"Nobel fight" against cancer: breakthrough in the treatment of deadly tumors. Posts tagged ‘fighting cancer’

Maxim Nagorny is 37 years old. He learned that he had lung cancer two years ago. Maxim is a fan of outdoor activities. Due to illness, he was prohibited from long hiking trips and his favorite cycling routes. In the free time, he began to collect unusual things from wood and improvised means - cameras, rotary phones.

Maxim told Profilaktika.Media about the word “oncological”, inaccessible medicine in Russia and a new attitude to life after diagnosis.

I was born in Penza. When I was one year old, my parents moved to Perm, where they still live. Dad worked as a foreman at a fan factory, mother graduated from the preschool faculty, worked as a methodologist in kindergartens, and as a specialist in the Ministry of Education. She is now retired, but cannot imagine her life without children, so she works as a nanny.

In 2006 I graduated from the Physics Faculty of Perm state university. I work in the IT field. He got married in 2015 and has no children yet.

In November 2015, during a routine fluorography, I was diagnosed with darkening chest. After this, long trips to doctors began. After hospitalization and a biopsy in April 2016, a tumor near the left lung was removed. After reviewing the glass blocks, a diagnosis of mediastinal tratoma, a benign formation, was made.

When a control CT scan was done in July 2016, they found multiple shadows on the surface of the left lung. Consultations with thoracic surgeons and oncologists began again. The process was slow.

As a result, in September 2016, a biopsy was done again and the glass blocks were revised. And after this, the final diagnosis was made - “bilateral disseminated large cell lung carcinoma T4NxM1.” Simply put, stage four lung cancer or stage four squamous cell large cell lung cancer.

In October 2016, chemotherapy began at the Perm Oncology Center, with a total of eight courses. And on every test computed tomography there was a negative trend. Each time the doctors said something like: “Well, everything is individual. Let’s try treatment with a different protocol.”

By the eighth course of chemotherapy, I had a strong feeling that this treatment was just for show. This feeling was especially strong when I looked at people who were doing their tenth, fifteenth or twentieth chemo, and they did not have good dynamics.

Speaking of people with: it is important to understand that these were different sequential treatment regimens with different drugs. Chemotherapy is prescribed, then the treatment itself comes. The effect is then assessed. If there is no effect, then the scheme changes. Unfortunately, due to lack of information, patients after several cycles and regimens of “chemotherapy” believe that it “does not help,” forgetting that the regimens and medications have changed.

Yes, with each subsequent regimen - that is, line of therapy - the effectiveness decreases, which is why the most effective drugs in the first lines. But if there is no answer to standard circuits, then perhaps we do not yet know some genetic characteristics of a given tumor (for example, some kind of mutation), which makes it sensitive to the drug that was prescribed in the third or fourth line, and there will be an excellent response! There are many complexities and nuances in the process of drug therapy that are not visible and often not understandable to the patient. This misunderstanding causes denial and hostility. But no one would want to check how long they would live without treatment at all.

Therefore, in parallel, requests were sent to Israeli and Turkish clinics, which suggested that it was possible to be treated with a new modern medicine, active substance pembrolizumab. Realizing that this treatment could be more effective for me and with my diagnosis, and that chemotherapy could “kill” the entire body along with the cancer, I voluntarily refused chemotherapy and decided to switch to pembrolizumab. But in August 2017, this medicine had not yet been registered and was only undergoing clinical trials in Russia. So I had to buy it abroad and install it in private clinic we have. Of course, my condition was monitored - I donated blood every two weeks and had a CT scan. At the same time, the medicine has been used abroad for a long time; it is quite officially used to treat melanoma and lung cancer.

Comment from Katerina Korobeynikova, a resident of the Higher School of Oncology:

Nowadays, everything that chemotherapists do is called “ drug therapy" It includes “classical” chemotherapy - cytostatics, immunotherapy, targeted therapy, biotherapy... But all this treatment is with drugs.

