And about how brain cancer is treated, the famous neurosurgeon, Candidate of Medical Sciences Igor Borshchenko.

1. Zhanna was diagnosed with inoperable glioblastoma. Why inoperable?

Glioblastoma is a malignant brain tumor. The reasons for its development are not completely clear. This tumor affects the nerve cells of the brain and develops very quickly. But there are no radical treatments yet.

Glioblastoma often develops in areas of the brain that do not show signs of disease. And the disease can remain without symptoms for a long time. And when the disease makes itself felt, the tumor can already be large and inoperable.

2. She fell ill immediately after the birth of her son. It is believed that pregnancy hormones can trigger the disease. Is there a connection?

Fortunately, there is no connection between pregnancy and the growth of glioblastoma. A more likely cause is a connection with viral particles. That is, cytomegalovirus and some others may be involved in the occurrence of the disease. But clear evidence and unambiguous reasons have not been found. All connections are just being explored.

3. Zhanna sunbathed a lot, including in the solarium. Is it possible to talk about the harmful effects of ultraviolet radiation?

Don't make a fuss about tanning. Long exposure to the sun has a negative effect on the skin and can cause melanoma (skin cancer), but no connection has been found with brain tumors.

4. The singer was treated abroad. Can we count on the same technologies and treatment capabilities that exist in America or in Germany?

We have everything - and opportunity surgical intervention, and radiation therapy, and the latest chemotherapy. Where to receive treatment is simply a choice for each individual family. Jeanne's family made their choice.

5. There were mentions in the press that Zhanna was treated with experimental methods. What could we be talking about?

There are three ways to treat glioblastoma: surgery (if the tumor is small and located in an area of ​​the brain accessible for surgery), radiation and chemotherapy. Research and treatment are ongoing in this direction. These three methods are modified so that medications were delivered only to the tumor area and did not damage surrounding healthy tissue. This new direction is called targeted therapy, from the word “target” - target. Perhaps it was this method of treatment that was used in America.

Unfortunately, the recovery rate for stage 4 glioblastoma is approaching zero. When glioblastoma is at this stage, both surgical and non-surgical treatment can only alleviate the patient’s condition, only temporarily improve it. Like most central tumors nervous system, glioblastoma does not metastasize, but causes destruction of tissue around it.

6. Everyone is now concerned about one question: how not to overlook the disease? What tests should be carried out preventively?

It is important to contact a specialist as soon as possible. Everyone has headaches. If you have had them for 10 years, they are familiar, that’s one thing. But if headaches and dizziness suddenly begin, they are strong, unusual, nausea and vomiting in the morning, you need to urgently contact a specialist. People, as a rule, come to the doctor when they begin to faint, when sensitivity in the face is impaired. And we attribute “simpler” symptoms to fatigue, weather, depression. But you need to contact us as soon as you notice something unusual. First of all, you need a consultation with a neurologist, then an MRI scan.

DISEASE HISTORY

• April 2013 Zhanna Friske began to complain of poor health and headaches immediately after the birth of her son Plato. Many publications wrote that Zhanna learned about the terrible diagnosis during pregnancy, but allegedly refused treatment in order to bear and give birth to a child. In fact, the singer was diagnosed with cancer a few months after giving birth.
• Autumn 2013 Friske stopped appearing in public, posting photos and communicating with her fans on social networks.
• January 20, 2014 Family and friends officially announced that Zhanna was ill. The diagnosis was confirmed - glioblastoma, a malignant brain tumor, inoperable.
• Winter 2014 Zhanna Friske begins treatment in a German clinic. There, the singer was prescribed a course of chemotherapy for 12 months. But she had a hard time with the treatment, and the family decided to transfer her to the American clinic Memorial Sloan-Kettering Cancer Center in New York.
• Spring - summer 2014 Due to intensive therapy, Zhanna gained a lot of weight, but felt better. In the summer she was transported to Jurmala (Latvia), to the seaside, to undergo rehabilitation. It was reported that the singer flew to China for treatment, and in the fall she returned to Moscow and even abandoned the wheelchair, walked on her own, communicated with her son and husband, and gave interviews by phone.
• February 2015 Friske flew to America for treatment. Then she continued therapy in Moscow, but, despite the efforts of doctors, the singer’s well-being rapidly deteriorated, and for the last three months of her life, Zhanna was in a coma, although her relatives hid this fact from the public.
• June 15, 2015 Zhanna Friske died in her country house in the village of Krasnovidovo.

The popular artist died on Monday evening at the age of 41.

She left quietly, surrounded by her family. She died at home in Krasnovidovo, near Moscow, where in recent months she lived with her family, her beloved husband and two-year-old son Platon. The baby was taken to Bulgaria two days before his mother’s death - Zhanna’s relatives and her husband Dmitry Shepelev decided that the child did not need to see his mother pass away.

She was in a coma for three months, we just didn’t talk,” the singer’s father, Vladimir Friske, admitted to KP.

Now Dmitry Shepelev is flying to Moscow from Bulgaria, where he left his son for now. But the boy will live with his father.

The child must stay with his father,” Vladimir Borisovich told KP. - If he allows us to raise him, we will help him, naturally.

