STOP LEUKEMIA

Chronic lymphocytic leukemia (CLL) is one of the most common forms of hemoblastosis. According to a number of specialists, the proportion of CLL in the structure of this pathology is 30–40%. CLL is a benign tumor, the substrate of which is predominantly morphologically mature lymphocytes. The disease is manifested by lymphatic leukocytosis, diffuse lymphocytic proliferation in the bone marrow, enlarged lymph nodes, liver and spleen.

The main manifestations of CLL are caused by the proliferation of mature lymphocytes belonging to a small subpopulation of CD 5+ B lymphocytes. Along with an increase in the number of lymphocytes in the blood, an increase in lymph nodes, liver, spleen, the presence of a large number of autoimmune complications (autoimmune hemolytic anemia and autoimmune thrombocytopenia) is a specific feature of the pathogenesis of this disease. In the overwhelming majority of cases, the B-cell variant of CLL occurs; the T-cell variant of CLL occurs very rarely, in 2–5% of cases. B-cell CLL is traditionally considered a disease of the elderly. Often the disease is benign; over the course of many years, the progression of the tumor process has not been observed even in the absence of primary restraint therapy. But there may be a rapidly progressive course of the disease when death occurs within 1 to 2 years.

CLL is a heterogeneous disease that has many forms with different clinical manifestations, the duration of the disease and the response to therapy. There are several clinical classifications of CLL. Abroad mainly use classifications. These classifications are designed for staging CLL, taking into account tumor progression. In Russia, in the majority of cases, the classification allows for differentiated therapy of hemoblastosis to be distinguished from a benign, progressive (classical), tumor, spleen-night, abdominal, bone marrow, pro-lymphocytic forms. Some authors suggest to distinguish different types of disease in the CLL classification . Therapy for CLL is constantly being improved.

In addition to tumor progression, a significant factor affecting the life expectancy of CLL patients is the development of secondary immunodeficiency, manifested by infectious complications of various localization. The problem of infectious complications in none of the hemoblastoses has such independent and decisive significance as in chronic lymphocytic leukemia. Modern cytostatic therapy allows to significantly control tumor growth in CLL.

At the same time, success in treating patients with this disease is often determined by the possibilities of timely prevention of infectious complications, by the adequacy and timeliness of therapy. Infectious complications in this disease occur in 52 – 86% of patients. In 69.8 – 85% of cases, they are the direct cause of death. The increased susceptibility of such patients to infections is defined by the term “infectivity”. The susceptibility of CLL patients to various infections manifests itself already in the initial stage of the disease. Infectious complications occur even in patients with a benign variant of CLL. As the tumor progression syndrome develops in CLL, the frequency of infectious complications increases.

In the early stages of tumor progression, increased infectivity is associated with defects in the immune response, impaired interaction of T and B lymphocytes, and the development of hypogammaglobulinemia. Immune insufficiency in CLL patients is characterized by a defect in the humoral linkage with symptoms of panhypo immunoglobulinemia, an imbalance of T lymphocytes, characterized by an increase in the number of T suppressors (CD8 + cells) and a decrease in the number of T helper cells (CD4 + cells), impaired phagocytic complementary link; the degree of these changes increases with the development of the disease.

With the progression of CLL, repeated and protracted infectious processes can contribute to their short treatment due to inadequate antibiotic therapy. Cytostatic therapy has a inhibitory effect on the number of T-lymphocytes and neutrophil phagocytic activity. The use of traditional cytostatic treatments (cyclophosphamide, chlorbutin, prednisone) leads to a decrease in the total number of T- and B-lymphocytes.

Among all infectious complications of CLL, the most common inflammatory nonspecific pulmonary-pleural diseases (from 50 to 80% of all infectious complications of CLL) are pneumonia, tracheitis, bronchitis, bronchiolitis, pleurisy.

A high incidence of AML is observed in persons living in areas of high latitudes. In the Amur region, NZL are characterized by a more severe and protracted course. In the structure of morbidity in the Amur region, among respiratory diseases, pneumonia occupies a special place, a high level of the disease was noted in most regions of the region. Severe AML in the high latitudes contributes to the formation of pulmonary and cardiac insufficiency in these patients. This is due to many factors, primarily, the climatic and geographical conditions of the Amur region and the influence of low temperatures on the human immunological reactivity. Low temperature and high relative humidity of the air contributes to the formation of airway hyperresponsiveness in the population living in these climatic conditions. Because of this, a large role is played by methods of detecting premorbid conditions of chronic nonspecific lung diseases.

The occurrence and protracted course of infectious diseases of the respiratory tract is also promoted by the increase in paratracheal and bronchopulmonary lymph nodes in most CLL patients, which disturb the drainage function of the bronchi, ventilation and blood circulation in the lungs. For the most part, peripheral lymph nodes are larger than the intrathoracic, but reverse relationships can also occur. The severity of mediastinal lymphadenopathy depends on the stage of development of the tumor process.

Lymphadenopathy in patients with CLL is mainly peripheral. In this case, for the first time, patients come to a doctor for the first time. Only a few of them at this time radiographically determine the increase in mediastinal lymph nodes. Later, in the advanced stage of the disease, mediastinal lymphadenopathy is detected in more than half of the patients, sometimes reaching considerable sizes. Hyperplasia of the intrathoracic lymph nodes is observed in 63.9% of cases, at autopsy – in 73% of cases. However, even with a significant increase in lymphoid organs, the development of a compression syndrome is not characteristic of the classical course of CLL.

The development of tumors in tissues is not specific roofing­to for people. Neoplasms are found in the tissues of plants, in animals – in all representatives of wildlife except unicellular.

General biological features of the tumor TKA­It became known as tumor atypia. Distinguish structural, metabolic and functional atypia.

