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Interview with the oncologist of the National Cancer Institute — Anatoly Shudrak
Anatoly Shudrak is a doctor of oncological proctology with 20 years of experience, Doctor of Medical Sciences. Specializes in laparoscopic operations on the rectum and sigmoid colon. Performs laparoscopic mesorectumectomy.
In the interview for MedTour, the doctor told how to minimize the risk of colon cancer, how not to miss the first symptoms of the disease and what should be the treatment approach.
In this article, we will consider the important questions that disturb all patients when choosing a clinic and a doctor: how is the cost of treatment formed, what determines the success in the fight against the disease? Is it possible to organize a complete treatment of bowel cancer in compliance with all the standards of oncological medical care in Ukraine?
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Tell us about your work experience.
«My experience in oncoproctology is more than 20 years. I started my work in the Main Military Medical Clinical Center of the Ministry of Defense. I have been the deputy chief of surgery at the National Cancer Institute for the seventh year. My main surgical activity is oncocoloproctology.»
What examinations should a patient with bowel cancer undergo?
«These are standard examinations. Colonoscopy with a histological conclusion. CT scans of the chest, abdomen, pelvis and in the case of rectal cancer — MRI of the pelvis with intravenous contrast. Also, a set of general clinical tests: a general blood test, a general urine test, a biochemical blood test, a coagulogram. If necessary, consult with an endocrinologist or cardiologist.»
Why is late-stage cancer more difficult to treat?
«In the later stages of cancer, we are talking about a worse prognosis and an increase in the treatment duration. It’s mandatory to use complex treatment, that is, with the use of surgery, radiation therapy and chemotherapy. But even at the 4th stage, if we are talking about it, many patients achieve good results. By good results, I mean not just prolonging the patient’s life, but the patient’s recovery.»
What new treatment methods can we offer patients at the National Cancer Institute?
«Over the past 5 years, no fundamentally new methods have appeared in oncology. If we talk about trends, these are laparoscopic treatment of all types of intestinal cancer and radical treatment of metastatic liver and lung damage in intestinal cancer. Here, at the National Cancer Institute, we can provide such treatment.»
Could you tell us about the difference in treatment in Ukraine and in other countries?
«If you perform treatment in accordance with what is required to be performed within the standard clinical protocol, there will be no difference in treatment in Ukraine and in other countries. Clinical protocols contain extremely clear and unambiguous information. There are technical possibilities to fulfill these conditions.»
How many patients come to your department per year?
«The department performs about 800 surgical procedures for colorectal cancer per year. The entire National Cancer Institute treats about 22,000 patients a year.»
What can you say about the technical equipment of the department?
«Treating a patient with colorectal cancer requires a laparoscopic stand, a linear accelerator and a high level of anesthetic support. The National Cancer Institute is fully provided with all this.»
What can you say about the clinical trials?
«They are now actively carried out on the basis of the National Cancer Institute, including clinical trials of medicines for colon and rectal cancer. Currently, there are no clinical trials in the field of surgery for rectal cancer, as research of this kind isn’t currently being carried out in principle.»
How is the cost of treatment formed? Is it true that the treatment of rectal cancer in Ukraine is much cheaper?
«Yes, it’s true. The cost is formed from the payment of medical labor, which is still much lower in Ukraine than in other developed countries, the payment of utilities, which is also lower, and the payment of consumables. The last point cannot be influenced in any way — this cost will be approximately the same in any country in the world. The cost of consumables is high and it largely determines the high cost of cancer treatment in principle, but due to the first two factors, treatment in Ukraine is much cheaper than in other countries with the same protocols and volumes of operations.»
Cancer is always stressful for the patient. How do you usually calm patients?
«The patient should not be reassured, he should be motivated. In most cases, oncology isn’t a sentence. The result of treatment depends both on the actions of the doctor and the actions of the patient. All this must be conveyed to the patient and explain what he can do to get a good result, and then the patient will be ready to try for the sake of his recovery, without neglecting medical procedures and examinations. At the same time, you need to talk openly, without hiding the real situation and the likelihood of an unfavorable outcome. It’s very important to find the same language with the patient — I see this as the key to success.»
Patients from the neighboring countries often come to the medical center: Kazakhstan, Uzbekistan. What can we offer them in terms of treatment at the National Cancer Institute?
«That’s a very good question. Today the National Cancer Institute is the flagship of cancer medicine in Ukraine. This is a medical institution of a high level, both scientific and practical. It has a very high bar. We establish it for ourselves and don’t allow ourselves to fall below — we provide medical care at the level of European institutions and the United States of America. This is probably why patients come to us.»
Note from the author.
This interview provides an overview of how cancer treatment is organized at the National Cancer Institute. Summing up, we can highlight the main trends in treatment:
Compliance with clinical protocols for the provision of oncological medical care;
Performing operations by the laparoscopic method;
An approach to the treatment of stage 4 cancer as a potentially curable disease.
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National Cancer Institute
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Medical Doctor, oncologist, PHD student
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