Pembrolizumab, which Maxim is talking about, is a monoclonal antibody, that is, a biotherapy. In the register medicines the following is written about it: “Pembrolizumab is indicated for the treatment of patients with advanced non-small cell lung cancer patients with confirmed tumor cell expression of PD-L1 and disease progression during or after platinum therapy.” That is, they could not immediately prescribe it, since cytostatics with platinum are more effective in the first line (if the tumor is sensitive to them). Unfortunately, the problem is the lack of some medicines, registered abroad, really exists in Russia, it needs to be addressed.

Help groups were created on social networks, and fundraising began for the purchase of the drug. Of course, personal savings were used, and a lot of things had to be sold to buy medicine. My friends helped me a lot, I couldn’t have done it without them. At that time, all the help I received from strangers, gave me strength and the desire to fight further. These people wrote to me, supported me, and sent me money to buy medicine.

By January 2018, I learned that you can take the drug for free - at the expense of compulsory medical insurance funds. Having received a referral for examinations at the Blokhin Russian Cancer Research Center, I underwent examinations and tests, on the basis of which I was prescribed treatment with pembrolizumab at the Perm Oncology Center.

Now I continue treatment and am waiting for the next course after the control CT scan. By the way, it showed a lack of dynamics compared to the previous study. This is a good result.

What helps you in your daily struggle?

It helps to communicate with people like me who live with cancer. The name “oncology living” was coined by a new friend of mine who also has cancer. Sometimes I advise something when people contact me, sometimes they advise me what to do in a given situation. And communication with these people gives fuel, strength and confidence that we are on the right way, paths to recovery.

Of course, after everyone around me learned about my diagnosis, many were perplexed and could not believe that this was happening to me. Some said: “You mean sick? Look how happy and joyful he is in the photographs. He can't have cancer." For this reason, someone left my life, and someone came, new interests, new hobbies, new perspectives appeared. I am grateful to both people for everything.

At some point, he began making decorative elements, lighting and furniture from wood and improvised materials. I use everything - cameras, rotary phones, in general, everything that can be found at flea markets. And this activity makes me happy, distracts me and takes up my free time. I want to dedicate my immediate future to this activity while I recover. In addition, I work at my previous job in free mode. This is a definite plus, because I am doing what I really want to do now, and this helps a lot.

What would you like to change in the healthcare system and cancer screening?

But all the problems are in the system, not in people. After all, almost everywhere, in all hospitals and clinics, I communicated with adequate, friendly doctors and nurses. They get into the situation, help as best they can, give advice, look for options for solving some difficult issues. I think that it is precisely because of people like this - responsive, professionals with a capital P - that our medicine stays afloat.

What questions were the most difficult to answer?

The main thing that I understood is that such a disease is not given “for something”, but “for something”, so that a person understands what needs to be changed in himself, in his attitude towards people, towards the life around him.

What did your diagnosis tell you?

Once again I realized that you have to fight for your life, for your health, no one owes you anything. It is necessary to take x-rays of the lungs on time, go to doctors for preventive appointments, and get tested.

What advice could you give to loved ones of patients and people themselves facing cancer?

2. Every person living with cancer needs support. We need to support the person, but we shouldn’t forget about loved ones. It’s hard for them too, they also need support, they also suffer both for the person with cancer and for themselves.

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According to the World Health Organization for 2015 (there are no more recent statistics yet), 8.8 million people died from cancer. Oncological diseases killed every sixth person in the world. At the same time, 10-14 million new patients are diagnosed with this terrible diagnosis every year. And although cancer is significantly inferior in mortality to cardiovascular diseases, it still remains a death sentence in the minds of most. Tragic cases, most covered by journalists in Russia - the deaths of Zhanna Friske, Mikhail Zadornov and Dmitry Hvorostovsky - against the backdrop of almost daily reports from doctors about the discovery of new effective means against cancer are left perplexed. Are we still powerless against tumors? In fact, over the past 10 years, a real breakthrough has occurred in the fight against cancer, but its fruits have not yet reached the mass patient, says Daniil Kuznetsov, head of the KP science department.

What is cancer?