Among structural abnormalities distinguish tissue and cell.

tissue atypiaexpressed in a change in comparison with the norm, shape and size, an ordered­magnetizations and orientation of structures in nature­GOVERNMENTAL for a given tissue and organ. So, due to cells that retain signs of maturity, may from­menitsya ratio of individual tissue plas­Comrade. Of these mature cells form tumor nodules with fibroids (of muscle tissue), whether-komah (adipose tissue), fibromas (fromunite­tion of tissue). When adenomas can be seen again­crease glandular tissue, which is the secret of Scapa­Lebanon in the ducts of the glands, forming cysts. tissue­vy atypia characteristic of the benign tumors and is an important diagnostic Cree­teriem.

cellular atypia is a sign of Naru­sheniya cell differentiation, the process to­Torah cells acquire specialized structures and receptors that allow them to react­Vat to regulate their function substance and mountains­Mons. In the absence of such structures the cells can not perform their functions. Dezifferentsirovka cells accompanied by their structural features rejuvenation and atypia form and were­ranks. Often the cells are rounded, the mass of the nucleus in:relation to the cytoplasm increases – such cells are called blasts. These nuclei can be seen a large number of enlarged nucleoli, indicating the previous cell division activated its synthetic functions. Athy­Pismo form expressed in ugly appearance nuclei tsitoplasticheskih outgrowths. In the nucleus and cyto­plasma may occur emptiness.

In fast-growing tumors, cell mass increase speed ahead vascular ingrowth. The tumor is growing faster in the periphery, while in the center there is necrosis of the tumor mass, due to the tumor cells than in many cells found in a state of degeneration and necrosis.

Features of tumor cells explained rampant uncontrolled body during growth of the tumor mass associated with atypia times­cell multiplication, violation of a genetically programmed process of aging and death.

Funktsionalny atypia tumors often associated with the loss of the original fabric of specialized structures.

Depending on the tumor tissue atypism manifestations distinguish benign and malignant tumors.

Benign tumors are characterized by slow growth, rising in the capsule, pushing the surrounding tissue and without destroying them. They do not metastasize or recur after treatment, not when­lead to the depletion of tumor – cachexia.

Malignant tumors have characterized­strym growth, growing up without a capsule, penetrating the c­Rouge tissues, destroy them and break function­tion bodies. They metastasize give relapses after treatment and lead to tumor depleted­NIJ.

Development of tumor cachexia phenomenon can contribute to malnutrition due to non food­walk of the digestive tract, krovotech­Niya, food intoxication tumor disintegration, pain, insomnia, appetite disorders, depres-­these.

A new concept of the origin of swelling­lei. It is based on the state of existence­SRI common ways to implement the mechanism of action of various carcinogens. This does not deny the role of the chemical, physical and biological factors as a cause of tumor growth.

Due to the wide spread of the chemical­Sgiach substances in the production and life, pollution, chemical carcinogens (called exogenous) are the most frequent cause of tumor growth. carcinogenic vesche­ARISING formed in the body (endogenous carcinogens). Or non-physiological concentrationprolonged exposure to these substances, such as certain hormones, may cause carcinogen­Noah action by inappropriate activation of regularity­liruemyh of tissue function and the stimulation of the glue­exact division.

Carcinogenesis influenced by physical factors occurs in the areas of impact on the body of radiation exposure, as well as when exceeding the dose of X-ray or ultraviolet irradiation. Tumors can arise in the area of ​​burn scarring or prolonged continuous Sports­Corollary mechanical factors causing loss­toast and inflammation.

Of great importance for the study of the pathogenesis of tumors were studies of viral carcinogenbehind. Works LA Zilber proved that the essence of wi­Rusnė oncogenesis not merely infecting the cell at which the reproduction of the viral particles and cells in malignant transformation following­Corollary inclusion of viral genetic material or its part in the cellular genome. Previously it was thought that the chemical and physical factors of influence­added to the cell through viruses genes included in the genetic apparatus of the cell. new facts­ry only enriched this theory, without changing it received­fundamentally provisions.

Number of tumors of viral origin are well established small. This is not a direct infection, but only about the complex mnogosta­diynom during the transformation of normal cells to tumor that develops in accordance with the laws different from those in the Institute­infectious process. From this perspective, cancer is not a contagious disease. The virus causes the cell changes hereditary and is not involved in the further development of the tumor. Infections malignancies people from one another, or surgery infection, operating it­NVIRONMENTAL patients were observed.

Occurrence of tumors depends not only on the under­rank, caused it, but also on factors contributing to­boiling implementation of these reasons, ie. e. on the conditions. foundations­GOVERNMENTAL tumor occurrence conditions are antineoplastic decrease resistance, the presence of foci of chronic inflammation, proliferation and dystrophy, hereditary predisposition.

Antineoplastic rezistentnost is determined by many factors: the disposal of carcinogen­Sub- stances in liver, activity antimutatsion­hydrochloric protection and control mechanisms tissues antigenic composition.

If tumor cells do occur, they are detected and eliminated with the help of cellular immune surveillance mechanisms. Therefore, the level of immune protection is very important for antineoplastic resistance. It is known that in the elderly develops atrophy Tumus -principal regulator of the immune system, the frequency of neoplastic diseases is greatly increased.

One of the risk factors for swelling­Left the inflammatory diseases are chronic­tion and proliferative processes in tissues. Outbreaks atrophy, cell multiplication in areas of chronic inflammation Cesky, substitution of one species epite­Leah other tricks represent violations tissue growth, create instability hereditary apparatus of cells and predispose to mutations. These states are called precancerous. Patients with precancerous diseases should undergo medical examination.

There is also a genetic predisposition to the development of tumors, passed on to offspring od­These gene and polygenic. Predisposition, Obus­lovlennaya one gene usually explained by a defect in DNA repair enzymes. In these instances,­s offline enzyme provides the restored­Lenie mutagenic DNA and each mutation is being developed. In these individuals the risk of malignancy is increased tenfold.

When polygenic predisposition to devel­The term feature is influenced by many genes, some of which are basic, and others – modifiers, auxiliary­nye, changing of fixed genes. Poskol­ku development characteristic associated with gene complex, sometimes located in different chromosomes, re­Dacha offspring trait is more complicated­E ways, and susceptibility manifests itself in higher incidence of disease in families with burdened­hydrochloric heredity.