Dmitry Shepelev, although shocked by the loss, still could not remain silent and left words of grief on his Facebook:

“We always repeated: “Happiness loves silence.” I remain true to these words, because Zhanna remains for me absolute, pure, unique happiness. We did not give up and fought to win. They say that two years in such a situation is a long time. But , of course, for us this is very little. I know for sure that we could not cope without you. I want to thank everyone: who donated money for Zhanna’s treatment, prayed for her health, simply thought about her, wished her happiness and strength. I want , so that you know: these two years are largely your merit. Thank you! I wish you and your loved ones health. And in the near future I would like to focus on helping those who, like us, do not give up and fight for health and life" .

Zhanna's funeral is being handled by her family and her closest friend, singer Olga Orlova, who has been with her since that fateful day when Friske was diagnosed with an inoperable brain tumor. “Farewell, my girl... Sleep well... You will forever remain in my heart...” she wrote on her microblog. And in a conversation with a KP correspondent she added:

Now I’m organizing a funeral, and I’m in so much pain that I can’t say anything...

FATE

The struggle for life began in infancy

Everyone believed in her healing so much that they were waiting for her return to the stage.

Today it sounds tragic, but at the end of 2014 Zhanna told KP that she dreams of this:

It’s too early to talk about the stage, but me, my friends, and my family - of course, we all dream about it. I'm slowly getting out. Step by step. I'm trying really hard to get better. Right now I’m at home, taking care of my son, we walk, read, play - I spend as much time as possible with Plato. He is so wonderful, and he is my great happiness...

Zhanna lived to see Plato’s birthday, who turned 2 years old on April 7. She never celebrated her 41st birthday...

TWIN BROTHER DIED AT BIRTH

The future singer was born in Moscow on July 8, 1974. The baby was weak - she weighed only 1380 grams and was only 38 centimeters tall. Her struggle for life began from birth. Already as an adult, Zhanna learned that she had a twin brother who died of asphyxia at birth in the seventh month, despite the fact that he weighed twice as much as his sister.

Zhanna’s mother, Olga Vladimirovna Kopylova, a Ural Cossack woman and housewife, gave birth to her daughter’s sister Natalya 12 years later.

FROM MSU TO "BRILLIANT"

Zhanna owes her desire to perform on stage to her father, Vladimir Borisovich Kopylov (he took his wife’s last name, but later returned his own, Friske). He served as an artist at the Central House of Artists for 20 years. After the collapse of the USSR, he went into business and has a hotel in the UAE. It was her father who said that he saw her as an artist. Zhanna even entered the Moscow Institute of Culture, but dropped out, deciding to study as a journalist at Moscow State University. However higher education I never received it.

At the age of 22, she auditioned for the group “Brilliant”. In the late 90s, the group was considered the best in the CIS, but at the peak of its popularity, Zhanna left it, already having the title of sex symbol. She made the decision to pursue a solo career after participating in the show “The Last Hero 4” in 2003.

PEAK OF FAME

Friske became an independent singer. And in 2004 she tried herself in cinema. Her role as the witch Alice in "The Night's Watch" was not the main one, but very bright. In "Day Watch" Zhanna has already decorated posters. She also played herself in the film “What Men Talk About” and a role in the detective story “Who Am I?”

About her personal life There were legends, but she only officially told about her last love - Dmitry Shepelev. In 2013, their son Plato was born in Miami.

Former colleague in the group "Brilliant" Yulia KOVALCHUK:

“I know for sure that very soon you will return to us as a little bird, an affectionate puppy or a blue-eyed baby... Your soul will always be with us... I know how much you liked to smile and how much you didn’t want everyone to be sad.. "I appreciated and loved you immensely... We all loved you... Fly away, our dear Zhannochka."

Member of the group "Brilliant" Anna SEMENOVICH:

“I was lucky enough to know you and work together, I was lucky enough to listen to your wise advice as an older friend and laugh in unison. There are very few such wise, kind and deep people in the world, and when they leave this world, it becomes very sad! Everlasting memory and an easy road home to the Kingdom of God."

Writer Daria DONTSOVA:

“I remember the year 2000. Zhanna and I were assigned to host a concert. She sings in the group “Brilliant”, I have 12 books published. I’m on some kind of chemotherapy, I have a wig on my head, she is healthy, full of strength and talks to me all the time : “I know for sure, you will get better!” We had plans, we wanted to make an audiobook of fairy tales, I read the text, and Zhanna sings children's songs, we thought that the work would give her strength to fight the disease. She really liked this idea.. "What can I say? God takes to himself those whom he loves very much."

Singer Lolita MILYAVSKAYA:

“The last time we wished each other a Happy New Year, you, Zhanna, said in a cheerful voice: “I want another child!” You laughed into the phone, and I was sure that everything would be fine... Lord! Let it be there Zhanna will be fine."

On April 7, 2013, Zhanna Friske gave birth to a son, Plato. On June 7 of the same year, Zhanna's father learned that the singer had a brain tumor. It all started when Zhanna began to complain of headaches. And when I was in Miami, I went swimming and didn’t return for a long time. Then it turned out that she had confused heaven and earth. Zhanna often went to bed and darkened the rooms with curtains. And there was a case when she tried to put Plato to sleep, holding him upside down.

ON THIS TOPIC

Zhanna fainted. The worst thing is that at these moments, according to Vladimir, she was “severely crippled,” and the doctors feared that she would break her spine. Therefore, Zhanna began to be tied up.

In New York they found a very expensive medicine that helped Zhanna. So much so that her tumor began to disintegrate. As Friske explained, it was impossible to get rid of the tumor surgically - it was too far away and there was a risk that after the operation Zhanna would “become a vegetable,” as Vladimir put it. The same drug had a miraculous effect on the singer.

