Posted 23 сентября 2022, 10:42
Published 23 сентября 2022, 10:42
Modified 24 декабря 2022, 22:38
Updated 24 декабря 2022, 22:38
Irina Mishina
The increase in the incidence of cancer of the gastrointestinal tract is just right to call an epidemic. We are talking not only about the traditional risk group 40+, but also about quite young groups of Russians who are overtaken by this disease.
For example, pancreatic cancer in the age group under 35 has increased over the past few years in men by 3 times, and in women by 7.5 times. Only bowel cancer accounts for about 80 thousand cases annually. Scientists attribute this to an increase in the accuracy and availability of diagnostics (the principle “the more you cover, the more you will find” in action). But the diet of Russians is likely to play an increasingly fatal role in the growth in the number of diseases of the digestive tract.
No matter how regrettable it may sound, the current level of well-being of the population significantly spurs the development of gastrointestinal diseases. The impoverished population is switching to cheaper and not the highest quality food analogues, being at work from morning to evening and switching to semi-finished products due to lack of time for cooking. The most unenviable position now belongs to young people: after all, the basis of health is formed precisely at a young age. Who are they, people who are affected by cancer of the intestines, stomach, pancreas, liver?
“99% of patients with cancer of the gastrointestinal tract are people over fifty, long-term smokers who consume a lot of strong alcohol. About 15-20% of patients with stomach cancer are patients under 50 years of age. There are very early forms - in thirty-year-olds. Quite often, young age is combined with aggressive forms of cancer. As a rule, the survival rate in such patients is quite low. Most patients come to us at the third stage of the disease (when the lymph nodes are already affected by tumor cells). This applies to both esophageal cancer and stomach cancer. This is because there are no state screening programs in Russia that would allow the detection of early forms of cancer among a large number of patients. In our country, until the pain starts, no one goes to the doctors”, - says the head of the Oncology Center for Combined Treatment Methods of the Clinic for High Medical Technologies named after Pirogov St. Petersburg State University Andrey Pavlenko.
The transformation of healthy cells into malignant ones is a complex process. It is influenced by the state of the immune system, and genetic predisposition, and the way of life of a person. Not the last role is played by malnutrition. According to doctors, the foods that we regularly eat are perhaps the main factor that increases the risk of developing tumors.
“Foods with a high content of preservatives can contribute to the development of cancer of the gastrointestinal tract. Among them: sauces, mayonnaises and many products with a long shelf life. It is advisable to give up pickles as well - a high salt content has an irritating effect on the mucous membrane. This can be one of the factors in the development of cancer of the stomach, as well as the esophagus or larynx. It is also worth remembering that the World Health Organization has officially included red meat among the carcinogenic foods. Scientists at the Boston Institute for Cancer Research analyzed the medical records of patients with oncology who had a disrupted diet. As a result, the researchers concluded that mutations in gut cells were often associated with the consumption of red meat, but chicken or fish did not cause them. It has been proven that the likelihood of cancer of the gastrointestinal tract in vegetarians is several times lower than in meat eaters”, - says oncologist Olga Vysotina.
Doctors also warn: during frying and smoking, even initially safe foods can become dangerous. Meals rich in carbohydrates (all kinds of battered foods, donuts, etc.) begin to release carcinogens that are dangerous to health.
A serious surge in diseases of the gastrointestinal tract is also associated with an increase in the proportion of palm oil in products. Palm oil is popular with manufacturers due to its relatively low price. It accounts for one third of the world's vegetable fat production. In addition to sweets and bars, palm oil is added to cream, margarine, bread, cookies, muffins, canned food and baby food. In addition to the threat to the digestive tract, palm oil, according to doctors, provokes other equally dangerous diseases. Scientists conducted experiments involving women who were diagnosed with high cholesterol. With the use of palm oil, this indicator became even higher, and in fact it is associated with diseases of the cardiovascular system.