This disease has been known since ancient times. The term was introduced by Hippocrates. It seemed to him that the tumor resembled a cancer claw, so he gave it a name carcinos- carcinoma, from where it already got into Latin and then English language – cancer, and then it was literally translated into Russian. Strictly speaking, modern doctors they only call it cancer malignant tumors from epithelial tissue– carcinomas. However, such neoplasms can occur in all tissues - bone, connective or muscle (sarcomas), nervous (gliomas), cells lymphatic system(lymphoma), blood and bone marrow(leukemia), etc.

It's no joke, but in the genome of one somatic cell, up to 10,000 errors can occur per day! However, our body actively fights them. For example, carrying out DNA repair - correcting various damages and breaks. Or "checking" control points cell cycle, the passage of which either “allows” the cell to form some components, prepare for division and, finally, form new cells. Or, on the contrary, it triggers “stop lights”. If DNA repair is not successful and checkpoints have not been passed, then apoptosis—programmed cell death—is triggered.

The problem is that several mutations can happen at once. And then both the mechanisms of cell division and apoptosis will be disrupted. She will begin to constantly share, as usual, and completely refuse to die. However, this does not mean that it will cause a malignant tumor, because our immune system is still working. Malfunctioning cells and even “microtumors” appear in the human body regularly, most often from the age of 20. However, the natural killer cells of the immune system keep them under control.

And everything would be fine, but mutations, especially with unfavorable ones external conditions, so much passes that some “mutant cells” successfully jump through all the barriers. And as we age, our immune system weakens. The surviving defective cell divides, there are more and more of them, they acquire new unfavorable mutations, and then the moment comes when the balance can shift - the cell will be reborn and become an enemy of the body. She will become “immortal” and uncontrollable. It will turn into a foreign organism that devours the host’s organism.

Individual tumor cells evolve, undergoing the most severe natural selection in the fight against the immune system, and acquire the ability to separate from the “maternal” tumor and travel through the bloodstream and lymphatic vessels, from where they spread to other organs, forming metastases. And this is the beginning of the end. Tumors deprive other organs of normal nutrition, destroy their structure, block various excretory pathways, reduce hematopoietic functions, cause filling of the lungs with fluid, numerous blood clots, strokes and absolutely wild, unbearable pain. And ultimately death.

Early warning

The main risk factor is age. Indeed, in Russia, the number of diagnosed cancers among women begins to grow exponentially from the age of 25. The risk nearly doubles every four years, peaking between ages 60 and 70. In men, the risk of developing cancer increases from the age of 35. Up to 55 years of age, it is approximately 30% lower than in women. At the age of 55-59 it is practically equal, and then from 60 to 70 it surpasses the female indicators.

Prevalence of cancer in Russia, 2014

In Russia it was noted serious increase incidence of oncology, however, this increase is not at all due to the deterioration of life and health care, but quite the opposite: over the past decade and a half, they have learned to diagnose cancer very well, and early stage. Moreover, prognoses for successful therapy of malignant tumors directly depend on early diagnosis. Therefore, the first and most effective method are regular complex medical examinations, allowing you to identify a problem before it becomes fatal.

Over the past five years, our country has been rapidly developing genetic testing. Let us remember that cancer is the result of fatal mutations, a de facto disease of the genome. There are oncogenes in our DNA; their activation can turn a cell into a cancerous one. And also suppressor genes that protect the cell from degeneration.

The latter, for example, includes the BRCA1 gene. He is involved in reparations damaged DNA, maintaining the integrity of the genome. At the same time, in human population There is a large number of carriers of a mutant form of this gene. In total, more than 1,000 such mutations are known today, and each of them is associated with an increased risk (on average by 20 percent) of cancer of the breast, ovaries, prostate, intestines, larynx, skin and other organs and tissues. BRCA1 mutations pose the greatest risk to women. If genetic analysis shows that a 25-year-old girl has a mutant form, then the likelihood of developing breast cancer before the age of 70 increases for her by 50-80 percent (depending on other factors), and ovarian cancer - by 30-40 percent.