Vladimir advised Dmitry Shepelev to consolidate his success and invite the director of the Institute of Virology to help, but the TV presenter refused. And two months later Zhanna began to relapse. Friske said that when her daughter could no longer speak, she was asked who to leave Plato with. And Zhanna chose her friend Olga Orlova.

According to Friske, at the end of her life Zhanna realized what kind of person Dmitry Shepelev was. When he came (and, as Vladimir said, in two years the presenter was with her for 56-60 days), Zhanna turned away, her pulse even quickened.

Friske’s friend Alena Premudroff also appeared in the studio of the show “Secret for a Million”. She stated that Zhanna suffered from headaches long before pregnancy. And she even fainted. She advised her to visit a doctor, but she did not listen to her.

After giving birth, when the disease progressed, Zhanna, according to her friend, became simply unbearable. According to Alena, it was impossible to communicate with the singer; they often quarreled, and over trifles. Vladimir Friske admitted that his wife’s parents and older sister died of cancer.

An innovative Russian oncologist explained whether it is possible to spot cancer in time, who can do it and how, whether it makes sense to collect millions of rubles for treatment, and is there a chance to survive?

Oncologists have revealed a cruel dependence: doctors save weak children, but nature kills them.Photo - pixabay.com

“Cancer of the poor” and “cancer of the rich”, “disease of offended people” and generational curse. All these are not myths or fairy tales, but a cruel reality that every third Russian will face. After this interview, your life will not be the same: someone will think about their lifestyle, someone will begin to frantically undergo oncology tests, and someone - it is possible - will give up and begin to enjoy every day they live. An oncologist, candidate of medical sciences, spoke in an interview with URA.Ru about why Zhanna Friske’s death was a foregone conclusion, why Russia will never get rid of “Apanasenko syndrome” and why everyone needs to do three things right tomorrow.Pavel Popov.

— Pavel Borisovich, the first question is the simplest and most difficult at the same time: why does cancer occur?

“I am of the opinion that cancer is a mechanism of self-destruction. Nature has created many such mechanisms, including atherosclerosis, diabetes mellitus and many other diseases. The evolutionary feasibility of such a mechanism lies in the fact that it allows for a change of generations and a reduction in intraspecific competition. Nature is interested in subjects of active reproductive age, and as soon as this age ends (for a person this is 30-40 years), a timer is turned on, which begins to implement the genetic mechanism of self-destruction. Therefore, the percentage of malignant tumors begins to increase exponentially after 40 years. In the language of science, this is called “phenoptosis” - the hypothesis of programmed death.

— Has science come to a consensus about the causes of cancer? Or is this just one of the hypotheses?

— In science, by definition, there cannot be a consensus, otherwise it is not science, but religion. But the facts that are now known allow us to substantiate the opinion that I expressed - this is phenoptosis. You can disagree with him, you can criticize him, but there is no criticism that could completely refute him. This is at least indicated by the fact that

oncogenes - DNA fragments that encode products necessary for the formation of a malignant tumor - are also involved in other biological processes. Without them human body would not have developed from the very beginning.

This means that the entire mechanism of carcinogenesis was created specifically by evolution. At least the previously existing opinion that a malignant tumor is the result of a random genetic failure does not stand up to criticism. In order for a cell to become malignant, six mutations must occur in it successively, which is impossible from the point of view of probability theory.

— If we agree that nature regulates the number of individuals past reproductive age, then why is cancer so common among young people, in children? There are plenty of examples...

— Here you need to understand that only certain types of cancer have become “younger.” For example, cervical cancer has become younger because it is directly linked to the human papillomavirus (HPV). Since people become sexually active much earlier than, say, 30-50 years ago, and maintain many chaotic relationships, many women become infected at the age of 15-17. Within ten years, the virus is guaranteed to trigger the genetic code of cancer, and if we add this period to the average age of onset of sexual activity, then we have the incidence of cervical cancer among women under thirty years of age. For stomach cancer, breast cancer, average age its manifestation (manifestation) remains approximately the same as twenty years ago.

And one more point: the development of medicine has led to the fact that We have practically eradicated infant mortality. As a result, natural selection no longer operates during the birth and nursing stages. Even over the last ten to twenty years, medicine has made a great leap forward, and now even the most non-viable babies are nursed, which has significantly changed the structure of the population.

A paradox emerges: the higher the level of development of medicine, the lower the health of the nation. Eliminating factors natural selection, we create bionegative selection, since these children live to adulthood and leave offspring.

It sounds harsh, but high infant mortality rates in the early 20th century meant that adults were generally healthier.

In addition, the structure of population mortality has changed. In the first half of the 20th century, the main causes of death were infections, hunger and war injuries; accordingly, the proportion of cancer diseases was several times lower. Nowadays, lethal factors such as infections, starvation and war injuries are minimized in developed countries, and their place was taken by cardiovascular diseases and cancer. In countries with low level people still die mainly from infections, hunger and wars.

— The conclusion arises that common forms of cancer are provoked by the development of medicine. Let's record this. The question is different. People are very afraid of cancer, so they come up with all sorts of myths that somehow explain its appearance. For example, “cancer is a disease of offended people.” Can thoughts, actions, moods provoke thought cancer?