Diagnosis of tumors carried by chemistry­cal and laboratory manifestations. treatment evil­tumors value must be timely, and complex radical. Comprehensive treatment includes surgery, radiotherapy, drug exposure (chemotherapy).

• Pain, often dull, localized in the upper otde­crystals of the stomach and is not related to meals.
• Swelling and heaviness in the stomach, arising after a meal, there is belching air, and later – and the food.
• Vomiting of food eaten the night before, there is the narrowing of the output of the stomach tumor. Vomiting brings relief. If the tumor constricts the entrance to the stomach, disturbed permeability to solid alloy­Doi, and then for the liquid food.
• stomach bleeding – vomiting as coffee grounds or tarry stools appearance.
• pallor of the skin develops gradually, sometimes accompanied by tachycardia (increased heart rate), reduced blood pressure, headache, increased abdominal volume due to fluid accumulation. increased lymph­cal nodes left supraclavicular painless or seal in the area of ​​the navel.

Symptoms of colon cancer are not CCA­-singular differences from chronic or inflammatory diseases. On their existing manifestations bo­existing illness for a long time people prefer not to pay attention, which leads to the identification of a tumor in the later stages.

Colon cancer is accompanied sledujushchi­E symptoms:

• loss of appetite, nausea, belching, feeling of heaviness and swelling in the epigastric region;
• constipation, leading to bloating, rumbling­NIJ and resolution of diarrhea – the release of pain­shogo amounts of liquid malodorous mass then occurs again constipation. The tumor can cause for­Derzhko feces and gases and can cause acute or chronic intestinal obstruction;
• Strong pain, paroxysmal in the left polo­wine belly, sometimes take the spilled nature of without a clear localization. If there is no obstruction, pain localized in the right half of the abdomen, are characterized by dull and aching;
• pale skin, increasing weakness, Ned­Hassium, increased body temperature. In rare SLU­teas tumor can be detected during the inspection or palpation of the abdomen, even in the absence of any manifestations.

symptoms:

• constipation; stool after constipation are evil­vonny smell, semi-liquid consistency. Sometimes there is a violation of the form of fecal column – “tape-like feces,” “sheep feces”;
• feeling of incomplete evacuation, false desires on a chair;
• stool may be mixed with mucus, pus, mucus sometimes only released when the urge. With the development of inflammation in the wall of quiche­ki, diarrhea may occur;
• allocation of unmodified blood at the act of DEF­katsii. Blood can be allocated to fecal masses located on their surface in the form of strips or be mixed with them. Severe bleeding almost never occur;
• Pain dull, aching, may be given in the sacrum or tailbone. When tumors arising in the sa­Mykh the lower regions of the rectum, pain arising­an early and is pretty intense. In cancer of the colon department can be observed an increase in the inguinal lymph nodes.

• pain – one of the symptoms of the disease. UsuallyPain dull, aching and pressing, are located in the upper abdomen. Increased pain may WHO­Nick after a fatty meal or alcohol. Upon accession, inflammation, pain can have herpes character. Sometimes strong pain due to compression of the solar plexus;
• jaundice, which is growing rapidly, there is itching. Characteristically dark urine staining and light (gray) cal. Fecal fat­nye poorly washed with water on the bowl wall;

. • Weight loss of up to 10 – 15% per month;

• increase in body temperature to 38 ° C and above;
• palpation can be felt the presence of ca.­ruglogo painless in ne Education­Cheney – an enlarged gall bladder. Enlargement of the spleen and the pain in her area are rare.

Esophageal cancer has the following symptoms slaughtering­Levan:

• salivate – first and quite early symptom of malignancy;
• violation of swallowing, while taking fuss food­cabins unpleasant sensation, scratching feeling when passing food bolus or at any level or delay. Difficulty swallowing solid alloy­Doi food. Food has to drink, later hardly passes and liquid food, in this case, the patient feels a sense of fullness. Choking when eating;
• halitosis due food DELAY­alive in the esophagus;
• vomiting eaten food;
• chest pain or interscapular Oblas­ty, cough, hoarseness;
• progressive weight loss.

Breast cancer – the most common­Noah disease common in women. on wounds­these stages there is a seal of painless­transform of in breast size “pea” hereinafter – with a “nut” or more. Uwe­lichenie in size can be rapid or months­E do not change size. Uneven surface, OPU­Chol may be movable with the gland otno­respect of the chest, or be associated with it. The patient has the following symptoms:

“Discharge from the nipple, often bloody, nipple retracted;

• skin above the tumor can be retracted, hyperemic;
• there is an increase in body temperature;
• in the nipple may cause erosions, weeping surface coated flakes and peels;
• an increase in the lymph nodes of the subclavian and axillary areas;
• swelling of the upper limbs on the affected side.

At external examination should be addre­of discoloration on the skin.

Pallor could be fold­kovremennoy and prolonged. Short-Bled­Nost occurs when a strong negative emotional stimulation. Long pale skin, mucous membranes associated with a decrease containing­Nia hemoglobin or red blood cells; blood loss may be caused by, associated with tumor growth and destruction of blood vessels and TKA­her or disintegration of the tumor itself.

Icteric staining of the skin and sclera Svyda­ments of pancreatic disease, liver, bile ducts, associated with zlokache­governmental tumors or with compression of the bile duct, or hepatic metastases lesion OPU­Hawley stomach, intestines. jaundice is accompanied­etsya pruritus.

darkening of the skin associated with the bilateral lesion adrenal primary tumors or metastases.

Pigmentation disorders. The skin may be different spots: a completely amelanotic, korich­nevye or almost black. When the erosion, Th­shuek, warty excrescences in place pigment­GOVERNMENTAL spots rapidly growing pigmented lesions and tumors should alert the patient.

Malignant melanoma – they never hair growth. Melanoma tends to decay and bleeding. A defect may,­be covered with crusts, but does not heal. when discovered­SRI these changes should be immediately Obra­titsya to the oncologist.