This gene became most famous thanks to Angelina Jolie. After undergoing a genetic test, she learned that she had a defective copy of BRCA1, the same as her mother, who suffered from cancer for 10 years and died at 56. Fearing a repeat of her fate, Jolie, who already had children by that time, decided to undergo preventive removal mammary glands - double mastectomy - and ovaries - oophorectomy.

The preventive approach is gaining great popularity in the West, especially among wealthy people who can pay not only for organ removal surgeries, but also for expensive cosmetic implants. However, removal of the ovaries is a radical step that excludes motherhood and causes artificial menopause. However, genetic testing is now available to everyone at a very reasonable price. Only in Moscow there are several companies where you can find out not only about your variants of the BRCA1 and BRCA2 genes, but also many other oncogenes and suppressors. Breast cancer is easily diagnosed in its early stages. If you receive an unfavorable genetic prognosis, you will only need to undergo a mandatory examination once a year.

Fight to the bitter end

OK well. I'm 25 or 35. I passed genetic testing and revealed hereditary factors risk. I pass every year full examination. But still, if I get sick, what awaits me? This is not an idle question.

Back in the early 2000s, three classical approaches to therapy prevailed malignant neoplasms: surgery, radiation therapy and chemotherapy. The first implies complete surgical removal tumors and parts of tissues with which it comes into contact. The method only works if the tumor is small, well localized and has not yet metastasized. For example, women have their affected breasts cut off almost completely.

Next (or sometimes instead) radiation therapy is used - exposure to the tumor or adjacent tissues ionizing radiation, destroying cancer cells or preventing their growth. However, this method also negatively affects healthy cells of the body. Chemotherapy, which uses drugs that inhibit uncontrolled cell division, has the same effect. They have a generalized effect (affecting the entire body as a whole) and have a mass side effects(decreased immunity, hair loss, etc.). But most importantly, none of them guarantee a complete cure. Single mutant cells can survive, and against the background of reduced immunity, again give a powerful relapse.

However, in the last 15 years, the development of new types of anti-cancer therapy has been proceeding at an incredible pace. American Society of Clinical Oncology President Daniel Hayes recently stated:

When I came to this area 35 years ago, I could not have imagined where we would find ourselves today. We can now effectively detect cancer at an early stage, carry out effective targeted (“molecular targeted”) therapy and minimize undesirable consequences so that our patients can live longer, better and more fully. Today, two out of three patients diagnosed with cancer are still alive five years after diagnosis.

The number of cancer patients is growing and getting younger. Thus, the number of cancer cases in China is more than 3 million per year and this figure is growing by 3% annually, and in Russia for last years The number of women diagnosed with breast cancer has increased by a third. More and more young people are becoming ill or at risk.

What you need to know about oncology!

Basic pathological processes in the body lead to a shift in pH towards acidification and, conversely, acidic environment aggravates and promotes the development of tumor diseases. Acidification also occurs due to insufficient water flow, which supplies the body with oxygen and cleanses it. Long-term water deficiency is another aggravating factor that contributes to the transformation of ordinary cells into cancer cells, which quickly develop, their colonies grow and threaten our lives. Young people prefer drinks that are not water and additionally “acidify” the body.

Smart people - made a conclusion!?

To prevent cancer, you need to drink water and get more oxygen. But it turns out that not everything is so simple. The water is all different. Only active water enters the intercellular space through the walls of the capillaries, which differs in many respects from what we usually drink.

And the oxygen we need is not the one we breathe, it is neutral. Required active forms oxygen - ROS.

There are only up to 500 of them in the air and in the blood, which is 94% water, they help produce ROS from neutral oxygen (NO). There are 1016 degrees of NA molecules in 1 ml of air, 8-10% of ROS are produced from it in the blood, and in stressful situations, for example, during illness, they are already needed by 20-30%.

And here, as studies conducted at Moscow State University have shown, active waters (“BioVita” and “Svetla”) quickly thin the blood and help increase the amount of ROS produced by 3.5 times, and the healing process is accelerated by 35-40% - this is already a study at the Scientific Center for Resortology. But studies conducted in 2001 at the Oncology Research Center named after. Blokhin, showed that the deficiency of ROS and its derivatives during chemotherapy and radiation sessions is life-threatening.