“Unfortunately or fortunately, we do not have such control over our body that we can, with the power of thought or anything else, prevent cancer or cause it. Only the genetic constitution and a number of different factors are at work here. In fact, oncology is an illustration of the folk wisdom about “it was written in the family.” Cancer can be predicted: for example, if previous generations suffered from cancer, then, most likely, phenoptosis will work in a similar way in their descendants. But there is no guarantee that atherosclerosis will not work earlier. But a person has no power to choose his own ending. Unless he is an alcoholic or a drug addict, that is, he wants to destroy himself long before his cancerous phenoptosis works.

As for the “offended people,” let’s see who is usually offended among us. These are people after forty years of age with midlife crisis syndrome - they are the ones who fall into the age category when phenoptosis begins to work. And if our pessimistic friend over forty dies of cancer, then a person far from medicine and science can connect these two factors.

- Does it have any effect? psychological attitude on the outcome of treatment? It’s also a popular myth: believe in the best and you will be cured. And if he was not cured and died, it means he gave up.

“My experience with chemotherapy has shown that if a person is at the stage when the generalization of the process has begun, then neither nutrition, nor lifestyle, nor psychological attitude can change the inevitable ending. Alas. Moreover, the treatment that is sometimes used in the hope of a miracle tends to bring the end closer rather than delay it. When Zhanna Friske went to America, I already knew the ending of this trip and even predicted when it would all end. There is no magic: there are statistical data on how long a patient lives after being diagnosed with glioblastoma. A year or two depending on how he was treated.

— By the way, speaking of Zhanna Friske. After her death, there was another surge in myth-making: even in the federal press they began to use the terminology “cancer of the rich” and “cancer of the poor” - they say, expensive anti-aging procedures are to blame.

— “Cancer of the rich” and “cancer of the poor” certainly exist. Only it is expressed exclusively in how the patient will feel during the illness. A rich person can afford expensive treatment, decent care, and some last joys in life. But the poor one doesn’t. But the ending will be the same for both, believe me. If this cancer is treated at all, such as basal cell carcinoma (one of the types of skin cancer - ed.), then the poor will be treated “cheaply and cheerfully” - with short-focus X-rays, and the rich will pay for photodynamic therapy from their own funds. But if the problem has no solution within the boundaries scientific knowledge Today, as is the case with pancreatic cancer, even the rich will not be able to “pay off”.

Just remember Apple founder Steve Jobs; his entire fortune did not help him overcome the disease.

— What about nutrition and bad habits? Lists of “carcinogenic” products are published on the Internet every now and then—it’s scary to read.

— Nitrites, which are a mandatory additive in sausages, increase the likelihood of developing stomach and colon cancer by two to three times. So it’s not safe to eat smoked meats and sausage every day. Products intensely fried in fats cause approximately the same harm. If we talk about vegetarianism, then those who do not eat meat are much more likely to develop stomach cancer due to gastritis. Yes, vegetarians are more likely to have gastritis due to consumption plant food, which does not contain buffer proteins that neutralize the effects of acids on the mucous membrane. But there is a nuance: those who do not eat vegetables at all are more likely to get colon cancer.

At low content dietary fiber Problems with stool and chronic colitis arise, which is also a background for the formation of malignant tumors in the intestines. However, we must understand that this probability is not too high. I’ll tell you honestly: you shouldn’t worry so much about food, its harmfulness and usefulness. There are no foods that can insure you against cancer. And there are no diseases that are guaranteed to cause cancer if you maintain moderation in your diet and create a balanced diet. AND, Of course, statistically, lung cancer occurs more often in smokers. Make a choice.

— Excess weight also called one of the factors causing cancer. This is true?

- They call it, yes. However, there is no reliable relationship. Within their age group, thin people get sick just as often as obese people.

— Oncologists voice the same idea: cancer is curable, but in the early stages. But identifying it at these stages is quite difficult. What's the difficulty? Lack of diagnosis or careless attitude of people towards their health?

— Oncologists are absolutely right, cancer is indeed curable at an early stage, only they are slyly silent about what this stage is and what is meant by cure. If we talk about a complete cure, then cancer is 100% curable only at stage zero (non-invasive cancer), when the tumor is a thin film within the upper layer of the skin or mucous membrane. The thickness of such a film is less than a millimeter. And already at the first stage of cancer, when the tumor grows only a few millimeters deep, the process of dissemination begins - circulating tumor cells appear in the blood. Some of them parachute from the bloodstream into the tissue of the lymph nodes, liver, lungs, bones, and brain and create new colonies there - micrometastases, which are so small that they cannot be detected during normal examination, for example, with ultrasound or computed tomography. According to the data I received, melanoma is in the lead (due to its high mortality rate, skin melanoma is called the “queen” of malignant tumors); already at a thickness of 1.6 mm, micrometastases are present in every fifth patient.

So, when they say that at the first and second stages cancer is curable, it does not mean cure, but remission - a clear interval from 1 to 5 years (depending on your luck), after which in 80% of patients the disease recurs in the form of growing metastases, and the ending is known to everyone. And at the “zero” stage, the cancer does not bother the patient and he does not seek help.

The statistics I collected say that more than half of patients seek medical help in advanced stages. Although it is not difficult to make a visual diagnosis, outpatient doctors, who are the first to see patients, extremely rarely recognize this tumor even at stages 1-2, not to mention “zero”.

I have encountered cases where a local physician mistook a palm-sized melanoma for a birthmark. This is due to the low level of professionalism.

If this is the case with the early detection of cancer of external localization, then is it surprising that cancer of the esophagus, stomach cancer or other internal organs is detected obviously late: such a tumor at an early stage does not cause any inconvenience to the patient and can only be detected by chance, during an endoscopic examination . But which of us just goes for an endoscopy once a year? No one.

