out by doctors at a polyclinic, a rural district hospital, a medical facility at an enterprise or a fluorographic station. Suspected or diagnosed a tumor in a patient, the doctor should determine the affected organ, if possible, the extent of the spread of the malignant process and urgently send the patient to the appropriate dispensary;
• refined diagnosis of cancer, which is carried out in an oncological dispensary, hospital or clinic. At this stage, with the use of modern special methods determine the exact location of the tumor, the nature and extent of its spread in the organ, metastasis, concomitant diseases, the functional state of the patient. The specified diagnosis of cancer ends with an accurate formulation of the clinical diagnosis, which takes into account all the individual characteristics of the course of the disease. An obligatory condition is the investigation of the morphological structure of the tumor.

The formulation of the diagnosis of cancer patients should always result in the definition of the stage of the disease. Diagnosis of cancer ends with the establishment of the stage of the disease, it serves as one of the main criteria for choosing the method and the volume of therapeutic measures. In addition, the precise definition of the clinical stage of the disease development allows to correctly predict its course, rationally plan the follow-up and reliably evaluate the results of treatment.

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