Slightly education in the lower lip, painless, takes the form of ulcers with valikoobraznymi edges or sprawl resembles a “cauliflower”. Sprawl may ne­Wraith to the mucosa of oral cavity, on the skin, to capture most of the lower lip. The appearance at­lenii patient must first sign of­ratitsya to the oncologist.

Swelling in the lower jaw. at­may be cause of cancer of the salivary glands. At the bottom of the neck to the left or right from the center in the isthmus of the thyroid gland tumor can be observed more often – benign. Inspection should be subject to over-and podklyuchich­nye region, as there are often localized various pathological processes.

Swollen lymph nodes. when it’s time to­zhenii lymph node metastasis of the tumor they took­Chiva, may merge with each other in konglo­Merate. The skin over them, normal color,

 The appearance of puffiness, pastosity face and neck, and then swelling with erythema and cyanosis. Emerging symptoms associated with passing-leniem or tumor invasion of vascular or nerve structures localized inside the breast­hydrochloric cells.

On examination of the chest is important symmetric­Nosta and even participated in the act of breathing both its halves. Neoplastic processes lead to lagging­vaniyu one of the halves of the chest that we meet again­ments abuse department of respiration­GOVERNMENTAL sites or the entire lung.

If a strong increase in the liver or the spleen, at least – for tumors of the stomach and intestines, pancreas, abdominal wall deformation occurs and its asymmetry, but it happens very rarely.

Changing contours of the upper and lower finite­NOSTA, edema associated with compression of vessels OPU­holyu. Swelling of one upper limb are at the apex of the lung cancer or metastatic cancer of lactic­hydrochloric gland. Swelling of both upper extremities – metastases in the mediastinum.

Swelling, deformation of large joints, as well as thickening of the nail phalanxes of fingers (like drumsticks rounded and bulging nail plates on watch glasses type) is accompanied by lung cancer.

On examination of mammary glands (standing in front of a mirror), you must pay attention to the possibility­Noe appearance asymmetry, contour changes or form one breast due Inverted nipples or protrusions or uniform skin increasing mammary abrupt swelling of the nipple. The appearance of the tuberosity, the change in color of the skin on the breasts, the appearance of erosions, crusts in the area of ​​the nipple – are manifestations of cancer.

After the inspection is necessary to palpation. Palpation is based on a subjective feeling and evaluation of the examined organs and tissues. In this study, measured density, flexibility, mobility and pain of the subject body part or organ. In palpation teaching­exist fingertips, nails should not ka­satsya skin. The study is best done in van­hydrochloric, when the body is sufficiently good and fresh Preheat­the right or in the shower, when lathered hands and body. You can use the cream for relief slidin­Nia fingers over the skin.

Palpation begin with feelings of stroking­yuschimi movements:

• Skin and facial tissues;
• scalp;
• the front and back of the neck;
• supraclavicular and subclavian areas;
• chest front and sides;
• separately palpable mammary glands (samopalpatsiyu mammary glands);
• armpits;
• stomach;
• inguinal region;
• upper and lower limbs.

Tumors of the salivary glands can be felt in the form of dense hilly, maloboleznennyh or bezboleznennyh formations at the front and a little to the bottom of the external auditory canal in the sides of individuals or in the submandibular region. In the neck area, and over the subclavian, axillary and inguinal areas of palpable lymph nodes. Normally, he would not be felt, are small, oblong, painless education. When a malignant tumor lesion skie lymph nodes increase in size, they take another shape and become dense touch Sometimes they merge together into a conglomerate which is defined as the formation of irregularly shaped lumpy palpation.

Palpation of the abdomen is best done in the supine position with gentle pumping

movements in a clockwise direction. you can Detectlive dense formations, enlarged liver, right upper quadrant, the spleen – in the left upper quadrant pain Palpation revealed place strengthening the already existing pain.

Inguinal lymph nodes is determined by palpation, normally they are rarely palpable.

Palpation painless dense formations on the external genitalia is a cause for consultation at the oncologist. conduct samoob­you must follow at least the 1st time in a month.

The detection of tumors, which has proved itself in no way, should be alert and make you immediately consult a specialist­sheet for diagnosis. The sooner reveal­Lena tumor, the better the result of her treatment. By­Try not to worry, do not despair, and mood­os to fight the disease, believe in the possibility, if not cure, the considerable improvement.

Currently, it is desirable to self-examination­it do after 40 years. To do this:

• undergo an annual fluorography obsl­dovanie, and in the presence of unfavorable factors

— 2 times per year;

• Women should be 1 once a year obsl­dovanie a gynecologist, in the presence of mastitis – 2

-3 times a year examined by a breast physician or oncologist;

• at the slightest changes in the stomach req­Dimo conduct fluoroscopy fibrogastroscopy;
• a change in the gut is recommended wasps­Motril proctologist, endoscopic examination – colonoscopy, sigmoidoscopy, rentgenissledoBani, and barium enema.

It must be remembered that the older the person, the more likely the occurrence of his cancer.

Many patients experience a panic in determining the tumor during self-examination.

The word “fear” comes from the Latin ango] (compress, compress). Fear – the uncertainty, the devil­objective, anonymous, unmotivated emotion, fear changes the direction of the thoughts and behavior.! Experiencing the emotion of fear, the patient has] a likely prognosis of possible troubles and acts on the basis of this (often not reliable) forecast. This emotion can.] Be like sthenic and asthenic and against­Cach either in the form of stress conditions, either in the form It affects (horror – as an extreme variant of fear).

It is impossible to eliminate all the experiences of life ,, are associated with an aspect of its destruction, t. E. The sensation of pain, suffering, fear, and hatred just as it is impossible to imagine life without the positive experiences associated with aspects of her creations mi (joy, pleasure, love).