— What about tumor markers? Will they help detect cancer?

— Firstly, tumor markers are not early means of detecting a tumor. I think that this type of diagnosis works when we are talking about dissemination (spread - editor's note) of the tumor. According to the data I received, in 80% of cases, an elevated melanoma tumor marker indicates tumor dissemination. However, there is a benefit from this tool, since it allows you to evaluate the treatment process over time, to see whether the tumor is progressing or whether the treatment is moving towards remission. But, for example, in case of prostate cancer, the PSA tumor marker makes it possible to detect prostate cancer earlier than ultrasound.

— Only in Russia, with our diagnostic system, it is difficult to detect a tumor on early stages? Or in other countries too? Do you have statistics?

— In general, cancer statistics in Russia are the most dishonest due to a number of circumstances, and we, oncologists, know this very well. The percentage may be underestimated at the request of the regional or city administration to demonstrate the success of officials in the fight against cancer.

I know of a completely anecdotal case in which a high-ranking official ordered the registration of deaths of cancer patients in affiliated funeral homes in a neighboring region in order to demonstrate a decrease in mortality in his own, supposedly as a result of skillful management of health care. Everything was fine until a scandal broke out in the neighboring region: the mortality rate there doubled!

Foreign statistics in this sense are much more honest. In America, with all its diagnosis and treatment, 95% of patients die from esophageal cancer. The reason is the same as ours - late detection. This is an international problem. And this is connected not so much with the development of technology, but with the mentality of people.

The average Russian goes to the doctor when something hurts; few people take care of their health.

In Germany, due to voluntary medical examination, there is statistically more cancer detected at an early stage, and the highest percentage of remissions for stomach cancer is in Japan - they buy a gastroscope for a family there. Do you know people who would go to the doctor and regularly have gastroscopy, colonoscopy, bronchoscopy?

In Russia, prevention is as follows: they hand out brochures in clinics that describe the symptoms of cancer - weight loss, poor appetite, constant pain. A person with cancer has some pain and loses weight, which means that the disease has gone too far. And you no longer need to go to a doctor, but to a priest.

— There is an opinion that Israeli clinics are actively lobbying for, noting that treatment protocols in Russia are outdated, and diagnostics are a complete disaster. What do you say about this?

— I have never seen treatment protocols that are more outdated than in Israel anywhere. Here's an illustrative example: in 2004, a patient came to me for consultation regarding colonorectal cancer. We recommended removing the affected area of ​​the intestine and administering chemotherapy according to the most modern regimen at that time. The patient, believing that they would not give good advice in Russia, flew to Israel. There he was operated on and prescribed chemotherapy according to a scheme as old as time. When the patient showed my recommendation to the Israeli oncologists, they told him that they were treating according to their standard, and the recommended Russian regimen was only undergoing clinical testing in Israel.

The situation is similar with the treatment of melanoma in Israel. Even for melanoma with a Breslow tumor thickness of more than four millimeters, they offer wide excision. So that you understand, the peculiarity of melanoma is that when its thickness reaches four millimeters, the probability of micrometastases appearing in the body is more than 80%. And as soon as we excise the tumor, their rapid growth begins and the patient dies two to three years, or even within a year after the operation. This explosive metastasis can be prevented using photodynamic therapy developed in Russia, which is still not included in the standards of Israeli medicine.

In general, if we compare Russian and Israeli medicine, our diagnostics and treatment are in no way inferior to their foreign counterparts.

Another thing is that the budget of chemotherapy departments does not allow treating all patients with medications at a cost of 200-300 thousand per course. But if a person has money for treatment in Germany or Israel, he can purchase medicines at his own expense and inject them into a vein in Russian clinics, which in the end will cost less, since living in a foreign clinic costs a lot of money, and the prices for instrumental diagnostics , for example, computed tomography, are simply fabulous.

“But people who have been rejected by domestic medicine often go to Israel and Germany for treatment...

“I refused because nothing could be done.” How many people do you know who recovered from such a situation and lived happily ever after? Let's at least remember the celebrities who, having a lot of money and connections, went to foreign clinics for treatment. Alexander Abdulov, Mikhail Kozakov, Raisa Gorbacheva, Zhanna Friske - there is not a single one miraculously cured. Nor are they among those patients with advanced cancer who raise money for their treatment on the Internet.

Simply because it is useless, unfortunately - in the last stages, cancer cannot be cured. It is impossible not only to change the ending, but often even to delay it.

Here is an example from my practice: relatives of a patient with stomach cancer, whose metastases had welded the entire intestine into a tight cocoon, the so-called peritoneal carcinomatosis, came to me for consultation. My verdict: symptomatic therapy and adequate pain relief are all that can be done to help him. Looking for last hope The patient’s wife went to an Israeli clinic, where, after examining the discharge documents, they cheerfully told her: “Bring it, we’ll treat you.” The examination, tests, etc. cost fifteen thousand euros, one course of chemistry - the same amount. The patient became worse, and then the cheerful Israeli doctors advised his relatives to take him home to die while he was still able to move, since transporting the “200 load” would cost more.

Another example. A patient with melanoma of the lower third of the trachea, which German doctors refused, after using photodynamic therapy in Russia, went home after the operation. The problem, a dead end for German oncologists in the hospital, was solved in our clinic on an outpatient basis, at minimal cost!

