Reaching out to heaven: is it possible to hope for a miracle in oncology
An oncological diagnosis does not always turn into a verdict: when breast cancer is detected at an early stage, for example, more than 95% of patients are cured. Time is still the main enemy of patients: missed days, weeks, and months can cost lives, and timely diagnosis increases the chances of healing. Another problem is that modern people are not ready to deal with grief, either their own or someone else's. Misplaced optimism, depreciation, and unsolicited advice from loved ones only exacerbate the worries of a person who has just learned about a terrible diagnosis. What topics should not be raised in a conversation with a cancer patient and how to accept the inevitable — in the "Izvestia" material.
Causes of cancer
""""The risk factors that provoke cancer are divided into two large groups: the unavoidable (which the person himself cannot influence) and the avoidable (which can be influenced)," Ruslan Sultanov, chief specialist in oncology at the "Be Healthy" clinic network, explains in an interview with Izvestia.
— The unavoidable ones are age, gender, and heredity. Cancer is more often detected after the age of 65, because mutations accumulate in cells over the years. Men are more likely to have lung, stomach, and bladder cancers, while women have thyroid and breast cancers. Hereditary mutations are associated with only 5-10% of cancer cases, but if close relatives had cancer, especially at a young age, then this is a reason for more careful monitoring, the specialist warns.
Avoidable causes are related to lifestyle and bad habits. The main problem is that in youth people do not attach importance to the negative consequences of addictions.
— According to WHO, about 30% of cancer deaths are related to behavior and nutrition: smoking, alcohol, overweight, lack of physical activity, and poor nutrition. Smoking causes 86% of lung cancers, 65% of esophageal cancers, and 37% of bladder cancers. These are not abstract figures, these are real people," the doctor continues.
A personal predisposition to cancer can be recognized through genetic testing, he suggests.
— There are hereditary syndromes, for example, Lynch syndrome (mutations in the genes MLH1, MSH2, MSH6) or BRCA1/BRCA2. If a person has such a mutation, they can start screening earlier and more often — for example, with Lynch syndrome, colonoscopy is recommended from the age of 20-25," the oncologist points out.
Why do cancer cells appear?
Cancer occurs when mutations in the genes responsible for growth and division accumulate in one cell, explains Ruslan Sultanov. This can happen due to heredity, accidental errors in cell division, or external influences.
— Chronic inflammations and infections play an important role. The human papillomavirus (HPV) causes almost 100% of cases of cervical cancer. Hepatitis B and C lead to liver cancer. These viruses cause mutations and support chronic inflammation, which creates a favorable environment for the tumor. Carcinogens from the environment — tobacco smoke, asbestos, polluted air — also damage DNA, says the oncologist.
The source notes that people often have no pain in the early stages of cancer. But there are non-specific signals that should alert you:
— unexplained weight loss. Losing 5% of body weight in three months without dieting is a reason for examination.;
— constant weakness and fatigue that do not go away after rest;
— night sweats, fever;
— prolonged disruptions in the digestive tract — pain, bloating, loss of appetite for more than four weeks;
— skin changes, non-healing wounds, transoformation of moles;
— constant headaches;
— unusual discharge.
The algorithm of actions when such signs are detected is not to panic, but also not to postpone the visit to the doctor. First, you should make an appointment with a therapist and tell him about your symptoms. The doctor will refer you for screening or to a specialist. Early diagnosis is a person's main ally, the expert suggests.
With timely diagnosis, according to Ruslan Sultanov, many types of cancer are completely curable.:
— breast cancer. If detected at an early stage, recovery occurs in more than 95% of cases.;
— prostate cancer. The ten-year survival rate is approaching 100%;
— skin cancer (early stage melanoma). 94% five-year survival rate;
Testicular cancer and papillary thyroid cancer also have a very favorable prognosis.
The most aggressive forms of cancer are pancreatic cancer, gallbladder cancer, and some forms of lung cancer. But even in these cases, timely detection changes the situation, the oncologist emphasizes.
— The stage of the disease is a key factor. With stage I colorectal cancer, the probability of cure is high, and with stage IV, it is only 7%. For gallbladder cancer: 50% in stage I and 2% in stage IV. The difference is enormous," the doctor emphasizes.
There are miracles in oncology, the specialist encourages. Modern immunotherapy and targeted drugs make it possible to achieve remission even in difficult cases. But the doctor does not advise counting only on a miracle.
How to survive the news of a diagnosis
A person cannot be prepared for events such as an oncological diagnosis, says clinical psychologist and body therapist Sergey Volkov.
— No one will ever be able to prepare for experiences that are a biological reaction to loss, including loss of health. This condition is called grief, and what a person experiences and experiences is grief," he explains.
However, modern people have almost lost the ability to grieve, and without this reaction it is difficult to cope with strong emotions, the specialist complains.
— We are taught to gain, take away, and win, but we are not taught to lose, let go, and live defeat. We live in the illusion of security and have simply erased from the mass consciousness what we do not want to feel — grief. But you can't run away from it. Meanwhile, the institution of social grief is the foundation of all religions, the foundation of public associations," says the source.
A person cannot always cope with this feeling on his own, so the safety and acceptance of grief depend on the behavior of the people around him. According to the psychologist, how much they accept his condition depends on how quickly and how much easier the patient can come to terms with the new reality.
The question "How to live now" is most often asked to specialists by relatives of patients, says Sergey Volkov. It's like they're hoping to get instructions that will make them feel better.