“To avoid cancer of the stomach and intestines, you need to lead a healthy lifestyle. And HSE is expensive. The population in Russia is mostly poor. Accordingly, food is mostly cheap and unhealthy. In addition, many live in a state of constant stress. How to take it off? Smoke, drink, go to Tasty and Tochka, where everything is cheap and fast, eat junk food... Do not forget that in terms of alcohol consumption, Russia is in 2nd place in the world. And alcohol and smoking in many cases lead to cancer of the digestive tract. In addition, the lack of well-being does not allow you to focus on yourself and take care of your health. The main thought of the majority is how to survive, and not how to maintain health. Eating habits also matter. In the USSR as a whole, there was no shortage of quality nutrition, and the incidence of bowel cancer was correspondingly lower, because food technologies made it possible to maintain a certain standard. Now there are no such standards”, - Maxim Rykov, Doctor of Medical Sciences, Professor of the Department of Oncology, Surgery and Palliative Medicine, Tver State Medical University of the Russian Ministry of Health, told NI.
In terms of the incidence of cancer of the gastrointestinal tract, Russia today ranks second in the world after Japan. But by a strange coincidence, the mortality rate from gastrointestinal cancer in Japan is extremely low, in contrast to Russia. What is the reason?
“Medical examinations in Japan and in many Western countries are monitored by an employer who is interested in his employee. That is, the state fulfills its social guarantees. If an employee does not undergo a colonoscopy and gastroscopy on time, he will simply not be allowed to work. And these little pleasant procedures in most countries are done under sedation and free of charge. In our country, people are subjected to humiliating painful procedures, which, moreover, are not so easy to sign up for. If a tumor or polyp is found, they are removed and the person lives on. In addition, in most countries, laparoscopic resection of the tumor has long been used, making a tiny incision, that is, the operation is not traumatic. It's rare for us. Many people say that it is easier in Japan, it is a small country. But there are 280 million people there, and they’re coping!”, - Oncologist Maxim Rykov told NI.
Russian oncologists say that in most cases, patients turn to them in the late stages of cancer, when oncological pain and bleeding already begin, when the tumor blocks the lumen, and the person is unable to swallow or digest food. According to statistics, 60% of patients turn to doctors already at the third stage. Early forms of cancer can be detected at a time when nothing bothers a person. But our medicine, unfortunately, is not focused on prevention and early diagnosis.
“What kind of early detection of cancer can we talk about when, in Moscow, for example, a general practitioner has 10-12 minutes to see a patient according to the standard? What can be recognized and diagnosed during this time? Yes, and we have critically few relevant specialists. Earlier in Moscow, the 24th city hospital was engaged in coloproctology, now it has been redesigned. Doctors with suspicion of cancer of the gastrointestinal tract refer to a colonoscopy, but many ignore it, since this procedure is very painful, we perform it in 90% of cases without anesthesia. But after 40 years in many countries of the world this is a mandatory regular procedure. In the world there are painless technologies for diagnosing the condition of the intestines using computed tomography, this is psychologically more correct, but these technologies have not been mastered in our country. And in general, there are critically few doctors of this profile”, - says Dmitry Epshtein, vice president of the Moscow Association of Nurses.
“The oncological school in Russia is collapsing. Practical approaches are needed in oncology, knowledge must be transferred to students. And in our country, most of the teachers are part-time workers, they earn money in clinics, students are part-time jobs for them. The seniority is worked out purely formally. Approaches to learning also raise questions. After all, for 2 years in residency, you can only teach at the top. There are residencies in the USA and other countries. There, they study to become a doctor for 4 years, and then work as a doctor's assistant, and for a decent salary. 20-30 years is the most active age, when people buy apartments, start families, give birth to children. Who at this age would agree to work for several thousand rubles a month, as in a Russian residency? After six months of training, no one puts pilots to fly an aircraft, but doctors can be allowed to undergo treatment. But if in Moscow a novice doctor can still ask an experienced colleague for advice, in regional centers young specialists often act at random”, - says Maxim Rykov.
Hope for changes in our medicine in the near future is not necessary. Therefore, it is worth living according to the old principle: the salvation of man is the work of man himself. Let's add: and his financial capabilities too.