“I recently read about a project that I found interesting: you take a test that, taking into account all factors - age, bad habits, heredity - determines the likelihood that you will get cancer. Then you install the application on your phone and you receive reminders based on the test results. Does it have an effect?

— The probability of dying from cancer is 30% - this is the general statistical probability. In people with elevated risk factors, this probability is higher, but even with the worst heredity it cannot be said that the probability will be, for example, 50%. It simply increases the likelihood that it is not atherosclerosis that will cause your end. This means that no online tests can even approximately determine what your personal likelihood of getting cancer is. And even more so, no application will diagnose you - only a highly qualified specialist. The latter is of key importance because the outpatient doctor may miss early cancer.

Of course, on topic early diagnosis There is a lot of speculation about cancer - all kinds of programs, applications, diagnoses based on photographs. But all this is, in a certain sense, profanation, because a well-trained oncologist will be able to make an accurate diagnosis in a minute with a verification rate of 98%. And the most sophisticated computer with digital camera makes a diagnosis using a photo with 50-70% verification and spends an order of magnitude more time on it.

— Well, well, if things are going well with diagnosis and treatment in Russia, then with palliative care it’s a complete disaster. There are still no federal programs to support hopeless patients, and there are very few hospices. Do you think something will change in this direction?

- Honestly? Nothing will change. Firstly, not a single budget includes an item on “assistance for the dying” - it is too expensive. Secondly, the topic of death is still absolutely taboo for our society. People simply don't want to know that 4 out of 5 cancer center patients will die within a few years.

Until recently, as you remember, the patient was not even told about his diagnosis. Even now, when asked by a patient how long he has left to live, some oncologists shyly turn away. In order for the issue of supporting hopeless cancer patients to be resolved at the federal level, so that comfortable conditions are created for them, the appropriate atmosphere that should be in a hospice - we need to start discussing issues of death directly and bluntly.

— What do you usually advise relatives whose loved ones will soon pass away?

— It often happens that you look at tomography, tests and understand what the patient has left less than a year. No treatment will help, no matter where it is carried out. I could tell the relatives of the patient: “Take him to rest in Antalya or the Maldives while the person is active and can enjoy the world around him, because then there is a known ending.” But I know that my words will not be heeded. They will drag you around to other doctors, magicians, wizards, and will take you to Israel. In due time, the person will die anyway and they won’t even be able to extend his life.

But aggressive treatment methods can add torment to a person exhausted by the disease. In the terminal stage, a person needs nothing except painkillers. But before going to bed, an incurable patient has six months to a year in reserve, when he is still somatically active and the symptoms of the disease do not overwhelm him. Therefore, I recommend that the patient put things in order and communicate with loved ones whom the patient rarely saw.

But people rarely listen to my advice and spend the rest of their lives in clinics for useless and painful treatment.

— By the way, about pain relief. The term “Apanasenko syndrome” has already appeared, when a person commits suicide due to the fact that he could not get pain relief. After a series of such terrible cases, officials announced that they would try to solve the problem, but literally in August there was a wild story in Chelyabinsk when pediatric oncology patients could not be provided with morphine. Is anything being done to solve this problem?

- Nothing. Neither after Apanasenko’s suicide, nor after other cases, the procedure for issuing painkillers did not change. This is due to a contrived system that is supposed to prevent these funds from ending up on the black market. But all over the world, doctors who have a diploma and practice have the right to prescribe such drugs. There are violations, but they are few in number: after all, doctors for the most part are responsible and decent people. If it were possible to return such a system (and it once was), such cases as with Apanasenko would not have happened. But I don’t believe that the Federal Drug Control Service will allow this, because it is easier to twist the arms of doctors than to block billions of drug traffic.

— So there are still stories about how relatives of cancer patients buy heroin from gypsies?

- Anything can happen. But basically the person groans in pain, and his family goes crazy.

- What a nightmare. Tell us better what to do to avoid such a fate.

- First of all, don’t panic. Cancerophobia is also an extreme, there is little benefit or joy from it. Remember that the highest incidence of cancer occurs after 60 years of age. This means that if you are young, you should not constantly exhaust yourself with examinations without special indications. If there are indications (bad heredity, underlying gastrointestinal or respiratory tract diseases), it is advisable to undergo gastroscopy or bronchoscopy once a year. And a colonoscopy if there is a family history of colitis and colon cancer. Everyone else can do it less often.

Women should visit a gynecologist once every six months and demand an extended colposcopy of the cervix - this is like the “Our Father”. If there are any neoplasms on the skin or mucous membranes, you should consult a doctor, and only a highly qualified one. For women over 35 years of age, it is advisable to visit a mammologist once a year and have a mammogram. Cancer prevention brochures often recommend self-diagnosis—that is, palpating the breasts yourself. However, a retrospective analysis shows that such diagnostics are of no use. For men over forty, I would recommend taking the PSA tumor marker.

Contrary to popular belief, the time interval between the stage of cancer that can be cured and the hopeless stage is not six months or a year. This is five, or even ten years. This means that there is enough time to identify most tumors at an early stage, when the outcome of treatment can be optimistic. And remember that science does not stand still. For example, photodynamic therapy, which was introduced into treatment standards four years ago, makes it possible to defeat cancer in the early stages without losing an organ. Be attentive to your health.

That singer Zhanna Friske died after a long battle with cancer - glioblastoma. Lenta.ru understands what kind of illness this is, what its symptoms are, how it is treated, and whether doctors had a chance to prevent the tragic outcome.