""There is a great Russian word for mercy, which means willingness to help, to show leniency out of compassion. Being merciful is very difficult. It is very difficult to put not yourself and your condition first, but to help someone else. This also needs to be learned," the expert emphasizes.
Relatives, trying to support the patient, unknowingly and inexperience make a lot of mistakes in communicating with him. "For example", they demonstrate inappropriate optimism, repeating "everything will be fine", "keep a gun on your tail". "Or "they actually demonstrate a lack of empathy—"don't cry," "it could have been worse."
— The most popular phrase is "I understand how you feel." She is spoken to with a desire to show compassion and comfort, but no one has yet received comfort from this. Everyone is unique, you can't know how another person feels," warns Sergey Volkov.
A clinical psychologist says that, on average, people face bereavement or a difficult event once every 10-15 years, so few people know how to survive sadness. Loved ones often give "advice" that is impossible and even dangerous to follow. """"""""For example, they say phrases like "everything will work out," "you just have to keep living," "think about pleasant things, don't worry your head," "everything is perishable," "the main thing is that your children are healthy."
"But those who have learned about their terrible diagnosis (sometimes in the form of a verdict) are experiencing intense emotions, one might say, mental pain, so such statements are completely inappropriate," the clinical psychologist is convinced.
Another problem of misunderstanding, in his opinion, is that people are afraid of showing feelings. And this also complicates the relationship between the patient and his relatives.
— That's because by the age of four or five, a child already knows that it's a shame to cry, that the strong don't cry. We were not taught to support and express suffering, we were taught to endure and hide it. Hence the second most popular form of imaginary support: "Get together! Don't be sour. Pull yourself together. Look at everything more positively." We all get embarrassed at the sight of someone's pain. And this reinforces in us the fear of showing our emotions and enduring others," the specialist continues.
Relatives sometimes even try to change the subject, as in the case when a person wants to tell a friend about something important, and a friend responds with something like: "How terrible is this! Listen, did you see how the ruble fell?" This allows someone who is trying to support another person or is watching their suffering to psychologically protect themselves by rejecting and denying someone who needs help, the expert explains.
In moments of grief, a person tends to tell others about their pain, fears and experiences, but sometimes healthy people do not hear the sick.
— This is a legacy of the ancient function of the brain — to alert fellow tribesmen of danger and escape together. Either everyone or no one will survive. But the person tells, and in response he hears something like: "Don't worry, everyone is being treated now. We will help you if we give you money. The main thing is not to lose heart." And it sounds like, "Don't feel what you feel. It's a bad feeling, we don't like it. Here, take a piece of candy." Sufferers need to be heard, not corrected," emphasizes Sergey Volkov.
The psychologist compares this behavior with a situation when children in tears come running with a broken toy, and instead of feeling sorry for it, parents begin to fix the damaged thing. But at the moment when a child talks about his tragedy, he does not need a solution to the problem, but compassion.
What to do when everything is bad
Sergey Volkov advises anyone who is faced with the need to care for seriously ill people not to do it on their own, but to find an opportunity to pay for the services of a specialist. At home, it is impossible to provide proper care with all the desire, he emphasizes. Palliative care specialists are trained in safe communication and proper care.
— In our country, there is a (albeit poorly developed) institution of dole of death (by analogy with dole of birth). These are not medical professionals. Douls take on a very difficult role — to help and guide families with a seriously ill person. They help with household chores, know how to conduct a conversation competently, know how to apply for documents, and which authorities can be contacted. In short, they take on things that people just can't handle because they're focused on the medical side of the issue," says the clinical psychologist.
If a loved one (husband or wife) has left a patient in a difficult situation, the expert advises to seek support and help in groups for cancer patients, which are often organized at cancer centers, in hospitals. Those who are not in the center all the time can also come there.
— Perhaps a person has friends and relatives who can support him. Also, do not neglect faith. A competent clergyman chooses very good words of support, knows how to listen and hear. Since its creation, the church has been a place where people have grieved and received help. It is not necessary to avoid knowledge of several millennia, — says the interlocutor of the editorial board.
For those who have to accept their "new" appearance (lack of hair, swelling, weight gain, mastectomy, etc.), Sergey Volkov advises them to go through a grieving process, the meaning of which is to accept that it will not be the same as before.
— Everything will be different, but this does not mean that it will be bad or terrible. Everything new causes fear. There is no quick way to stop this fear, even a medical one. Such a state can only be lived in the circle of those who support and help you. There has never been a period in life when a person could survive on their own, we can only live when we live with our own, in our own "pack," the expert emphasizes.
How to live in remission
It is important to remember that remission is not the end of treatment, but a new stage, Ruslan Sultanov notes. In this case, the patient needs regular examinations: usually every three months in the first year, once every six months in the second year, then once a year for up to five years of follow—up. The specific schedule is determined by the doctor.
— Lifestyle is of great importance. Recommendations: 90-150 minutes of aerobic exercise per week plus two or three strength training sessions. Nutrition — more vegetables, fruits, whole grains, less processed meat and sugar. Smoking cessation and alcohol restriction. There is no specific "cancer—fighting diet," but healthy habits reduce the risk of relapse and improve the quality of life, the oncologist explains.
But still, remission is a victory, overcoming, emphasizes Sergey Volkov. If it has come, it means that the person has done everything right and can be proud of himself.
— Usually, remission is followed by relief of the psychoemotional state — it's like seeing light in the dark. And no matter how many days we are given, it is important to live them efficiently. This realization usually comes to people in remission," the clinical psychologist summarizes.
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