When the objective changes in the health status of the patient has obsessive fears. So ,, for diseases affecting vital functions may thanatophobia – the fear of death. Defeating this condition a person may not always be very, very often the patient needs psychological help aimed, first, of all, to reduce the level of fear and anxiety, improvement of psychological adaptation.

Cancers are very bye­wounded kind of pathology. But further propagation­Country population inadequate representation­Lenia about cancer and incorrect information about the possibilities of dealing with it.

Most forms of cancer develops’s advantage­governmental in the elderly. With the aging of at­villages the number of cases increases regularly. There are three areas of the fight against cancer:

1. Prevention.
2. Early diagnosis.
3. Treatment.

At each of these stages are used definition­lennye methods and opportunities.

disease prevention – this is the most chapters­a specified direction. Prevention is always went­human, more humane than cure. Development of methods and recommendations for cancer prevention bases­camping on objective knowledge about its etiology and epi­demiologii. The relationship of different factors with the risk of cancer, as well as the prevalence of these factors and cancers they cause, allow us to determine the share of cases­s disease caused by a specific factor­torus.

• Tobacco. Tobacco smoke – carcinogen for a human. Numerous epidemiological studies have proved the link of smoking to the development oflung cancer, oral cavity, the lower lip, larynx, esophagus, stomach, pancreas. Even passive inhalation of environmental tobacco smoke among non-smokers can significantly increase their development of cancer and other diseases.
• Nutrition. The relationship between the development of a number of pa­postglacial diseases with excessively high-calorie meal (high Ms consumption­votnyh fats). The consequence of this nutrition is­Smiling overweight. In these patients increases the risk of colon and prostate cancer- in men, breast, uterus, gallbladder – in women. The increase in consumption ovo­cabbage soup and vegetables significantly reduces the risk formed­Bani most forms of cancer. The protective effect of fruits and vegetables is due, above all, contains­zhaschimisya them vitamins and food portage­us.
• Alcohol. Regular consumption increased­GOVERNMENTAL doses of alcohol increases the risk of cancers such as cancer of the mouth, larynx, pharynx, esophagus. Moreover, the combination of alcohol with smoking the risk of increase cancer­INDICATES repeatedly.
• Solar radiation. After a special IC­investigations proved the connection of increased risk of skin tumors, including cancerous­hydrochloric melanoma, a part of the solar radiation and periodic burning sun. recom-etsya be in the area of ​​solar radiation in the ut­rennie and evening hours.
• reproductive behavior – in the absence of birthhistory or late delivery (after 30 – 35 years of the first birth), chronic disorders of menstrual­Foot cycle, late onset of menopause (after 55 years) – may increase the risk of their wives­Shin breast, ovarian and uterine body.
• Professional carcinogens. There are production and technological processes, koto­ryh used substances that cause cancer in humans. As a result of years of research proved that asbestos, nitrosomines, coal tar, cadmium, arsenic, nickel compounds, chromium, polycyclic carbon­hydrogens increase the risk of developing cancer.
• Viruses. A role in the development department­GOVERNMENTAL forms of cancer viruses play. Human papilloma virus may increase the risk of developing cervical cancer. Einstein’s virus-Bard – the development of nasopharyngeal cancer. Hepatitis B, C – the development of liver cancer.

Scientific studies on the factors and conditions of development of cancer prevention methods for determining:

• Give up smoking, do not smoke in the presence of non-smokers;
• Avoid sunbathing, avoid sunburn;
• Follow the safety precautions in the workplace and at home with regard to substances that can Call­Vat tumor;
• do not abuse alcohol; “Avoid excess weight, keeping physically active;
• eliminate overeating. Bring total calorie­riynost power in accordance with the physics mode­iCal loads and energy costs;
• Limit your intake of animal fats, cop­chenyh and savory foods;
• Eat more vegetables, fruits, vegetables, cereals high in fiber;
• take regular vitamins, mikroelemen­you antioestrogens protease inhibitor;
• carry out preventive vaccination pro­TIV hepatitis B virus

Methods of drug prevention Settle­Vanir experimental and epidemiological­E research has shown that WHO­possibility of preventing or deterring times­Vitia tumors using appropriate with­Unity.

For the prevention of breast cancer have been offered anti-estrogen drugs, poskol­ku estrogens in certain conditions STI­formulated the development of neoplastic changes in this organ.

Antiestrogen drug tamoxifen effects­veins in relation to breast cancer prevention as­lezy, It is prescribed prophylactically in women with a hereditary predisposition to cancer of this localization or women who have re­carrying the cancer is a breast for its pro­Galaxy are in the other.

Patients undergoing surgery for evil­quality tumor, it is necessary in the diet to introduce vegetables and fruits rich in vitamin­E. patient’s body after surgery requires at­complements mineral substances, various trace elements, which are fruits and vegetables. Because of the low calorie they are widely used in clinical nutrition.

Potatoesrightly called a second bread. It is well absorbed by the body, potato fiberIt does not irritate the mucous membrane of the stomach and ki­shechnika. 100 grams of young POTATO tubers­To contain up to 20 mg of vitamin C (cook­hydrochloric processing is lost to 10 mg of vitamin C). Kar­Tophel contains potassium salts calorie potato substantial (greater than 2 – 3 times the caloric content of many other vegetables). Those who are inclined to corpulence, a potato in the diet should be restricted.

tomatoes are very useful, they guest carotene – provitamin A, ascorbic acid, vitamins of group B. From mineral salts they contain potassium, phosphorus, iron, organic acids, millstands­Chatka. Low calorie tomato allows you to include them in the diet of people who are overweight. Recent evidence suggests that the oxalic acid in tomatoes is not larger than in potatoes. Less than in other vegetables, contain­zhitsya purines in them that could disrupt exchange ve­stances and lead to the development of gout.

cucumbers composed of 95% water in small amounts they contain vitamins C :, Bp B2. Mineral salts in greatest potassium.

Carrot (Especially brightly colored korneplo­dy) contains a large number of carotene from to­torogo in the human body is formed vitamin A. In carotene in carrots is other vitamins: PP, C, group B is rich carrots potassium salts. th­tovit carrot juice and carrot salad req­Dimo immediately before use, because carotene quickly loses activity under the influence of Kis­Air loroda.