Glioblastoma is the most aggressive and most common of the malignant brain tumors (52 percent of all cases). If it is not treated in any way, the patient will live about three months from the moment the first symptoms appear. But even with treatment, the life expectancy is not much longer: for half of those sick it is one year, and only five percent manage to live longer than three years.

Causes

The causes of glioblastoma are largely unclear. It is known that the tumor affects neuroglial cells, a subtype of nervous tissue whose elements nourish and protect neurons. There are ten times more neuroglial cells than neurons. These cells do not reproduce in mature age, however, glial cell precursors are present in the brain. If there are disturbances in their development and reproduction, glioblastoma may occur.

It is impossible to predict who will develop the disease and when. This tumor affects men somewhat more often than women, especially if we talk about men over 50 years of age. The disease is not inherited. The risk does not increase if a person smokes, eats canned meat, or is exposed to electromagnetic radiation. However, some viruses increase the likelihood of the disease, such as cytomegalovirus, human herpes virus type 6 (HHV-6) and SV40 (a polyomavirus first discovered in monkeys). Ionizing radiation (radiation) also contributes.

There are certain mutations (in the p53, CDK4, Rb genes) associated with the disease, but glioblastoma is almost always accompanied by several mutations in a complex. The types of such mutations are also different: they can be deletions (loss of DNA fragments from chromosomes), amplifications (increased number of DNA copies compared to the norm) and even point mutations (replacements of one or two nucleotides out of thousands of similar ones in the DNA molecule).

It is reported that Zhanna Friske felt unwell some time after the birth of her child. There is no evidence that pregnancy and childbirth can cause the disease. However, they can accelerate the development of any glial brain tumor (not necessarily glioblastoma), especially the second or third degree.

Image: Christaras A. / Wikipedia

Symptoms

On the one hand, the adult brain does not have special capabilities to restore its functions. On the other hand, there are so many cells in it that the brain is able to survive very significant losses without deterioration in performance.

This plays a cruel joke on all patients with brain tumors, including patients with glioblastoma. As a rule, a tumor is detected on tomographic images when it is already irreparably large and contains hundreds of billions of cells. Only then does the patient begin to feel unwell: nausea, vomiting, convulsions, headache. Obviously, none of these signs are unique. The same symptoms apply to traumatic brain injuries (which, by the way, sometimes cause brain tumors).

“Early diagnosis of glioblastoma, unfortunately, is only possible by chance: for example, as a result of an MRI. Given the clinical indicators for diagnosis, the disease is far from at an early stage,” said Alexey Remez, CEO of the medical startup UNIM.

Treatment

Modern medicine cannot cure glioblastoma completely. All doctors can do is to increase the patient's life expectancy after diagnosis by 10-12 times. In absolute numbers, the increase is insignificant: without treatment, a patient dies after three months, and someone who has had the tumor surgically removed lives one to two years, sometimes three.

It is difficult to treat glioblastoma, since drugs that could act on the tumor do not pass well through the blood-brain barrier - the cellular layer between the vessels and neurons of the brain that does not allow bacteria, viruses, or cells to pass through. immune system, no medicine. In addition, the tumor cells themselves are extremely resistant to many chemotherapy drugs.

The main treatment method is surgical removal of the tumor. The patient's life is prolonged if at least 98 percent of its volume is removed. Considering the normal size of the tumor, there are still a billion malignant cells left after surgery. Radiation therapy and chemotherapy reduce this number by ten thousand times, but the tumor quickly grows and returns to its previous size.

Of course, doctors and patients pin their hopes on new treatment methods. For example, in February 2015, Israeli scientists in scientific journal ACS Nano reported an experiment to treat glioblastoma in laboratory mice using nanoparticles that deliver small interfering RNA to the tumor. Such molecules can block the production of proteins by malignant cells. One hundred days after the start of the experiment, 60 percent of the individuals from the experimental group remained alive, and in the control group (without therapy at all) no one lasted longer than 40 days.

Of course, the experiment was conducted on mice, not humans. In addition, the tumor did not disappear after such therapy, which means there is no need to talk about a complete recovery.

Was there a chance?

“Theoretically, Zhanna Friske’s tumor could have been detected earlier. In practice, the timing of diagnosis, as well as life expectancy, depend on many factors. The localization of glioblastoma plays an important role: depending on which area of ​​the brain the tumor is located, it will make itself felt sooner or later. Accordingly, life spans will differ. For example, glioblastoma in the trunk would have been found earlier, but the patient’s life expectancy would have been shorter... Unfortunately, the disease is incurable. Two years (that’s how long Zhanna Friske fought the disease) is above average. The patient’s life expectancy is influenced by age: as it increases, life expectancy after diagnosis progressively decreases,” said Alexey Kislyakov, a pathologist specializing in tumors of the central nervous system, head of the pathomorphology laboratory at the Morozov Hospital.

Published 01/22/14 08:23

Experts explained why Zhanna Friske might have gotten sick. Meanwhile, another famous singer Elena Vaenga angrily spoke out “against staging a show because of illness.”

An active discussion of the serious illness of the famous Russian singer Zhanna Friske continues on the Internet and in the media. Last week her . Fans of the artist believed that she had been diagnosed with a severe form of brain cancer in the fourth stage (glioblastoma). However, within a few days, Zhanna's common-law husband.

According to the celebrity's father, the disease intkbbach was discovered two months after the birth of Jeanne's first child, the son of Plato. The performer is currently undergoing treatment in New York, but what could have triggered the development of the tumor?