What is the takeaway for cancer patients?

During oncology, when undergoing chemotherapy and radiation sessions, it is vital to drink active waters to increase the production of ROS.

What about medications?

In recent years, 46 cancer drugs have been developed in Europe, but they prolong the lives of patients only from a few hours to several months.

Is it possible to prevent cancer?

Yes! And even calmly leave the risk zone of its occurrence if you have significantly exceeded the K - malignancy coefficient for RO (cancerous tumor), it should be. Have studies been carried out in the presence of oncology?

Yes, and they showed impressive results. The first was research into restoration healthy work the body after surgery, chemotherapy and radiation sessions for oncology of the mammary, prostate and thyroid glands.

In the experimental group (OG), which took water, the immune system became envious healthy people and was restored 100% (this has never happened before!) In the control group (CG), the indicators did not reach the minimum level. Patients drank water 15-20 minutes before meals medicinal water"Stelmas Mg", and 2 and 3 hours after - active water "BioVita". Released guidelines for doctors.

Then studies were carried out after surgery on the mammary gland (on which organ the operation was performed does not matter). During chemotherapy, women drank 0.5 liters of Svetla active water 3 times a day 0.5 hours before meals and 1.5 liters of BioVita - drunk 2 and 3 hours after meals. In the CG who did not drink water, her hair fell out, her body was covered with ulcers, and there were other indicators that indicate illness in the whole body. But the OG went through chemotherapy as if it had never been done. After all chemotherapy sessions, K was significantly below the limit value, which means that the risk of new cancer was excluded.

Today, studies are carried out during chemotherapy sessions before surgery. Stelmas Mg water was added to the diet - drink 15 minutes before meals and a glass before bedtime. We hope that someone will be able to overcome the disease without surgery.

What is the reaction of official medicine?

Probably everyone understands that domestic medicine is aimed at eliminating the consequences, at the same time, prevention is very important, but it does not bring money and, accordingly, no emphasis is placed on it. So according to Dr.Med.Sc. Prof. A.A. Maschan - Deputy general director Children's Oncology Center named after D. Rogachev, more than 200 thousand rubles are allocated for the treatment of each patient, and more than 2 million are required. This is what medicine strives for, and our efforts with preventive measures those who help well are not enough. Therefore our proposal is free provision the patients needed water and the speech of the professors who conducted the research was rejected. And this happens not only in oncology - gastritis, diabetes, Parkinson's disease..., special selection of water helps, but is not accepted by medicine, and today this information is still prohibited by law. Why?

What to do?

According to the WHO (World Health Organization), 20% of our health depends on the environment - we cannot influence it, but we can help the body maintain endoecology (the ecology of the body), which is much more important for health. 20% - from heredity. Released interesting book Oliver James, and it turns out “It’s not about the genes.” 12% - from the help of doctors and 48% - from our lifestyle, and if you analyze it, then at least 70%. And the WHO claims that 1% of patients die from side effects medicines. Of course, the WHO is disingenuous - much more.

Today, scientists have studied the mechanisms leading to cancer by about 80%. However, even this knowledge does not yet provide grounds for asserting that the ideal medicine will be invented in the near future and the disease will finally be defeated. But the best minds on our planet are busy with this issue. For example, in the United States they are developing new methods for diagnosing and treating cancer tumors and publishing articles in the scientific press. Each of them is a small discovery about the mechanisms of disease development. It developed targeted therapy, an innovation that has made a breakthrough in cancer treatment. It is based on the effect of special antibodies on certain target molecules (targets) in tumor cell, which cause malignant growth or degeneration of a normal cell into a tumor cell. Before the advent of targeted therapy, chemotherapy drugs, which were discovered back in 1944, ruled the roost. Chemicals They kill everything in the body, but antibodies only block what needs to be killed.