Beet It characterized by a high sugar content, fiber, organic acids (malic, citric, etc.), mineral salts (potassium, mag­Nia), vitamins. Young beets used vmese­those with tops, which a lot of ascorbic acid, carotene, B vitamins

White cabbage – source of vitamin C. In 100 g it contains up to 30 mg of vitamin C (summer and autumn). Of the mineral substances are contained in cabbage potassium, calcium, phosphorus. cabbage is­etsya low-calorie product, so it hunts­but include in the diet of overweight people. Very good­Shaw saved vitamins sauerkraut.

Onionrich in volatile production is delayed­conductive development of pathogens. It has long been believed that the bow is useful by “seven ailments”. Volatile inhibit putrefactive bacteria in the oral cavity, in the intestine. Onions stimulates the appetite. In large onions contain essential oils, we arrive at­guides him to a specific aroma and flavor. There therein vitamins: C ,, B2 (riboflavin), PP (niacin) from E­neralnyh substances are potassium, phosphorus, calcium, and iron.

Pumpkinuseful and tasty. Use it as a CBE­ments, and in baked or boiled. Very useful pumpkin juice. In the pulp of ripe pumpkin contains­Xia: sucrose – 4.5%, vitamins B2, B2, C, carotene in large quantity, potassium, phosphorus, magnesium.

courgettescontain sugar about 3%very rich in minerals, vitamin C.

eggplantrefer to the tomato vegetables. They contain vitamins (PP, C), carotene, minerals­nye substances (potassium, phosphorus). eggplant Maloka­loriyny, so it is recommended to enter into the diet of obese people power.

Sweet pepper the content of vitamin C (Al­korbinovoy acid) – one of the richest ovo­soup. The mature red pepper contains vitamin C.­camping several times more than oranges or tangerines. 40 – 50 grams of raw sweet lane­ca correspond to the daily rate of the forehead needs­Century vitamin C in peppers a lot of carotene (TEST­Tamina A), Bl vitamins B2, E, PP. of mineral­Sub- stances especially a lot of peppers potassium salts. In the heat treatment of the vitamins is lost,so it is particularly useful pepper fresh.

Melon It contains a lot of nutrients. Among them easily digestible carbohydrates, vitamin C, carotene. Mineral substances particularly valuable Nali­Chie iron.

Watermelon contains up to 90% water, it has a pleasant­nym sweet taste, good thirst quencher. Sla­Dost watermelon depends digestible chelove­com fructose and glucose (13%). The watermelon at­absence of fiber, pectin, vita­With mines, B1, B2, PP, carotene, mineral ve­stances – potassium, calcium, sodium, phosphorus, and iron. Due to the content of iron and folic sour­you are taking part in hematopoiesis, watermelon is used for therapeutic purposes in case of anemia.

Fruits and berries – not only of vitamins (C, carotene, etc.). They contain easily digestible carbohydrates, sugars (glucose, fructose, sugar­for) various mineral substances of organic­skie acid, volatile, dietary fiber (millstands­Chatka).

apples– dominated by glucose and fructose. They are not rich in vitamin C. Apples are rich in salts ka­Leah, have a diuretic effect. They contain­zhatsya malic, citric and other organic acids.

plum – fresh, dried, especially prunes – has a gentle laxative effect, contains­INH potassium, vitamin C.

cowberryrich in organic acids (whether­monnoy, malic acid, oxalic acid, benzoic acid).

strawberry(Garden, forest) contains a lot of wi­Tamina C and relatively little organic acids.

Raspberries – the therapeutic effect is due to contain­zhaniem therein salicylic acid.

Sea buckthorn It combines extremely large amounts of vitamin C (200 mg per 100 grams of berries), a significant amount of vitamin E. By containing­NIJ buckthorn carotene than even carrots.

Blackcurrantfamous abundance of vitamins C and P. The content of vitamin C black Smorodov­second only to the briar.

Red currants – less vitamin C, but the pain­Chez carotene.

bilberry It has a large number of tannins. It used as an astringent,

briar– record the content of vitami­on C (479 ml per 100 grams of fresh fruits and 1200 ml per 100 grams of dried fruits, as sous­xux berries per 100 grams accounts for more).

Aronia, rowan rich in vitamin P and S.

sorrel – useful for hematopoiesis. One of the first to appear in spring. It is rich in iron and magnesium. Sorrel need to eat in raw form, adding to salads. Nutritionists, naturopaths believe that Neorio­ganic oxalic acid, against which a cart­RAWA doctors (salt deposits, and so on. d.), formed by the heat treatment, which is why you need to cook sorrel is very rare, and fresh sorrel body brings many benefits.

From the above, the following recommendations – upot­reblyat vegetables and fruits with freshly prepared­kah, salads and as little as possible – in boiled and fried, as the vitamins lose their own­Properties. It is desirable for the entire year to use the parsley, and the green leaves and stem of parsley, the more useful it is for human consumption.

Surgical method of treating cancer It is the most efficient for most zlokache­governmental tumors. When this method was removed­are affected by a tumor organs or tissues, mouth­Wounding cause physical suffering of the patient, as well as the threat of further tumor spread throughout the body.

But this method does not always help the patient recover from cancer. Even a very small number of remaining after the operator­radio tumor cells that are invisible to the eye and does not distinguish by touch, sharing intense, can give rise to a new cell population which manifest themselves at some time in the form of relapse­va. Therefore, the surgical treatment of tumors removed within healthy tissue.