Zhanna Friske is seriously ill: photo from the airport

Did Zhanna Friske “earn” brain cancer on “Holidays in Mexico”?

Expert opinions began to appear in the press about why a young woman who carefully monitors her health developed cancer. Almost nothing is known reliably about the origin of cancer. However, the development of cancer is influenced by heredity, as well as a number of factors that can provoke this disease.

Doctors believe that in the case of Zhanna Friske, childbirth, of course, could have influenced the development of the disease, but this is not the main thing.

It is impossible to say what exactly could have triggered the development of brain cancer. There is discussion on the Internet that this could be due to Zhanna’s pregnancy, taking some hormonal drugs. I can say that there is no reliable data on the connection between glioblastoma and hormones; it is not a hormone-dependent tumor. According to statistics, both men and women are equally affected by this type of cancer. We can say something else - primary glioblastoma practically does not metastasize. This can give you hope. And is amenable to surgical and radiation treatment. There are cases where people recovered completely from such a tumor. The main thing is not to let the disease take its course, not to despair and to listen to doctors, not “well-wishers,” neurosurgeon Igor Borshchenko said in an interview with KP.

Meanwhile, the main reason cancer For the Russian singer, some doctors believe the large amount of time Zhanna spent in the sun in Miami and her passion for rejuvenating procedures. Thus, neurosurgeon Andrei Grin believes that Zhanna could have undermined her health during the filming of the show “Holidays in Mexico.”

“Most likely, the disease could have been provoked by the sun, solar radiation. I had patients who, after a trip to warmer climes, developed cancer or metastases after removed cancer,” the doctor said in an interview with NTV channel.

In addition, anti-aging procedures associated with the introduction of stem cells could lead to the disease. “We saw patients who had stem cells implanted into their spinal canal for money, and tumors appeared in several places at the same time,” Grin explained.

Did Zhanna Friske become seriously ill after filming the reality show "Vacations in Mexico"?

Friends of Friske: Zhanna monitored her health

In turn, according to the singer’s friends, she always looked after her health and meditated.

"She is an incredibly purposeful person. Her tenacity and iron will are amazing. When Zhanna (it seems, after participating in “The Last Hero”) decided to take care of her health, she excluded everything harmful from her diet. Not a piece of sausage, not smoked meats, not sweets. I remember how in front of me she scolded her younger sister for eating a sandwich with doctor's sausage. It’s strange to talk about this now... A man who flew to distant islands twice a year to spend a month in meditation and fasting (to cleanse the body and aura) is now seriously ill,” Alla Zanimonets wrote in her blog.

“Let Them Talk” raised 60 million for Zhanna Friske

On the evening of January 20, Channel One, together with Rusfond, announced a fundraiser for the singer’s treatment. The action was announced. The day before it became known that they managed to collect more than 60 million rubles. Also, Russian pop stars are preparing to give a concert in support of her.

“Let them talk” 01/20/2014 Zhanna Friske is seriously ill

Comments on the Internet about Zhanna Friske’s illness

No matter how cynical it sounds, to some extent because of the tragedy that happened to Zhanna, it was possible to draw attention to the problems of prevention and treatment of cancer; the topic was once again raised about how difficult it is in Russia to obtain adequate and timely medical care, if the sick person is not rich and is not a media person. But the most important thing is that thanks to the action to save Zhanna Friske, dozens of children with cancer will also be saved. The head of Rusfond, journalist Valery Panyushkin, writes about this in his article for Snob.

Panyushkin gives the arguments because of which Rusfond took up fundraising.

Channel One is our partners. If one of our partners, friends and even competitors gets sick, we always help... All excess money that is not needed for Zhanna’s treatment will be used for the treatment of Rusfond children. And when you collect money using TV, there is always three times the surplus,” wrote the head of Rusfond.

However, when he later looked at social networks, he was unpleasantly surprised by the comments that appeared there.

"And there, it turns out, they scolded us. Users social networks wrote, it turns out that Zhanna Friske has a million-dollar house, and therefore there is no need to help her. They also wrote that Rusfond should not help the rich and successful Zhanna Friske, but the poor and unknown. (As if we decided to help Zhanna Friske instead of helping the poor and unknown. As if the poor and unknown, due to the fact that we are collecting money for Zhanna Friske, will receive not more help, but less.) And I, of course, knew that envy is the main feeling driving users of social networks. But I could not even imagine that people would manage to envy Zhanna Friske. Envy! Zhanna! Friske! Now! This doesn’t fit in my head,” the journalist notes with bewilderment.

Zhanna Friske's serious illness caused a mixed reaction: Vaenga is angry

The hype around Zhanna Friske's terrible illness has angered a number of famous people. In particular, Elena Vaenga accused Andrei Malakhov of being too revealing.

"I wonder if Malakhov had stage 4 cancer. Inoperable. Of the brain. He, too, would have put together a quick program and went on air under the “motto”: “Andryusha, live”???????? The degree of my contempt for "This subject has reached its climax. After all, relatives and friends asked......... Not to touch, not to interfere, but only to pray for the person," the singer wrote on her website.

Later, Vaenga made another statement in which she clarified that she was not against raising funds for Friske’s treatment.

“I am against making a show out of a young woman’s illness. I know what cancer is. Two of my family suffered and overcame this disease. And two died. My aunt was 30, and my grandfather was 52. So to everyone who “stinks” into my side, cover your mouth,” she added.