Story targeted therapy began in the 1990s with the advent of a drug to treat the most aggressive form of breast cancer. With this type of disease, the disease quickly progresses and metastasizes - and even 15-20 years ago, patients died from it within six months. But with the advent of the drug, which scientists called a revolution in oncology, the situation changed dramatically. The survival rate of women with the most aggressive forms of breast cancer has become even higher than with less aggressive forms. Today, targeted drugs are used all over the world, many of them are included in the list of vital and necessary drugs in Russia. More recently, drugs have appeared (two at once) even for metastatic forms of cancer with the HER2+ mutation. This opens up new ways for doctors to treat patients with the most aggressive forms of the most common cancer among all types of cancer - breast cancer.

In fact, for each tumor, if you find its genetic target, you can select your own antibody. In addition, the same targets can occur when different types tumors - for example, breast cancer and stomach cancer. Scientists say that making a diagnosis based on the “geographical localization” of a tumor in the body (liver cancer, kidney cancer, etc.) is becoming a thing of the past. It won't be long before cancer will be diagnosed based on the molecular profile of the tumor, depending on what genetic mutation is causing it. These targets must be identified in order to select correct treatment- individual for everyone. In America they are already using the so-called. phenotypic screening of tumors (this technique does not yet exist in Russia). During the analysis, it turns out that it is more likely to kill the cell.

Immunotherapy. Scientists continue to search for new methods of treating cancer. Today, 80% of malignant tumors have been studied. It would seem that another 20% and we will defeat cancer. But it's not that simple. A lot of knowledge has been accumulated, but so far we cannot apply even half of it. But just a couple of years ago, another breakthrough technology for fighting cancer appeared, which scientists are actively working on today - the so-called immunotherapy. She is named chief scientific discovery 2013. The method is based on the ability to “wake up” the immune system, which is exhausted in the fight against cancer cells and eventually “falls asleep” - it ceases to recognize them and mistakes them for normal, allowing them to multiply uncontrollably. Theoretically, as soon as the immune system “wakes up”, it will be able to cope with hostile cells on its own. In many cases, research has already shown the veracity of this theory. It is already known how cancer cells manage to “hide” from the immune system - with the help of certain receptors. Now researchers are busy creating inhibitors of these receptors—that is, substances that can suppress them. Other methods are also in development. Here they study cell apoptosis, that is, the process of cell death. “Cancer cells have forgotten the mechanisms of death; they want to live forever. And the task of scientists is to find a way to remind them how to die,” the researchers explain. For example, scientists are trying to learn how to suppress proteins that help a cancer cell survive, and “multiply” those that lead it to the path of death.

Another breakthrough technology of the future is called "". Its essence is to train T-cells to recognize those cells of the body that choose a bad, carcinogenic development program, and destroy them on the way to this program. Research in this area is also underway. ...However, the cancer cell constantly proves how cunning and resourceful it is. Sometimes she manages to bypass all the traps set. Have time to adapt to the mechanisms designed to destroy her, and make them act in her favor. Or find other proteins that provide it with eternal life. In addition, many proteins cannot yet be made targets for innovative drugs - they are hidden too deep inside cells. Therefore, scientists are thinking about ways to deliver antibodies there; trying to learn how to guide bad proteins from the depths of the cells directly to the “garbage bin” (every cell has one). In addition, the development of armed antibodies operating inside the cell is underway (when added to a cancer target, special toxic substances), bispecific antibodies (simultaneously with the destruction of the cancer cell, they activate immune system), bispecific armed antibodies (both at once). It is very difficult to say which technology will be called the next breakthrough. But today it is known that various methods cancer therapies must be combined.

Today, oncology therapy has achieved fantastic success. “If back in the 60s of the last century only 5% of children with lymphoblastic leukemia survived, today 95% survive if the full range of therapy is used.

However, all innovative biological drugs are extremely complex. If aspirin, for example, has 21 atoms, and insulin has 3 thousand, then a monoclonal antibody has 25 thousand atoms. The synthesis of one such protein takes 6 weeks of continuous cell growth.

Of course, in the field of cancer treatment there are still a lot of questions that scientists will have to solve in the near future. However, the hope is that in this century terrible disease will still be able to win, getting stronger every day.

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