However, the increased volume of tissue removed can not always protect from disease progression. Cancer feature – the ability to give rise daughters­These tumors (metastases). Most often, the tumor cells spread through the lymphatic system. This system provides the suction of tissue water, and metabolic products consists of shrinking network­Shih vessels, gradually merging into a rump­nye, which flow through the lymph nodes. Lymph nodes are small glands performing protection of the organism from genetics­cally foreign cells or substances entering from the outside or generated in the body. Lymph­cal lymph nodes collected from any organ or body part, but their defeat Protective function­you assume the other node group. When injected into the lymphatic system tumor cells following­dnie delayed lymph nodes and mo­Gut cause metastasis development. Therefore, when the opera­tion removed lymph nodes related to the affected tumor anatomical area. This Obus­lovlivaet often crippling nature of such operators­tions, their severity and risk.

Refusal of surgical treatment is justified only in cases where the tumor affects organs that removal is not compatible with life, or when there are distant metastases. But even with this surgical procedure is applied to reduce swelling to expose the remaining tumor foci other therapies.

The earlier a tumor is detected the small size, the functional sparing operation will be carried out more easily. Such operation is well tolerated by the elderly and immunocompromised patients.

In some cases, a surgical method is used when to remove the cancer is no longer possible or feasible due to deliberate non-radical, but the associated complications are By direct­governmental threat to life. Patient death may at­not set foot on the progression of the tumor, and on the Call­Bathrooms her bleeding, intestinal obstruction, etc. The operation in this case -.. forced, and it is directed at overcoming these complications.

Surgical method used in malignant tumors, aims at saving or extending the patient’s life. Nevertheless, the fear of mutilation and the nature of the threat of being disfigured in some cases is the cause of failure of them. Some patients do not opt ​​for surgery because of lack of faith in the possibility izle­cheniya this way. If the patient offer operators­walkie-talkie, it means that oncologists have confidence in WHO­Moznosti complete removal of the tumor, the hope, if not a complete cure, the life-prolonging.

Thanks to a major development in oncology at rehabilitation of patients who have been previously ka­attending to surgery with modern amenities increased­mennye possibility of reconstructive surgery now. So, after a laryngectomy patients previously had to use the Voice of­Vym machines or study “of esophageal­losu “. Currently, developed methods for surgical repair of voice features such as using voice prostheses, and without them. After removal of the breast is possible not only to use the gel of the prosthesis, but its plastic recovery using GSS­governmental body tissues. For a better cosmetic result can be additionally used­vatsya endoprostheses, introduction of specific gels and the like. d. After removing the prosthetic jaw may­vanie its metal structures.

Currently, many cancer pain­nym administered as treatment for radiation therapy. In 40% of cases it is used as self­yours elf a treatment for cancer. Radiation therapy, also as a surgical method can completely destroy a cancerous tumor, there is a radical anti-tumor effect.

If patients understand what is happening the surgical treatment of tumors (removed certain organs, tissues), the effect of radiotherapy remains a mystery in many ways. If the tumor is not removed, then what happens to it? Where did she go? What complications are waiting for a patient after radiation therapy?

Common to all used in medicine ionization­ziruyuschih radiation is effective, from the point­of view of the biological action, transferability process­sa large amounts of energy in the sensitive structure of their action. Bearers of this energy can be type specific electromagnetic radiation (x-rays, gamma rays radioak­tive elements) or bundles of nuclei­particles (electrons, protons, neutrons, and t. d.).

The absorption of such quantities of energy DNA molecule – the basis of the genetic code – it leads to damage and as a result, disturbance of­cell activity. They can also be damaged by meme­brane cells, enzymes and other important biologists­cal molecules. This so-called direct WHO­effect of radiation energy. The indirect mechanism svya­coupled with exposure to ionizing energy for this different molecules and water, which is an integral part of the cell. As a result of the absorption­of the energy of the ions and the formation of free radicals. Each radical may in turn damage the whole molecule, which races­fall to the new radicals. So there is ionization­tion, which leads eventually to the harmed­Denia cell and tissue structures.

Radiobiological effect caused by radiation energy, depending on the biological properties of the exposed­shihsya irradiated tissue. Cells most sensitivity­tion to damaging factors when they in the process of division. Thus nai­are more sensitive to radiation tissue cells to­toryh most intensely divided. In the humanorganism are cells of the sex glands, blood-forming organs, some types of epithelium. insensitive­us to the radiant energy muscle and nerve tissue. .Zlokachestvennye tumors can occur in various­GOVERNMENTAL organs and tissues. sensitivity novoobra­mations exposed to radiation is higher, the bo­Lee was the primary sensitive tissue in which the tumor originated. But no matter of any tissue tumor originated, its cells divide much more frequently than the unaltered cells. Therefore, the same dose of radiation has on the tumor­fabric-hand more pronounced effect than Raspaud­Proposition near healthy. Based on this and radiotherapy. Its task – the maximum damage the cancer while preserving Pot­lities normal tissue structures.

Depending on where located zlokache­governmental neoplasm, oncologists use IU­todiku and a source of radiation that penetrates to a depth of a well-defined and absorbed by the OPU­holyu.

In some cases, using the contact method of radiation therapy. The radioactive source is disposed in the vicinity of the tumor:

• applicator treatmentIt is in apposition to the surface location with the most­-adjoint tumors (skin, cornea, etc.). plates of a material which is a source of radiation (strontium, cobalt, cesium, etc.);
• intracavitary treatment – summing a radioactive source tumors located­Foot in the hollow body. Source in the form of cylinders, spheres and other forms of organ lumen is introduced into and retained there for a certain time. Then – it is extracted. This method is used for the treatment of cervical and endometrial cancer, rectum, bladder. Sometimes radioactive elements in the form of colloidal solutions is introduced into the hollow bodies (mo­chevoy bladder, uterus) or body cavity (plevu­-sectoral, abdominal);
• Remote method of radiation therapy Prima­nyaetsya with deep-seated cancer. The name of the method was due to the fact that the source of radiant energy is determined on­Mr distance from the patient. radiation source provides deep penetration of radiation and uniformity of absorption fabrics. Treatment is carried out on the special, providing a high degree of radiation protection devices.

Used machines, in which the source of radiation energy is radioactive cobalt, which gives a deep penetrating gamma radiation. Such devices are used for the treatment of tumors of any localization. Currently began transition from devices with radioactive sources for accelerators of elementary particles (electrons, protons). The depth of penetration is governed by the energy under the influence of which the particles move. By changing this energy, and you can change the depth of penetration of particles into the tissue and the maximum irradiated tumor and minimal – healthy tissue. On such machines can be floor­chat almost divergent energy beams of diameter­rum up to 1 cm for the point of irradiation is not very­large tumors (e.g., brain).

Needed to damage the tumor dose lu­chevoy energy can not take it odnomoment­but. Treatment is carried out at regular sessionsintervals. The higher the radiation dose the patient received, the longer the interval until the next session. This protects the surrounding OPU­Chol healthy tissue.

Place in the skin through which the radiant energy tray is called “field irradiation­Nia “. To reduce the radiation exposure to healthy tissue, but to ensure the damage of the tumor, using multiple fields of radiation from different angles. Sometimes the source is moving at exactly calc­tannoy trajectory around the patient, the center of rotation is a tumor. With this method of treating the load on the healthy tissue is minimized.

Before radiation therapy is performed dosimetric planning (measured and rasschity­vayut maximum dose effect on the tumor). The dose of radiation received by tissue depends on the activity of the source and time of exposure, but partitioned­etsya usually uneven. The farther away from the source,the effect is less pronounced, since different areas of the tumor receive different doses of radiation.

Malignant tumors can metastasize to the lymph nodes, which are po zone­hundred new tumor. As the surgical treatment,and radiation therapy, treatment success can be achieved only rid the body of all the centers of evil­qualitative growth. Therefore, exposure should be under­jected and the tumor and its metastases. sometimes IU­tastazy located next to education and can be irradiated with the primary tumor, but more often they are about­spatially separated, which requires a separate le­cheniya. In advanced cases, when the cure Paci­cient is no longer possible, radiation therapy is used to inhibit tumor growth, reduce its size or tumor-induced removal of heavy sympto­mov (compression vessels, trachea, brain) and serves to prolong or improve the patient’s quality of life. Radiotherapy gives complications, and that they cause fear of this type of treatment. Oslozh­neniya may be general in nature and take the form of:

• weakness;
• sickness;
• loss of appetite;
• fervescence;
• changes in the blood (decrease Included Quantity­CTBA leukocytes or platelets);
• dermatitis, ulcerations of the skin at the site of radiation therapy;
• radial cystitis, proctitis, pneumonitis. Complications of radiation therapy can be corrected or eliminated by the termination of therapy or a break in treatment. The risk of complications of radiation therapy is much less of a risk at the same hee­rurgicheskom treatment.

Since ancient times, people worked on different cancers herbal medications or natural substances. These funds, having­guides cauterizing action applied mes-spot or inward to impact on the tumor.

Currently open substances that cause­Suitable growth inhibition or death of malignant tumors. Medicinal substances obtained chemistry­cal way, and the treatment they received the name of chemotherapy.

The use for the treatment of cancer pain­valuable natural or synthetic hormones called hormone therapy. The combined use of chemotherapy and hormones for therapeutic purposes in cancer is called chemo-hormonotherapy. Effects on the immune system in order to enhance anti-tumor immunity win­lo title tumor immunotherapy.

At the heart of modern chemotherapy is uc­use direct damaging effect about­tivoopuholevogo drug on malignant klet­ku. To achieve the destruction of all or the majority­ARISING tumor cell anti-tumor agents apply in person maximum tolerated doses. Chemotherapy drugs have side steps, and patients often refuse them. Chemotherapy or cytotoxic agents are capable of rapidly damaging the cells of any tissue, t. E., Not only the tumor but also healthy.

Patients often ask the question: “Is it worth it to do chemotherapy, especially the operation and radiotherapy did their job?”. Surgery and radiation but­FNF is essentially local in nature: these methods can be used to cure the tumor, located in the definition­lennom place, even if it reaches a considerable size and has regional metastases. but zloka­quality education, spreading their cells through the bloodstream, can metastasize to distant organs and tissues. How much and in what authorities were cancer cells as appeared metastases, you­yasnit is not always possible. Therefore, removing or y- irradiation­chenie recovery the patient is not given. Here also need chemotherapy. Spreading the bloodstream, the antineoplastic drug may impact­Vat on the tumor and its metastases, regardless of their to­lichestva and localization. damaging chemotherapy­by genetic apparatus malignant cells break fission process, causing its destruction.

Tumors are composed of an enormous number cancerous­GOVERNMENTAL cells. Only in one gram of tumor TKA­neither contains about a billion cells. Some are in the process of division and are sensitive to the action of cytostatic agents, others are in a state of rest, the action of chemotherapy reserved. Dividing cells, are in different phases of the process, damaged one antitumor cytostatic and remain bezraz­personal to the action of another. Therefore, to enhance the effect of chemotherapy oncologists old­are used simultaneous introduction of two, three and more cytostatics with different mechanisms of antitumor action. Such variants soche­tany dosage of anticancer agents are called chemotherapy regimens. for each­the first type of cancer vyrabota­us most effective schemes of treatment.

When you receive a complete response when the tumor after chemotherapy is not detected, to the bodies­Lowland is a sufficiently large number of OPU­-tumor cells that may cause recurrence (re-occurrence of tumors). It is therefore necessary to carry out repeated courses himiote­rapii. Each dose chemotherapy determinescytostatics, which is administered not once, but often­E, with certain intervals between administration­E. Such intermittent administration of cytotoxic drugs easier ne­Renos patient and the impact on a large number of tumor cells. During chemotherapy patient complications can occur:

• inhibition of blood (hematopoietic cells bodies are rapidly dividing and therefore highly sensitive to the cytostatic effect);
• appetite loss;
• nausea, vomiting, stomatitis;
• gastroenteritis;
• hair loss;
• phlebitis, thrombophlebitis.

There are a number of tools to help patients move chemotherapy. It must be remembered that this is not a harmless and simple treatment, but it is not necessary to be afraid of.